INTRODUCTION
The current risk of getting cancer before age 80 in Nordic countries is estimated at 42.7% in males and 36.2% in females. Based on the collaborative Nordic cancer registry (NORDCAN), breast, lung, and colon cancer are the most common cancers for women, while prostate, lung, and colon cancers are the most common in men.1 NORDCAN excludes nonmelanoma skin cancers (NMSC), which represent the third most common cancer according to the Swedish National Cancer Registry.2 Interestingly, while NMSC appears to be decreasing in much of Europe, there are increasing NMSC trends in specifically Northern Europe.3 As cancer therapies progress, patient lifespan and disease prevalence have increased within the Nordic European countries.
Cancer treatment varies by patient, cancer type, and stage. Therapies can include a combination of radiation, surgery, transplantation, chemotherapy, and immunotherapy. As treatments become increasingly available, there will be an increasing amount of possible treatment-related cutaneous adverse events (cAEs). While cAEs are widely regarded as common side effects of cancer therapies, there are limited evidence-based guidelines on how to manage the skin around cancer treatment.4 Despite this, early and preemptive management of cAEs can improve quality of life. Lacouture et al demonstrated that in patients receiving anti-epidermal growth factor receptor (EGFR) therapy, with known high rates of skin toxicities, pre-emptive skincare with moisturizer and a broad-spectrum sunscreen reduced the incidence and severity of cAEs in 50% of patients compared to reactive skincare.5 The most reported cAEs include papulopustular rash, xerosis, pruritus, nail changes, chemotherapy-induced alopecia, and hand-foot skin reactions; however, reactions vary greatly with treatment modalities.2 For example, radiation therapy is highly associated with radiation dermatitis or desquamation of skin, itch, erythema, bleeding, possible ulceration, and severe pain. In one study, heavy use of emollients, sunscreens, and a wound healing cream appeared to minimize the impact of radiation on the skin.6 Conventional chemotherapy is associated with alopecia, nail changes, and xerosis, while immunotherapy has been found to have a vast range of dermatological manifestations, including maculopapular rash, pruritus, eczema/spongiosis, lichenoid reactions, pyoderma gangrenosum, and vitiligo, among others.2 Patients report significant negative impacts of cAEs on their quality of life (QoL).7,8 Supportive oncodermatology is an emerging field
Cancer treatment varies by patient, cancer type, and stage. Therapies can include a combination of radiation, surgery, transplantation, chemotherapy, and immunotherapy. As treatments become increasingly available, there will be an increasing amount of possible treatment-related cutaneous adverse events (cAEs). While cAEs are widely regarded as common side effects of cancer therapies, there are limited evidence-based guidelines on how to manage the skin around cancer treatment.4 Despite this, early and preemptive management of cAEs can improve quality of life. Lacouture et al demonstrated that in patients receiving anti-epidermal growth factor receptor (EGFR) therapy, with known high rates of skin toxicities, pre-emptive skincare with moisturizer and a broad-spectrum sunscreen reduced the incidence and severity of cAEs in 50% of patients compared to reactive skincare.5 The most reported cAEs include papulopustular rash, xerosis, pruritus, nail changes, chemotherapy-induced alopecia, and hand-foot skin reactions; however, reactions vary greatly with treatment modalities.2 For example, radiation therapy is highly associated with radiation dermatitis or desquamation of skin, itch, erythema, bleeding, possible ulceration, and severe pain. In one study, heavy use of emollients, sunscreens, and a wound healing cream appeared to minimize the impact of radiation on the skin.6 Conventional chemotherapy is associated with alopecia, nail changes, and xerosis, while immunotherapy has been found to have a vast range of dermatological manifestations, including maculopapular rash, pruritus, eczema/spongiosis, lichenoid reactions, pyoderma gangrenosum, and vitiligo, among others.2 Patients report significant negative impacts of cAEs on their quality of life (QoL).7,8 Supportive oncodermatology is an emerging field
