SUPPLEMENT INDIVIDUAL ARTICLE: Skincare for Cancer Patients in Scandinavia

December 2021 | Volume 20 | Issue 12 | Supplement Individual Articles | ss4 | Copyright © December 2021

Published online November 30, 2021

Ada Girnita MD PhD,a Henrik F. Lorentzen MD,b Sampsa Kauppi MD,c Charles W. Lynde MD FRCPC,d Maxwell B. Sauder MD FRCPC DABD,e Henrik Schmidt MD,f Anneke Andriessen PhD,g Andreas Stensvold MD PhDh

aSkin Cancer Center Karolinska University Hospital Stockholm, Sweden
bDepartment of Dermatology and Venerology Aarhus University Hospital, Denmark
cPrivate practice, Terveystalo and Epilaser Oy, Finland
dDepartment of Medicine University of Toronto, Toronto, ON, Canada; Lynderm Research, Markham, ON, Canada
ePrincess Margaret Cancer Centre; Pigmented Lesion Clinic, Toronto Dermatology Centre, Toronto, ON, Canada
fDepartment of Oncology, Aarhus University Hospital, Denmark
gRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands
hOncology Department Oestfold Hospital, Norway

for the statements aimed at the Nordic European countries (other subjects, low quality, a small number, case studies), fifty papers remained. Thirty-two were review articles, including four systematic reviews, four guidelines/algorithms, one book, three definitions, and methodology articles, and eighteen clinical studies. The literature search results were evaluated independently by two reviewers who graded the clinical publications according to study type (A, B, or C) and assigned a level of evidence (level 1 to level 4) using the preestablished criteria.15 Of the eighteen clinical publications, most addressed cAEs impacting QoL, and only two studies (graded C-3 and B-2) evaluated a specific skincare regimen (Table 1).

Evidence and Opinion-Based Best Practice Recommendations
The reviewers drafted statements based on the selected literature before the meeting. During the virtual meeting, the NECOM group set and fine-tuned five consensus statements from the draft list of twelve statements and revised them online after the meeting. Through blinded reiterations and votes, the NECOM panel defined the final statements. The panel's consensus was established as an eighty percent agreement being obtained.


Statement 1: Dermatologic toxicities associated with cancer treatment are common and can significantly impact QoL and disrupt cancer treatment.
Depending on the anticancer treatment, various cAEs may occur.3,16,17 The NECOM group used the Common Terminology Criteria for Cutaneous Adverse Events (CTCAE) version 5.0.18 The CTCAE system has five grades (Grade 1: Mild, Grade 2: Moderate, minimal, local, or noninvasive intervention indicated, Grade 3: Severe, medically significant but not immediately life-threatening, Grade 4: Life-threatening consequences, urgent intervention indicated, Grade 5: Death related to the cAEs); however, not all five grades apply for cAEs.18 This paper focuses on best practice recommendations for oncology skincare programs. Therefore, only a short overview of cAEs is provided to inform clinicians on the conditions that may benefit from a skincare regimen.

Many studies are available on cAEs; however, information on prevention, treatment, and maintenance using general measures and OTC skincare is lacking.4-12