US Cutaneous Oncodermatology Management (USCOM): A Practical Algorithm

September 2021 | Volume 20 | Issue 9 | Supplement Individual Articles | 3ss | Copyright © September 2021

Published online September 1, 2021

Mario E. Lacouture MD,a Jennifer Choi MD,b Alice Ho MD,c Jonathan Leventhal MD,d Beth N. McLellan MD,e Anneke Andriessen PhD,f Maxwell B. Sauder MD,g Edith Mitchell MDh

aOncodermatology, Memorial Sloan Kettering Cancer Center, New York, NY
bOncodermatology Program, Department of Dermatology, Northwestern University Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL
cRadiation Oncology, Massachusetts General Hospital, Memorial Sloan Kettering Cancer Center, New York, NY
dOncodermatology, Smilow Cancer Hospital at Yale, New Haven, CT
eMontefiore's Division of Dermatology and Montefiore Einstein Center for Cancer Care; Dermatology, Jacobi Medical Center, New York, NY fRadboud UMC, Nijmegen and Andriessen Consultants, Malden, The Netherlands
gOncodermatology, Princess Margaret Cancer Centre, Pigmented Lesion Clinic, Toronto Dermatology Disparities; Gastrointestinal Centre, Toronto, ON, Canada
hCenter to Eliminate Cancer Disparities, Gastrointestinal Oncology, Thomas Jefferson University Hospital and Jefferson Methodist Hospital, Philadelphia, PA

treatment do not get medical attention needed to prevent their occurrence or provide early and effective treatment.8,9 As a result, cutaneous toxicities may be disabling or disfiguring, cause pruritus or pain, alter tactile exchange, impede interpersonal relationships, severely affect the quality of life,6,7 and may lead to reduction or discontinuation of anticancer treatment, affecting clinical outcomes.8-12

A preemptive skincare regimen has been shown to improve patients' quality of life and skin conditions.7,8 In a study of 95 patients receiving panitumumab-containing therapy, 48 received pre-emptive skincare and 47 received reactive. The incidence of severe skin toxicities in the pre-emptive skincare group had reduced by 50% compared to the reactive skincare group.7 Moreover, dermatology consultation has led to a reduced interruption of oncology treatment.9

A multidisciplinary oncology treatment team should educate on prevention, treatment, and maintenance using OTC skincare as part of their cancer patients' comprehensive care before cancer treatment starts.12 An algorithm was designed to reduce the incidence of cAEs, treat cAEs, and maintain healthy skin using general measures and OTC agents to support all healthcare providers treating oncology patients, including physicians, nurses, pharmacists, and advanced providers. The clinical algorithm would be feasible to implement by non-dermatologists. It aims to support clinicians working with oncology patients throughout the entire continuum of care to achieve optimal outcomes, improving patients' quality of life.


The US Cutaneous Oncodermatology Management (USCOM) project initiated by La-Roche Posay aims to improve cancer patients' and survivors' quality of life by offering tools for preventing and managing cAEs. The USCOM panel of clinicians who treat cAEs developed, discussed, and reached a consensus on statements and an evidence-based algorithm. The algorithm focuses on prevention measures and skincare for cAEs using a skincare regimen, including hygiene, moisturization, sun protection, and camouflage products. The algorithm aims to improve patient outcomes and seeks to determine the best approach for oncology skin care programs for all stakeholders in the US health care setting. These include medical oncologists, radiation oncologists, family practice/internal medicine physicians, dermatologists, oncology nurses, advanced practice providers (APPs), nurse practitioners (NPs), physician assistants (PAs), and pharmacists.


For the statements and the USCOM algorithm's development, the panel used a modified Delphi approach following the AGREE II instrument.13,14 The modified Delphi method is a communication technique for interactive decision-making for medical projects.14 The method was adapted from face-toface meetings to a virtual meeting to discuss the outcome of