- Radiation therapy, enhanced by concomitant chemotherapy or targeted therapy (especially 5-fluorouracil and EGFR inhibitors) but not necessarily by checkpoint inhibitors
|
- Cleanser with pH ~ 5
- Daily moisturizer but not to be applied within
2h before radiation therapy
- Sun protection when outside with UV broad spectrum UVB/UVA SPF 50 or greater sunscreens and strong UVA protection, especially with targeted therapy; clothing, sunglasses, and hats; patients with darker phototypes are at higher risk for PIH
- Avoidance of skin irritants
- Compression stockings for field cancerization on legs
- Aloe vera on Day 1 and throughout the course (apply post-treatment daily)
- Cocoa butter prophylax is daily during radiation therapy and one month beyond for darker skinned patients
- Sterile transparent film dressing from Day 1 through one week post radiation therapy (applied continuously)
- Mid-potency TCS (betamethasone/mometasone, betamethasone is superior) once daily from Day 1 and throughout course
|
- Gentle skin care
- Zinc oxide for low infectious risk dermatitis (non-immunosuppressed patients)
- Silvadene if risk of superinfection or refractory to OTC topicals
- Drying solution T1D as drying/healing agent
- Lidocaine 2% gel for pain
- Wound hydrogel pads for inflammatory reactions in regions that can support the pad without adhesive (such as inframammary fold)
- Medicated powder for initial moist desquamation, also provides antifungal activity
- Mid potency TCS
- Monitor for secondary infection (culture and use oral antibiotic as needed)
- Antibiotics in case of superinfection
- Oncologist may interrupt treatment in case of grade 3 ulceration
|
