BACKGROUND Severe cutaneous adverse reactions (SCARs) are frequent in inpatient oncology. Early intervention might reduce morbidity, mortality, and hospitalization costs; however, current clinical and histologic features are unreliable SCAR predictors. There is a need to identify rational markers of SCARs that could lead to effective therapeutic interventions. OBJECTIVE To characterize the clinical and serologic features of hospitalized patients with cancer who developed SCARs. METHODS Retrospective review of 49 hospitalized cancer patients with a morbilliform rash, recorded testing for serum cytokines (interleukin [IL] 6, IL-10, and tumor necrosis factor [TNF] α) or elafin, and a prior dermatology consultation. Patients were categorized as having a simple morbilliform rash without systemic involvement or complex morbilliform rash with systemic involvement. RESULTS Fifteen out of 49 patients (30.6%) were deceased at 6 months from time of dermatologic consultation. Elafin, IL-6, and TNF-α were significantly higher in patients who died compared with patients who were still alive at 6 months. IL-6 and IL-10 were significantly higher in patients with a drug-related complex rash. LIMITATIONS Retrospective design, limited sample size, and high-risk patient population. CONCLUSION In cancer patients with SCARs, elafin, IL-6, and TNF-α levels might predict a poor outcome. Agents directed against these targets might represent rational treatments for the prevention of fatal SCARs.

中文翻译：

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患有严重皮肤不良反应的住院癌症患者的全身受累和死亡标记。

背景技术严重的皮肤不良反应（SCAR）在住院肿瘤科中很常见。早期干预可能会降低发病率，死亡率和住院费用；然而，当前的临床和组织学特征不能可靠地预测SCAR。有必要确定可能导致有效治疗干预的SCAR合理标志物。目的表征住院发展为SCAR的癌症患者的临床和血清学特征。方法回顾性分析49例住院的患有丝状皮疹的癌症患者，记录其血清细胞因子（白介素[IL] 6，IL-10和肿瘤坏死因子[TNF]α）或弹性蛋白的检测，并事先接受皮肤科咨询。患者被分类为无系统性累及的单纯型杯状皮疹或全身性累及的复杂型杯状皮疹。结果49例患者中有15例（30.6％）在皮肤科会诊后6个月时死亡。与6个月仍活着的患者相比，死亡患者的Elafin，IL-6和TNF-α显着更高。与药物相关的复杂皮疹患者中IL-6和IL-10显着升高。局限性回顾性设计，有限的样本量和高风险的患者人群。结论在患有SCAR的癌症患者中，elafin，IL-6和TNF-α水平可能预示不良结果。针对这些目标的药物可能代表了预防致命SCAR的合理治疗方法。皮肤科咨询后6个月死亡。与6个月仍活着的患者相比，死亡患者的Elafin，IL-6和TNF-α显着更高。与药物相关的复杂皮疹患者中IL-6和IL-10显着升高。局限性回顾性设计，有限的样本量和高风险的患者人群。结论在患有SCAR的癌症患者中，elafin，IL-6和TNF-α水平可能预示不良结果。针对这些目标的药物可能代表了预防致命SCAR的合理治疗方法。皮肤科咨询后6个月死亡。与6个月仍活着的患者相比，死亡患者的Elafin，IL-6和TNF-α显着更高。与药物相关的复杂皮疹患者中IL-6和IL-10显着升高。局限性回顾性设计，有限的样本量和高风险的患者人群。结论在患有SCAR的癌症患者中，elafin，IL-6和TNF-α水平可能预示不良结果。针对这些目标的药物可能代表了预防致命SCAR的合理治疗方法。局限性回顾性设计，有限的样本量和高风险的患者人群。结论在患有SCAR的癌症患者中，elafin，IL-6和TNF-α水平可能预示不良结果。针对这些目标的药物可能代表了预防致命SCAR的合理治疗方法。局限性回顾性设计，有限的样本量和高风险的患者人群。结论在患有SCAR的癌症患者中，elafin，IL-6和TNF-α水平可能预示不良结果。针对这些目标的药物可能代表了预防致命SCAR的合理治疗方法。