Lecture

1. SKIN COMPLICATIONS OFSKIN COMPLICATIONS OF
CANCERCANCER
Roel S. Tolentino, MD, MBARoel S. Tolentino, MD, MBA,, FPCS, FACS, FPSGS, FPSO, FMOSPFPCS, FACS, FPSGS, FPSO, FMOSP
General Surgery – Surgical Oncology
Surgery Professor IV
Past President, PHILIPPINE SOCIETY OF ONCOLOGY
Sept. 7, 2018/8-9 am
Manila Hotel
Manila

2.  most common skin disorders
associated with cancer
Topics to be discussed

3. Did you know that > ½ of patients
undergoing cancer treatment will
experience skin complications?
- Northwestern Medicine, USA

4. Did you know that rashes are very
common occurrence in patients
undergoing chemotherapy or
radiotherapy?
- Texas Oncology Group, USA

5. Did you know that skin conditions
can hinder cancer treatment?
- American Academy of Dermatology

6. Imagine there is a DRUG which
can help prevent and treat skin
conditions associated with cancer.

7. You don’t have to imagine because
later, I will tell you a very good
TREATMENT!

8. 8
Common Skin Problems of
Cancer Patients
 decubitus ulcersdecubitus ulcers

9. 9
Common Skin Problems of
Cancer Patients
 malignant ulcers (necrotic area caused directly bymalignant ulcers (necrotic area caused directly by
cancer)cancer)

10. 10
Common Skin Problems of
Cancer Patients
 malignant ulcers (necrotic area caused directly bymalignant ulcers (necrotic area caused directly by
cancer)cancer)

13. 13
Common Skin Problems of
Cancer Patients
 fungating tumorsfungating tumors
Dermatofibrosarcoma

14. 14
Common Skin Problems of
Cancer Patients
 itching orpruritus, and infectionsitching orpruritus, and infections

15. 15
General Deterioration of Skin
Condition
 Thinning
 Loss of elasticity
 Dehydration
 Deepening of sores and wrinkles

16. Causes of Skin ColorChanges
 Paleness – anemia, malnutrition/cachexia,
and decreased blood pressure (seen in
advanced cancer)

17. Causes of Skin ColorChanges
 Jaundice – obstruction of the biliary tree
(cancer of the bile duct, pancreas, liver, and
gallbladder)

18. Causes of Skin ColorChanges
 Cyanosis – obstruction of airways (cancer of
the lung and thyroid cancer), lack of
circulation (seen in advanced cancer)
 Redness – skin involvement of cancer
- inflammatory breast cancer

19. Causes of Skin ColorChanges
 Darkskin/hyperpigmentation –
change in the appearance of a mole,
appearance of hyperpigmented skin cancer

20. Causes of Skin ColorChanges
 Darkskin/hyperpigmentation –
change in the appearance of a mole,
appearance of hyperpigmented skin cancer
(melanoma, Kaposis sarcoma)


21. 21
General Deterioration of Skin
Condition
Careful attention to:
(1) Prevention of problems, and(1) Prevention of problems, and
(2) Management of problems(2) Management of problems

22. BREAST CANCER

23. 23
Signs of Cancer
(Scaling)
Paget’s Disease

24. Peau d’orange

26. BED SORES

27. 27

28. Decubitus Ulcers
(PressureUlcers orSores, BedSores, SkinBreakdown)
 decreased circulation from pressure at a
specific site
 especially at or near bony prominences such
as:
- the sacrum ("tailbone")
- hip
- ankles
- ear

29. Decubitus Ulcers
(PressureUlcers orSores, BedSores, SkinBreakdown)
 Immobility and constant pressure on the same
site
 Moisture from any source, but especially urine
and feces

30. Decubitus Ulcers
(PressureUlcers orSores, BedSores, SkinBreakdown)
 Poor hydration, nutrition, circulatory, or mental
status.
 Ulceration extends into muscle or other tissue
past the full thickness of skin

37. 37

38. SKIN IRRITATIONS

39. 39

40. Chyle LeakChyle Leak

41. Mucocutaneous FistulaMucocutaneous Fistula

42. Lymphedema

44. Skin Care
Antibiotics, antifungal drugs, soothing ointments
Surgery/ Debridement
Control of the cancer
Pressure dressing

45. Skin Care
Antibiotics, antifungal drugs, soothingAntibiotics, antifungal drugs, soothing
ointmentsointments

46. Skin Care
Surgery/DebridementSurgery/Debridement

47. Skin Care
Pressure dressingPressure dressing

48. Skin Care
Control of the cancerControl of the cancer

49. Control of Cancer
Chemotherapy
Radiation therapy

50. COMPLICATIONS due to CHEMOTHE

51. COMPLICATIONS due to CHEMOTHE

52. Skin Care
multi-purpose moisture barrier ointment
- protect and promote healing from many skin
problems
 zinc + calamine ointment

53. Zinc Oxide
 provides fast skin cell
replication needed to heal cuts
and wounds

54. Calamine
 Astringent property
CLEANSING
EFFECT

55. Zinc Oxide and Calamine
Ointment

73. Summary
 Skin complications of cancer are very
manageable.

However, preventionprevention is the best course of
action for:
- betterquality of life- betterquality of life
- less expenses- less expenses
- betteruse of resources- betteruse of resources

74. Summary
 Skin complications of cancer are very
manageable.

However, preventionprevention is the best course of
action for:
- betterquality of life- betterquality of life
- less expenses- less expenses
- betteruse of resources- betteruse of resources

75. Summary
 Common disorders are very manageable.

However, preventionprevention is the best course of
action for:
- betterquality of life- betterquality of life
- less expenses- less expenses
- betteruse of resources- betteruse of resources

76. roel_tolentino@yahoo.com