Dermo-oncology

1° september 2018
Cancer epidemiology - Italy
Source: ISTAT 2017
Cancer epidemiology – italy
CANCER PREVALENCE BY TYPE AND GENDER
 Cancer prognosis (2010)

YEARS FROM
CANCER TYPE HEALED
DIAGNOSIS
 Therapies for oncological patients

➢ Radiotherapy: rx treatment may be very harmful for heatlh cells too, especially for
keratinocytes. Skin alterations due to Radiotherapy are called radiodermitis.

➢ Chemotherapy: cytotoxic drugs may seriously damage health skin cells causing
dermatological toxicity

➢ Target therapy: treatment based on molecules or antibodies which selectively act

on growth factors, receptors and bio targets. A typical target for such therapies is
EGFR (Epidermal Growth Factor Receptor), which is massively expressed on skin
tissues that results damaged
Epidemiology of dermatological toxicity in cancer patients
Cancer therapy and skin side effects

RADIOTHERAPY
Keratinocytes are targets of
radiotherapy
Cancer therapy and skin side effects

CHEMOTHERAPY
Is directed to kill the cancer cell
At different stages of its lifecycle,
Cancer therapy and skin side effects

TARGET THERAPY
Is directed to EGF receptors which
Are highly expressed on skin
Skin alterations after oncological treatment

Water loss and poor quality Epithelial cells show

of cellular inter-connection inflammation,
causes desquamation Swelling, reddening
Trans Epidermal Water Loss
(TEWL)
Dehydrated skin vs health skin
The dermatological product needs to
restore the physiological skin barrier adding
lamellar lipids and ceramides, which bind
water thus reducing the TEWL (trans
epidermal water loss). The daily
restoration of the barrier allows cells
protection from ionizing radiationsand
reduce inflammation.
The balming effect prevents erytherma, and
symptoms such as: pain, itching, burining.
Creams with liquid christals technology are
highly hydrating, antinflammatory, and
restore barrier integrity. la barriera.
 Hydrolipidic film

Lipids with a high similarity to skin lipids increase protection of skin

surfacegiving a balming effect, specific glucydes bind korneocytes
keratine to water, granting hydration of the korneal layer.
Cleansing
Cleansing must be performed with an
“affinity based” mechanism,
consisting of emulsion rather than
solubilization, using lipids with a high
similarity to skin lipids, in order to
gently remove from skin only the
excess of oily secretion and the dirt.

This surfactants-free cleansing is

called “eudermic” as it does not
dissolve epidermal lipids, avoiding
harms to hydrolipidic film and
mantaining skin hydration and
protection.
In vitro activities
In vitro activities
 Clinical trial - parameters
“We proposed that skin diseases affect patients in either psychosocial or physical ways. We
suggested that psychosocial effects could be cognitive (beliefs about self or others), social, or
emotional. Subdimensions of emotional effects include depression, fear, embarrassment, and
anger. Physical effects are either discomfort or limitations in physical functioning.”

M M Chren
Dermatol Clin. 2012 April ; 30(2): 231–236.
The Skindex Instruments to Measure the Effects of Skin Disease on Quality of Life
 Clinical trial –parameters

PJ Atherton et al Support care Cancer 2012 August 20(8): 1729-1735

Using the Skindex 16 and common terminology criteria for Adverse events to assess rash symptoms
 Clinical trial
Oliveri Serena, Faccio Flavia, Pizzoli Silvia, Ferrari Federica, Redaelli Carolina, Indino Mirella, Pravettoni Gabriella.

Caring for wellbeing and quality of life during breast cancer therapies: a study
on aesthetic treatment performed by qualified aesthetic practitioners
(in press)
169 patients
ENROLMENT Age: 52,8 (±11,4)
Diagnosis of breast cancer treated with:
•Radiotherapy
•Chemotherapy
•Target therapy
•Endocrine therapy

DERMATOLOGICAL SIDE EFFECTS:

INCLUSION •Erythrodysesthesia
CRITERIA •radiodermatitis
•edema
•xerosis
•Damage on nails
•Cuteaneous rash

•100 patients treated with On Therapy

TREATMENT •2/day for 28 days
•69 patients controls
•RANDOMIZED CONTROLLED TRIAL
DESIGN
Patients were administered the Skindex-16 scale and the Distress Thermometer at
three times:
•at recruitment, (T0),
•after one week (T1)
•and after 28 days (T2) from beginning of aesthetics treatments.

The Skindex-16 is a 16-item self-report instrument that measures comprehensively

the effects of skin disease on QoL. Each question asks subjects to rate on a 7-point
Likert Scale the level concern or discomfort due to their specific skin condition.
Items can be grouped into three subscales evaluating symptoms (items 1-5),
emotions (items 6-11), and daily functions (items 12-16).
Clinical trial
Clinical trial
 Clinical trial

Skin after treatment

 Clinical trial

Skin after treatment

 Clinical trial

Skin after treatment

PRODUCTS
PRODUCTS
PRODUCTS
PRODUCTS
 PRODUCTS

DEODORANT 100 mL
•Anti irritative13,
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•Antibacterial7-12 SEPTEMBER
2018