表皮生长因子受体酪氨酸激酶抑制剂致甲沟炎的预防和治疗研究进展

Prevention and treatment progress of paronychia caused by epidermal growth factor receptor tyro-sine kinase inhibitors

表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)为EGFR经典突变非小细胞肺癌的标准治疗药物,大多数会导致不同程度的甲沟炎。EGFR-TKI因药理作用引起的甲沟炎及甲周化脓性炎症,通常发生在用药的4~12周后;一般首先表现为急性甲沟炎,后可发展为化脓性肉芽肿;可基于患者病史、临床症状和检查,以及用药情况进行诊断。目前尚无标准的方案用以防治EGFR-TKI诱导的甲沟炎,较为有效的措施包括:(1)控制危险因素,(2)调整致病药物,(3)使用β受体阻滞剂、抗菌药物、局部糖皮质激素、中草药等。严重甲沟炎还可通过外科手术治疗。

Epidermal growth factor receptor tyrosine kinase inhibitors(EGRF-TKIs)were standard therapeutic agents for advanced non-small cell lung cancer with positive EGFR mutations,most of these drugs could cause paronychia with various severity.EGFR-TKIs caused paronychia and periungual suppurative inflammation mainly through their pharmacological effects,which usually occurred 4 to 12 weeks after medication.The paronychia caused by EGFR-TKIs was manifested as acute paronychia firstly,and then might develop into purulent granuloma.The diagnosis of paronychia could base on the patient′s medical history,clinical symptoms,clinical examinations,and medication situation.Currently,there was no standard scheme to prevent and treat paronychia induced by EGFR-TKIs.The relatively effective measures included controlling risk factors,adjusting the regimen of EGFR-TKIs,usingβ-blockers,antibacterial drugs,local glucocorticoids and Chinese herbal medicines,etc.Severe paronychia could also be treated through surgical intervention.