Abstract The frequency of the use of drugs that act on the epidermal growth factor receptor (EGFR) is increasing, with the consequent onset of cutaneous toxicity, specifically acneiform eruption. The authors extensively review the topic, focusing on describing how these drugs can affect the skin and its appendages, that is, the pathophysiology that encompasses the cutaneous toxicity related to the use of EGFR inhibitors. In addition, it was possible to list the risk factors that may be associated with adverse effects of these drugs. Based on this recent knowledge, the authors expect to aid in the management of patients who are more vulnerable to toxicity, reduce morbidities, and improve the quality of life of patients undergoing treatment with EGFR inhibitors. Other issues related to the toxicity of EGFR inhibitors, such as the clinical aspects of the acneiform eruption grades, and other different types of cutaneous and mucosal reactions, are also included in the article. (EGFR increasing topic appendages inhibitors addition knowledge morbidities grades reactions article

Abstract Background In cutaneous melanomas in general, tumor inflammatory infiltrate (TII) can protect against distant metastases, but there is no consensus when only thin primary cutaneous melanomas (TPCM) are considered. Objective To investigate the presence of TII in TPCM and the relationship between TII and the occurrence of metastases. Methods Case-control study including 50 patients with TPCM, 22 metastatic (MC group) and 28 non-metastatic (NMC group). The presence of TII was evaluated and, if present, qualified as mild, moderate or marked. Results The mean age was 50.7 years in the MC and 56.2 years in the NMC group (p = 0.234), and the male sex predominated in the MC group (63.6%). The average Breslow thickness was higher in the MC when compared to that observed in the NMC (respectively 0.8 vs. 0.6 mm, p = 0.012). The presence of ulceration occurred in 22.7% of the MC and 17.9% of the NMC (p = 0.732). TII was present in all 50 TPCM, being marked or moderate in 67.9% of the NMC and 54.5% in the MC group (p = 0.503). In the multivariate analysis, the presence of moderate and marked TII had an Odds Ratio (OR) of 0.57 (95% Confidence Interval [CI]: 0.18‒1.8) and adjusted OR of 0.68 (95% CI 0.13‒3.99). Study limitations Small sample size. Conclusions TII was present in all TPCM (with and without metastases), and it was not possible to demonstrate a protective effect of TII against the appearance of metastases. general (TII metastases (TPCM considered Casecontrol Case control 5 2 nonmetastatic non group. . mild 507 7 50. 562 56 56. 0.234, 0234 0.234 , 0 234 0.234) 63.6%. 636 63.6% 63 6 (63.6%) respectively 08 8 0. vs 06 mm 0.012. 0012 0.012 012 0.012) 227 22.7 179 17 9 17.9 0.732. 0732 0.732 732 0.732) 679 67 67.9 545 54 54.5 0.503. 0503 0.503 503 0.503) analysis (OR 057 57 0.5 95% 95 (95 [CI] 0.18‒1.8 01818 18 1 068 68 0.13‒3.99. 013399 0.13‒3.99 13 3 99 0.13‒3.99) size metastases) 023 0.23 23 63.6 (63.6% 001 0.01 01 22. 17. 073 0.73 73 67. 54. 050 0.50 05 (9 [CI 0.18‒1. 0181 01339 0.13‒3.9 02 0.2 63. (63.6 00 0.0 07 0.7 ( 0.18‒1 018 0133 0.13‒3. (63. 0.18‒ 013 0.13‒3 (63 0.18 0.13‒ (6 0.1 0.13

Abstract Background In hospital settings, dermatology can offer substantial clinical support for the diagnosis and management of skin conditions, reducing morbidity and mortality. Thus, the study aimed to analyze the profile of referrals and consultations performed by the Dermatology Service of the Santa Casa de Misericordia de Porto Alegre, from August 2018 to January 2020. Methods This study is descriptive, quantitative, and retrospective, conducted through data collection and review of medical records and referrals. The variables included were clinical data of referrals, in-patients profiles, dermatological diagnoses, complementary exams, therapeutic conduct, and recommended follow-ups. Results A total of 1020 referrals were analyzed, which resulted in 641 consultations (328 men, 313 women). The most prevalent skin disease groups were ‘Dermatitis and Eczema’ (33.1%) and ‘Other infectious skin diseases (21.8%), while the most frequent ICD-10 were ‘Drug eruptions - L27’ (9.9%) and ‘Other and unspecified dermatitis - L30’ (6.6%). Corticoids were the most recommended treatments (27.7%), followed by antifungals (13.1%). ‘Consultation Discharge’ (44%) and ‘Outpatient’ Dermatology follow-up (27%) were the most frequent causes for ending consultation. Study limitations Among the study limitations, the authors highlight its retrospective nature, with data analysis based on referrals and medical records, which may present inaccurate or incomplete information. In addition to this, the study may demonstrate a certain degree of subjectivity due to the review and interpretation process conducted by the researchers. However, the definition of objective criteria based on previous studies attenuates such possible bias. Furthermore, considering that the Dermatology teams are composed of a preceptor dermatologist and residents, the established diagnoses were not submitted to third-party verification, except in the cases of skin biopsies and cultures. Thus, the professional’s experience and skills may have influenced the dermatological diagnoses. Conclusions These findings underlie the importance of Dermatology in hospital assistance, contributing to the management of a wide range of skin conditions. settings conditions mortality Thus Alegre 201 2020 descriptive quantitative inpatients patients profiles exams conduct followups. followups follow ups. ups follow-ups 102 analyzed 64 328 (32 men 31 women. women . women) Dermatitis Eczema 33.1% 331 33 1 (33.1% Other 21.8%, 218 21.8% , 21 8 (21.8%) ICD10 ICD 10 ICD-1 Drug L27 L 9.9% 99 9 (9.9% L30 6.6%. 66 6.6% 6 (6.6%) 27.7%, 277 27.7% 27 7 (27.7%) 13.1%. 131 13.1% 13 (13.1%) Consultation Discharge 44% 44 (44% ‘Outpatient Outpatient followup up 27% (27% consultation nature information this researchers However bias Furthermore residents thirdparty third party verification cultures professionals professional s assistance 20 202 32 (3 3 33.1 (33.1 21.8 2 (21.8% ICD1 ICD- L2 9.9 (9.9 L3 6.6 (6.6% 27.7 (27.7% 13.1 (13.1% 4 (44 (27 ( 33. (33. 21. (21.8 9. (9. 6. (6.6 27. (27.7 13. (13.1 (4 (2 (33 (21. (9 (6. (27. (13. (21 (6 (13 (1