Side Effect: Skin Ulcer
What is a Skin Ulcer?
A skin ulcer is a type of wound that occurs when skin breaks down and the underlying tissue is exposed.
Skin ulcers are typically slow to heal and can become a chronic problem if left untreated.
What do Skin Ulcers look like?
- The appearance of skin ulcers can vary depending upon the underlying cause.
- Most ulcers typically have an open sore or wound that may be shallow or deep.
- The skin around the ulcer may be red, swollen, discolored, painful or warm to the touch.
- In some cases, the ulcer may have drainage or pus coming from the wound.
Who gets Skin Ulcers?
Skin ulcers can occur for many reasons and can develop on different parts of the body. Some causes of skin ulcers include:
- Prolonged pressure to an area of skin, also called pressure or decubitus ulcers
- Trauma to the skin
- Poor blood flow to an area of skin
- Poor wound healing
- Infection
- Nutritional deficiencies
In patients receiving radiation therapy for cancer treatment, skin damage can occur which can sometimes lead to the development of skin ulcers.
Additionally, skin cancers such as melanoma or basal cell carcinoma can also become ulcerated.
Certain chemotherapy agents can also increase the risk of developing skin ulcers or make it difficult for wounds to heal. These medications include:
- Epidermal growth factor receptor (EGFR) inhibitors:
- cetuximab (Erbitux©)
- panitumumab (Vectibix©)
- Vascular endothelial growth factor (VEGF) inhibitors:
- bevacizumab (Avastin©)
- sunitinib (Sutent©)
- sorafenib (Nexavar©)
How do you prevent Skin Ulcers?
Ways to prevent skin ulcers can include:
- Avoid activities that may cause pressure or friction to the skin
- Optimize nutrition
- Manage underlying comorbidities that increase your risk of developing ulcers
- Keep skin clean and dry
- Avoid scented soaps and other scented products as these can be irritating to the skin
How do you treat Skin Ulcers?
- Treatment of skin ulcers depends on the underlying cause and severity of the ulcer.
- Treatment may include removing damaged tissue (debridement), surgical intervention or skin grafting.
- Topical treatments may be used to promote wound healing and to keep the area clean.
- If an ulcer is infected, antimicrobial therapy may be used to treat the infection.
- In patient receiving VEGF or EGFR inhibitors for cancer treatment who develop skin ulcers, chemotherapy may be held until the wound heals.
References
1. Zaidi SRH, Sharma S. Pressure Ulcer. [Updated 2024 Jan 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK553107/.
2. Abid A, Hosseinzadeh S. Foot Ulcer. [Updated 2022 Sep 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557778/.
3. Güneri P, Epstein JB, Bolukbasi G, Spielberger RT. Neutropenic ulcers in oncology: terminology, diagnosis, and management. Support Care Cancer. 2023 Nov 22;31(12):716.
Barricklow Z, DiVincenzo MJ, Angell CD, et al. Ulcerated cutaneous melanoma: a review of the clinical, histologic, and molecular features associated with a clinically aggressive histologic phenotype. Clin Cosmet Investig Dermatol. 2022;15:1743-1757.
4. McDaniel B, Badri T, Steele RB. Basal Cell Carcinoma. [Updated 2022 Sep 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482439/.
5. Guggina LM, Choi AW, Choi JN. EGFR inhibitors and cutaneous complications: a practical approach to management. Oncol Ther. 2017;5:135-148.
6. Johnson KE, Wilgus TA. Vascular endothelial growth factor and angiogenesis in the regulation of cutaneous wound repair. Adv Wound Care (New Rochelle). 2014;3(10):647-661.
Created: May 5, 2024
Updated: May 5, 2024