Tarceva 'acne' side effect - 1261220

borntosurvive
Posts:52

I've been on Tarceva for 11 days now, and have broken out in 'acne' like small pimples on and around my nose. The only thing I have against this is Retin-A cream. Is it ok for me to use that, and/or is there another treatment you can recommend to me? I feel like a teenager!

Also, I have 'pleural effusion' and it's giving me an awful, annoying cough plus I can often barely make it across the room. I feel like I'm going to collapse. As a result of these, I have been spending most of my time in bed or in a chair. When I'm sitting down, I do not get out of breath and have no problem breathing. It only happens when I get up from sitting and walk.

I can speak to my oncologist around the 6th, and have an appointment with a thoracic surgeon on the 10th. Considering I'm so out of breath, should I treat it as an emergency?

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JimC
Posts: 2753

Hi,

Although the rash caused by Tarceva can look like acne, it's not the same thing and shouldn't be treated as such. I haven't seen Retin-A cream touted for Tarceva rash. Usually what you want to do is keep your skin as moisturized as possible without using an alcohol-based cream, which causes further drying. My wife’s favorite was Aveeno Baby Daily Moisture Lotion, but through trial and error everyone seems to find their own choice that works for them. There’s a good discussion of this issue here: http://cancergrace.org/forums/index.php?topic=6912.0 You may want to consult a dermatologist, especially if you have access to one who is familiar with Tarceva rash.

You can read a good discussion of the treatment of such skin issues by Dr. Mario Lacouture, one of the leading experts in the field: http://cancergrace.org/cancer-treatments/files/2011/09/dr-lacouture-on-…

As far as the shortness of breath, that is a common symptom of a pleural effusion, but it can also be caused by other conditions. I'm sorry, but no one on this site can advise you whether this is an emergency, both for practical and legal reasons.

Good luck in controlling the rash.

JimC
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Dr West
Posts: 4735

The more common interventions are hydrocortisone cream, an antibiotic cream or gel like Cleocin T gel, or oral antibiotics like minocycline or sometimes an alternative. Oral steroids are also sometimes administered but aren't a good long term solution (if people have a severe rash that persists, we generally favor lowering the dose of the EGFR inhibitor.

However, Retin-A is specifically NOT recommended for an EGFR inhibitor rash. I can't speak to the details for why, but dermatologists have noted that the rash may look like acne but isn't, and Retin-A is one drug that has been specifically called out as not to be used.

Here is a link with several posts discussing the rash, including its potential significance and management recommendations:

http://cancergrace.org/lung/category/lung-cancer/general-lung-cancer-is…

Good luck.

-Dr. West

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