Bracarda, S., Ruggeri, E.M., Monti, M., Merlano, M., D'Angelo, A., Ferrau, F., ... Sorafenib Working Group. (2012). Early detection, prevention, and management of cutaneous adverse events due to sorafenib: Recommendations from the Sorafenib Working Group. Critical Reviews in Oncology/Hematology, 82, 378–386. 

RESOURCE TYPE: Expert opinion  

PROCESS OF DEVELOPMENT: The SWG was a multidisciplinary team of experts in the field who were closely involved in the sorafenib clinical development program. The group was established with the objective of developing recommendations to allow the early detection, prevention, and management of cutaneous adverse events in everyday clinical practice.

PHASE OF CARE: Active antitumor treatment

The SWG aims to collect the experience of each clinician in order to develop detailed, practical guidelines for the prevention and management of dermatological adverse events associated with sorafenib.

For grade 1 HFSR on the hands, apply zinc oxide and magnesium silicate lenitive cream without Vaseline. For feet, wear comfortable shoes with a latex insole if possible. Wash with non-foaming cleansing creams, apply same cream as hands, and wear perspiring socks without seams. For grades 2–3 HFSR, aspirate fluid inside blister and then medicate with a PEG-based cicatrizing ointment. Avoid antibiotics. General erythema should be treated also with zinc oxide and magnesium silicate lenitive cream. For follicular rash, apply a cold compress of potassium permanganate 0.0125% solution followed by 2% sulfosalicylic cream without Vaseline. No antibiotics recommended.

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Nurses should consider these recommendations, especially for HFSR. Certainly, the preventative measures are worthy. However, one also needs to be familiar with any trials using the products that are recommended from this expert group.