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Skin Moisturization For Xerosis Related To Targeted Anticancer Therapies.

P. Gisondi, G. Girolomoni
Published 2015 · Medicine

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To the Editor: We read with interest the original article ‘‘Incidence and risk of xerosis with targeted anticancer therapies’’ by Valentine et al published online on January 27, 2015. Most of the targeted therapies used in the treatment of cancer could have skin-related adverse effects, including skin xerosis, and we commend the authors for creating a review on this topic. However, we have a major contention with this review regarding the proposed treatment of xerosis reported in Fig 4. We believe that the suggested treatment of xerosis using salicylic acid 6% cream twice daily is not appropriate. Salicylic agent (SA) is not a humectant or a moisturizing agent, because it does not exhibit any water binding properties. Salicylic agent is a keratolytic agent that decreases cohesion between corneocytes, and it is used effectively in hyperkeratotic skin conditions including psoriasis, warts, seborrheic dermatitis, and cradle cap. Owing to its aromatic structure, salicylic acid is a lipophilic substance that is not very soluble in water, so it is commonly vehiculated in petrolatum rather than in cream. Application of salicylic agent on xerotic skin likely worsens skin xerosis and easily causes skin irritation and eczema, and thus should be avoided in patients treated with targeted therapy. Also, the use of ammonium lactate 12% may not be appropriate, because the irritating effects may prevail over the hydrating properties. Finally, criteria for a clinical diagnosis of xerosis as well as for the differential diagnosis between xerosis and asteatotic eczema are not mentioned in the manuscript. The criteria would be very
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