A client on cetuximab develops an acneiform rash on the face… | MyMerci
Medical EmergenciesPA
Question
A client on cetuximab develops an acneiform rash on the face and upper chest. Which is the nurse's most appropriate response?
1Continue therapy with skin care (gentle cleansing, sunscreen, topical antibiotics or corticosteroids per protocol); rash often correlates with better tumor response✓ Correct answer
2Discontinue all therapy permanently
3Apply hydrocortisone and ignore
4Switch to immunotherapy immediately
Explanation
Correct (2): Cetuximab/panitumumab (anti-EGFR) cause acneiform rash in ~80%. Counterintuitively, rash often correlates with treatment response. Manage with skin care, sunscreen, topical antibiotics (clindamycin) or steroids, oral tetracyclines (doxycycline) for severe rash; dose reduction only if grade ≥3. (1) Premature. (3) Inadequate. (4) Inappropriate.
In-depth explanation
Memory Tip Anti-EGFR (Cetuximab·Panitumumab) = "Rash means RESPONSE." Hypomagnesemia common — monitor Mg. KRAS wild-type required for efficacy.
Clinical scenario
Scenario 55-year-old male on cetuximab for metastatic colorectal cancer; develops papulopustular rash on face/chest at week 2.
Key concepts
Anti-EGFR antibody — Cetuximab, panitumumab; for KRAS WT colorectal and H&N cancer.