# 一名使用cetuximab的個案臉部與上胸出現痤瘡樣皮疹。護理師最適當的回應是什麼？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391870&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

一名使用cetuximab的個案臉部與上胸出現痤瘡樣皮疹。護理師最適當的回應是什麼？

## 選項

1. 繼續治療並進行皮膚照護（溫和清潔、防曬、依流程使用外用抗生素或類固醇）；皮疹常與較佳腫瘤反應相關 **✔ 正確答案**
2. 永久停止所有治療
3. 塗hydrocortisone後忽略
4. 立即改用免疫治療

**正確答案: 1**

## 解析

正確（2）：Cetuximab/panitumumab（抗EGFR）約80%會造成痤瘡樣皮疹。反直覺地，皮疹常與治療反應相關。處理包含皮膚照護、防曬、外用抗生素或類固醇，嚴重時口服tetracycline；grade ≥3才考慮減量。（1）太早。（3）不足。（4）不適當。

## 深入解析

記憶提示 抗EGFR皮疹常代表反應；也要監測低鎂血症。KRAS wild-type才有效。

## 臨床情境

情境 55歲男性因轉移性大腸直腸癌使用cetuximab，第2週臉/胸出現丘疹膿皰疹。

## 重要概念

- **抗EGFR抗體** — Cetuximab、panitumumab；用於KRAS WT大腸直腸癌與頭頸癌。
- **痤瘡樣皮疹** — EGFR路徑抑制造成毛囊炎樣皮疹，可作為反應指標。
- **EGFR相關低鎂血症** — EGFR阻斷造成腎性鎂流失；需定期檢查Mg。

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