Tykerb Rash...help?

[LauraP]

Hi. My name is Laura and I am a Stage IV survivor recently put on Tykerb in August of this year. I am taking it with Xeloda. I have handled the majority of side effects okay, but I have this rash. I have tried different cleansers as my skin is really sensitive. I didn't want to resort to taking topical meds to counteract the rash as those can sometimes be pretty harsh.

Do you all have any suggestions? I have read that lots of you have had the rash and that is common. Just not sure if I should take a more natural approach with cleansers or if I should try to get a prescription to conquer this thing.

My only concern is that I don't want to do less of the dosage. I want to stay at the dose I am at.

Any help you can provide me would be great!

Thanks!

Laura

[hutchibk]

Hi Laura -

Here's the current info from The Oncologist (Peer review Journal for practicing Oncologists/Hemotologists)... regarding Tykerb/Xeloda rash:

*Employ a proactive approach in managing skin reactions.
*Suggest that patients use a thick, alcohol-free emollient cream.
*Suggest that patients use a sunscreen of SPF 25 or higher, preferably
containing zinc oxide or titanium dioxide
* If patient presents with rash, verify appropriate administration of drug and proceed with the following therapy algorithm:

Mild:
Minimally located
No impact on activities of daily life (ADL)
No sign of superinfection

(shows picture of mild rash occurrence across bridge of nose and cheeks)

Continue EGFR targeted treatment @current dose and monitor for change in severity.

topical hydrocortisone 1% or 2.5% cream and/or Clindamycin 1% gel

Reassess after 2 weeks, if reaction worsens or does not improve, proceed to next step.


Moderate:
Generalized
Mild Symptoms (e.g. pruritus, tenderness)
Minimal impact on ADL
No sign of superinfection

(shows picture of red worsened rash occurrence (pruritus) across nose, around nostrils, top lip, lower cheeks, and entire chin.)

Continue EGFR targeted treatment @current dose and monitor for change in severity. Continue treatment of the skin reaction with the following:

Hydrocortisone 2.5% cream or Clindamycin 1$ gel
or Pimecrolimus 1% cream
Plus Doxycycline 100mg BID or Monocycline 100mg BID

Reassess after 2 weeks, if reaction worsens or does not improve, proceed to next step.


Severe:
Generalized
Severe symptoms (e.g. pruritus, tenderness)
Significant impact on ADL
Potential sign of superinfection

(shows picture of worsened rash occurrence similar to moderate with more facial coverage and continuation to shoulders and neck)

Reduce EGFR targeted therapy as per label and monitor for change in severity. Continue treatment of skin reaction with the following:

Hydrocortisone 2.5% cream or Clindamycin 1$ gel
or Pimecrolimus 1% cream
Plus Doxycycline 100mg BID or Monocycline 100mg BID
Plus Medrol dose pack

Reassess after 2 weeks, if reaction worsens, dose interruption or discontinuation may be necessary.


Show it to your onc. I hope there is something here that can help you! Let us know how you are doing. There are more ladies here who might have additional ideas for you.

[LauraP]

Thanks so much for your help! i appreciate it and will give this a try.

Laura

[SoCalGal]

JUST got back from my dermatologist. We discussed this side effect (chatting in general) and she agreed that usual acne meds don't really work for this "favorable" side effect. For me, I used Tea Tree oil from trader joe's. I dipped a q-tip in witch hazel and then in tea tree oil and by morning the red stuff was gone. Someone on this board posted tea tree oil for skin and nail probs and I found it very effective.

[awjkej]

I have used Bag Balm and Udderly Smooth cream for my hands and feet. I didn't have any luck with my face except to reduce the mg of xeloda to 2000mg/day and tykerb to 1000mg/day. I also now do one week on and one week off for xeloda. My oncologist told me that the greatest benefit from xeloda comes in the first 7 - 8 days. So taking it after that just increases the side effects.

Hope this helps.

Anne

[Vanessa]

I started another post about Tykerb rash, but wanted to ask again here, Did anyone get the rash on their legs, arms and torso. It is like mosquito bites and itches like mosquito bites. I am currently using cortisone creme and Amlactin AP. It seems to help some.

[Vanessa]

My doctor gave me a prescription for Clindamycin(sp?). I just turned it in at the pharmacy and I will let ya'll know how it works.

[Unregistered]

Just got told yesterday, severe rash under
breast, torso - I'm off of Herceptin and Tykerb,
until rash cleared up. Glad to be on vacation,
but a little scary. I had a great NED pet scan
with tumor markers cea 0 and circulation 0
and cr27-90 is 19. I just pray alot!

Hope the dermatalogist has some answers......

[Jackie07]

CourtneyL posted her experience (and solution) for Tykerb rash last year:

Yes, I've gotten the rash on by body before. The Suki Serum recommended by someone on here works wonders at making the rash go away. As I recall it was several weeks into Tykerb the first time I was on it, when the rash developed.

I learned something interesting about Tykerb today. According to my onc, it can work later on down the road even if you previously progressed on it. Don't ask me how or why but I think he is right. It did very little for my brain tumors before and now they were shrinking before I even had the Gamma Knife. Of course it could be from the vaccine but you just never know.

[Jillynn]

Hi I am pretty new to this site and check it once in a while for new updates in the field of medicine ect. This is one area I can say I can offer advice because I have had the rash too. I was first placed on Tykerb in adjuvant therapy as part of a study. Broke out in the rash 2 weeks after being on it. It looks more like a case of severe acne - at least for me. My onc was just going to take me off the trial and at the time I thought Tykerb was the latest advance in therapy so I desprately wanted to stay on it. Having been told to always be your own advocate - I went to a dermatologist. She prescribed Doryx and my onc office approved the drug. It cleared up most in a matter of a week and eventually I just went off Doryx and never had a problem afterward. Three months after I finished radiation, I had liver mets so I am now stage IV and in the same therapy as you - Tykerb and Zeloda. One week into the new regimen I started showing signs again of the acne rash. I had left over Doryx and started taking it right away. I went back to the Dermatologist to get more and she recommended using a vinegar wash as well. Sounds strange, but I'm suppose to put vinegar in a papertowel and dilute it with water. Cleanse areas of my body with it before showering it off. I also wash face with Regenerist detoxifying pore scrub (wal-mart has an off brand I use too sometimes) and my face looks much better than other areas like chest and back. But all in all the Doryx really controls it. My dermatologist may switch me to another product closer to summer as she said the Doryx can make my skin sensitive to sunlight. So just a warning there.

[LOOKIN' FORWARD]

My Tykerb rash was so bad that my onc had me see a dermatologist the same day. She prescribed Prednisone for 10 days and Protopic and Clobex spray (expensive but she had samples) & OTC Aquapfor & Lubriderm Intense Repair lotion. I had to discontinue the Tykerb until it was cleared up & then restarted. Hope this helps someone.

[Rich66]

Mom has hive like itchy spots on lwoer leg and tops of feet. is this possible after being on Tykerb (4pills/day) for months? She had some lower leg/torso edema which has gotten much better..but now hives in select locations. She is also on low dose Xeloda and Cytoxan.

[KristinSchwick]

I also suffered from the tykerb rash, 90% of my legs and 30% of my arms. Itched, hurt, burned, miserable. Oncologist suggested topical 1% hydrocortizone, which can help alittle. But what I found most helpful was oral bendryl at night- hard to fall asleep when your itchy. And before bed, an oatmeal bath- Aveno makes a bath additive which is super soothing, oncologist actually recommended that one.

Here's a link to the product
http://www.aveeno.com/skincare/products/soothing-bath-treatment

[Trish]

Thanks for the info. I have a hive-like (not acne like) rash on my back and elbows of all things. I will try Aveeno oatmeal bath. Hydrocortisone didn't do much good. Have no idea what Suki Serum is but will investigate.
Trish

[Unregistered]

I developed the hive-like rash on my arms and some on my back, after about seven months on Tykerb. It feels like bugs are biting my arms all the time, and has gradually gotten worse. Very hard to deal with. I only have one more week on Tykerb, but am now up to 100 mg Vistaril 4 x daily and rx cortisone cream. From reading posts, it seems like there are two kinds of rash with Tykerb, the acne type and the hive type. Rachel

[KristinSchwick]

Trish, How did that oatmeal bath soak help? Did it clear up?

[Trish]

Thanks for asking Kristin. The bath certainly soothed the rash but the doctor at chemo simultaneously prescribed the corticosteroid Elocon. I was quickly rash free but am unsure which was effective. Next time my first recourse will be the oatmeal bath and progress to Elocon only if necessary. Hope you are well.
Trish