At the annual Hawaii Dermatology Symposium sponsored by the Dermatology Education Foundation (SDEF), Dr. Mario E. Lacouture, a dermatologist at Memorial Sloan-Kettering Cancer Center in New York, noted that cancer patients can suffer from psychological stress, financial burden, poor health, discontinuation of anti-cancer treatment, and decreased quality of life due to their skin disease. Rash RAF inhibitor-induced rash can appear within 1 to 2 weeks after starting treatment. Patients with this rash may experience a burning or pruritic sensation at the site of light exposure. In most cases, this rash can be managed with topical steroids and oral GABA agonists. the application of Vemurafenib has been associated with photosensitivity reactions, pruritus and alopecia in addition to rash. In addition, mTOR inhibitor-induced rash (including erythematous pruritic papules and ulcer-like lesions) has been observed in patients applying everolimus and temsirolimus. Skin cancers Data from several studies have shown a 7% incidence of squamous cell carcinoma and a 4% incidence of actinic keratosis in patients on RAF inhibitors. These skin cancers usually occur after 6 months of treatment and can be treated by surgery or destruction. There have been no reports of metastasis. Hand-foot syndrome Hand-foot syndrome (HFSR) is a common adverse reaction in patients with cancer, often occurring within 45 d of starting treatment. hFSR is usually associated with the administration of sorafenib, sunitinib, and pazopanib, and these patients have a history of epidermal necrosis. Patients who develop HFSR require a temporary reduction in dose. Other measures to treat HFSR include avoiding excessive pressure on the affected areas and keeping these areas cool and moist to reduce patient discomfort. Hair and nail changes Hair changes, including slow hair growth and hair loss, may occur in patients treated with epidermal growth factor receptor inhibitors (EGFRI). Hair quality changes (e.g., increased brittleness and hair curl) have also been observed. Other hair-related adverse events include facial hypertrichosis and eyelash coarsening. In addition, nail fungus has been observed in patients who have been on EGFRI for more than 6 months. Radiation dermatitis Approximately 50% of cancer patients (including 87% of breast cancer patients) develop radiation dermatitis. Some studies have shown no significant improvement in radiation dermatitis in patients who applied topical non-steroids such as aloe vera and triethanolamine compared to controls. However, studies are ongoing and have observed that topical corticosteroids such as mometasone, beclomethasone and betamethasone significantly improve radiation dermatitis in breast cancer patients.