Interest of a specific dermo-cosmetic product in the management of acneiform rash induced by anti-tumoral treatments

Acneiform rash is the most frequent cutaneous toxicities induced by anti-tumoral treatments (43 to 85% depending on treatment). It appears 1 to 3 weeks after treatment initiation and is characterized by pimples on hair follicles, with pruritic and painful lesions accompanied with redness, dryness, and discomfort mainly in face, neck, neckline, and upper back. Acneiform rash is a very good predictive marker of response to anti-tumoral treatment as the lesions’ intensity correlates to the treatment efficacy. It impacts, however, patients’ quality of life, leading to a bad compliance in one third of them. The aim of this study is to assess the interest and the safety of a specific dermo-cosmetic product in the management of acneiform skin lesions.

Firstly, to evaluate the soothing/anti-redness effect, skin colour was measured on 20 healthy subjects (average age 30) using a spectrophotometer before and after application of patches containing the product and 1% SLS after wearing the patch for 18 hours and 6 hours after removing it. Secondly, a multicentric observational clinical study was performed under oncological control on 36 patients (average age 60.6) starting an anti-tumoral treatment known to induce acneiform skin lesions. The product was applied twice daily (morning/evening) for 56 days (D56), on face, neck, neckline, and upper back. The oncologists evaluated at each visit (D0, D14, D28, D42, D56):

• the time to onset, the incidence and the severity of acneiform skin lesions according to the CTCAE v5.0 grades on the usual affected areas;
• the evolution of redness and dryness severity rated on a 4-point scale;
• pain and itching using a 10-point visual analogue scale declared by the patients.

In parallel, the subjects assessed daily for 56 days the presence of acneiform lesions and physical signs or feelings (as redness, flaking, tightness, or pruritus). They also filled the DLQI every 7 days and evaluated the subjective efficacy and global satisfaction of the product at D56.

Redness was significantly reduced by 46% (p<0.0001) with the product via the a* parameter measurement. During the follow-up visits of the clinical study, no subject presented acneiform skin lesions on the usual affected areas associated with no evolution in term of number, severity, nor percentage of BSA. Similarly, they presented no evolution of redness or dryness and declared neither pain nor itching. Concerning the subjective assessment, after D11, no subject reported the presence of acneiform skin lesions or any other physical sign or feeling (2 subjects before D11). Moreover, the impact on quality of life was not altered during the study period (inferior to 1). Furthermore, all subjects considered that their skin was supple, soft, and hydrated at D56. They found their skin soothed (96.9%), comfortable (93.9%) and smoothed (87.9%), and globally all subjects were satisfied with the product at the end of the study. The product was very well tolerated by 94.4% subjects according to the investigators.