Category:CTCAE4 Skin and subcutaneous tissue disorders
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| Adverse Event | Grade1 | Grade2 | Grade3 | Grade4 | Grade5 |
|---|---|---|---|---|---|
| Alopecia | Hair loss of up to 50% of normal for that individual that is not obvious from a distance but only on close inspection; a different hair style may be required to cover the hair loss but it does not require a wig or hair piece to camouflage | Hair loss of >50% normal for that individual that is readily apparent to others; a wig or hair piece is necessary if the patient desires to completely camouflage the hair loss; associated with psychosocial impact | - | - | - |
| Body odor | Mild odor; physician intervention not indicated; self care interventions | Pronounced odor; psychosocial impact; patient seeks medical intervention | - | - | - |
| Bullous dermatitis | Asymptomatic; blisters covering <10% BSA | Blisters covering 10-30% BSA; painful blisters; limiting instrumental ADL | Blisters covering >30% BSA; limiting self care ADL | Blisters covering >30% BSA; associated with fluid or electrolyte abnormalities; ICU care or burn unit indicated | Death |
| Dry skin | Covering <10% BSA and no associated erythema or pruritus | Covering 10-30% BSA and associated with erythema or pruritus; limiting instrumental ADL | Covering >30% BSA and associated with pruritus; limiting self care ADL | - | - |
| Erythema multiforme | Target lesions covering <10% BSA and not associated with skin tenderness | Target lesions covering 10-30% BSA and associated with skin tenderness | Target lesions covering >30% BSA and associated with oral or genital erosions | Target lesions covering >30% BSA; associated with fluid or electrolyte abnormalities; ICU care or burn unit indicated | Death |
| Erythroderma | - | Erythema covering >90% BSA without associated symptoms; limiting instrumental ADL | Erythema covering >90% BSA with associated symptoms (e.g., pruritus or tenderness); limiting self care ADL | Erythema covering >90% BSA with associated fluid or electrolyte abnormalities; ICU care or burn unit indicated | Death |
| Fat atrophy | Covering <10% BSA and asymptomatic | Covering 10-30% BSA and associated with erythema or tenderness; limiting instrumental ADL | Covering >30% BSA; associated with erythema or tenderness; limiting self-care ADL | - | - |
| Hirsutism | In women, increase in length, thickness or density of hair in a male distribution that the patient is able to camouflage by periodic shaving, bleaching, or removal of hair | In women, increase in length, thickness or density of hair in a male distribution that requires daily shaving or consistent destructive means of hair removal to camouflage; associated with psychosocial impact | - | - | - |
| Hyperhidrosis | Limited to one site (palms, soles, or axillae); self care interventions | Involving >1 site; patient seeks medical intervention; associated with psychosocial impact | Generalized involving sites other than palms, soles, or axillae; associated with electrolyte/hemodynamic imbalance | - | - |
| Hypertrichosis | Increase in length, thickness or density of hair that the patient is either able to camouflage by periodic shaving or removal of hairs or is not concerned enough about the overgrowth to use any form of hair removal | Increase in length, thickness or density of hair at least on the usual exposed areas of the body _face (not limited to beard/moustache area) plus/minus arms_ that requires frequent shaving or use of destructive means of hair removal to camouflage; associated with psychosocial impact. | - | - | - |
| Hypohidrosis | - | Symptomatic; limiting instrumental ADL | Increase in body temperature; limiting self care ADL | Heat stroke | Death |
| Lipohypertrophy | Asymptomatic and covering <10% BSA | Covering 10-30% BSA and associated tenderness; limiting instrumental ADL | Covering >30% BSA and associated tenderness and narcotics or NSAIDs indicated; lipohypertrophy; limiting self care ADL | - | - |
| Nail discoloration | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | - | - | - | - |
| Nail loss | Asymptomatic separation of the nail bed from the nail plate or nail loss | Symptomatic separation of the nail bed from the nail plate or nail loss; limiting instrumental ADL | - | - | - |
| Nail ridging | Asymptomatic; clinical or diagnostic observations only; intervention not indicated | - | - | - | - |
| Pain of skin | Mild pain | Moderate pain; limiting instrumental ADL | Severe pain; limiting self care ADL | - | - |
| Palmar-plantar erythrodysesthesia syndrome | Minimal skin changes or dermatitis (e.g., erythema, edema, or hyperkeratosis) without pain | Skin changes (e.g., peeling, blisters, bleeding, edema, or hyperkeratosis) with pain; limiting instrumental ADL | Severe skin changes (e.g., peeling, blisters, bleeding, edema, or hyperkeratosis) with pain; limiting self care ADL | - | - |
| Periorbital edema | Soft or non-pitting | Indurated or pitting edema; topical intervention indicated | Edema associated with visual disturbance; increased intraocular pressure, glaucoma or retinal hemorrhage; optic neuritis; diuretics indicated; operative intervention indicated | - | - |
| Photosensitivity | Painless erythema and erythema covering <10% BSA | Tender erythema covering 10-30% BSA | Erythema covering >30% BSA and erythema with blistering; photosensitivity; oral corticosteroid therapy indicated; pain control indicated (e.g., narcotics or NSAIDs) | Life-threatening consequences; urgent intervention indicated | Death |
| Pruritus | Mild or localized; topical intervention indicated | Intense or widespread; intermittent; skin changes from scratching (e.g. edema, papulation, excoriations, lichenification, oozing/crusts); oral intervention indicated; limiting instrumental ADL | Intense or widespread; constant; limiting self care ADL or sleep; oral corticosteroid or immunosuppressive therapy indicated | - | - |
| Purpura | Combined area of lesions covering <10% BSA | Combined area of lesions covering 10-30% BSA; bleeding with trauma | Combined area of lesions covering >30% BSA; spontaneous bleeding | - | - |
| Rash acneiform | Papules and/or pustules covering <10% BSA, which may or may not be associated with symptoms of pruritus or tenderness | Papules and/or pustules covering 10-30% BSA, which may or may not be associated with symptoms of pruritus or tenderness; associated with psychosocial impact; limiting instrumental ADL | Papules and/or pustules covering >30% BSA, which may or may not be associated with symptoms of pruritus or tenderness; limiting self care ADL; associated with local superinfection with oral antibiotics indicated | Papules and/or pustules covering any % BSA, which may or may not be associated with symptoms of pruritus or tenderness and are associated with extensive superinfection with IV antibiotics indicated; life-threatening consequences | Death |
| Rash maculo-papular | Macules/papules covering <10% BSA with or without symptoms (e.g., pruritus, burning, tightness) | Macules/papules covering 10-30% BSA with or without symptoms (e.g., pruritus, burning, tightness); limiting instrumental ADL | Macules/papules covering >30% BSA with or without associated symptoms; limiting self care ADL | - | - |
| Scalp pain | Mild pain | Moderate pain; limiting instrumental ADL | Severe pain; limiting self care ADL | - | - |
| Skin and subcutaneous tissue disorders - Other, specify | Asymptomatic or mild symptoms; clinical or diagnostic observations only; intervention not indicated | Moderate; minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental ADL | Severe or medically significant but not immediately life-threatening; hospitalization or prolongation of existing hospitalization indicated; disabling; limiting self care ADL | Life-threatening consequences; urgent intervention indicated | Death |
| Skin atrophy | Covering <10% BSA; associated with telangiectasias or changes in skin color | Covering 10-30% BSA; associated with striae or adnexal structure loss | Covering >30% BSA; associated with ulceration | - | - |
| Skin hyperpigmentation | Hyperpigmentation covering <10% BSA; no psychosocial impact | Hyperpigmentation covering >10% BSA; associated psychosocial impact | - | - | - |
| Skin hypopigmentation | Hypopigmentation or depigmentation covering <10% BSA; no psychosocial impact | Hypopigmentation or depigmentation covering >10% BSA; associated psychosocial impact | - | - | - |
| Skin induration | Mild induration, able to move skin parallel to plane (sliding) and perpendicular to skin (pinching up) | Moderate induration, able to slide skin, unable to pinch skin; limiting instrumental ADL | Severe induration, unable to slide or pinch skin; limiting joint movement or orifice (e.g., mouth, anus); limiting self care ADL | Generalized; associated with signs or symptoms of impaired breathing or feeding | Death |
| Skin ulceration | Combined area of ulcers <1 cm; nonblanchable erythema of intact skin with associated warmth or edema | Combined area of ulcers 1 - 2 cm; partial thickness skin loss involving skin or subcutaneous fat | Combined area of ulcers >2 cm; full-thickness skin loss involving damage to or necrosis of subcutaneous tissue that may extend down to fascia | Any size ulcer with extensive destruction, tissue necrosis, or damage to muscle, bone, or supporting structures with or without full thickness skin loss | Death |
| Stevens-Johnson syndrome | - | - | Skin sloughing covering <10% BSA with associated signs (e.g., erythema, purpura, epidermal detachment and mucous membrane detachment) | Skin sloughing covering 10 - 30% BSA with associated signs (e.g., erythema, purpura, epidermal detachment and mucous membrane detachment) | Death |
| Telangiectasia | Telangiectasias covering <10% BSA | Telangiectasias covering >10% BSA; associated with psychosocial impact | - | - | - |
| Toxic epidermal necrolysis | - | - | - | Skin sloughing covering >=30% BSA with associated symptoms (e.g., erythema, purpura, or epidermal detachment) | Death |
| Urticaria | Urticarial lesions covering <10% BSA; topical intervention indicated | Urticarial lesions covering 10 - 30% BSA; oral intervention indicated | Urticarial lesions covering >30% BSA; IV intervention indicated | - | - |
Articles in category "CTCAE4 Skin and subcutaneous tissue disorders"
There are 34 articles in this category.
