Local chemotherapy

6 June 2012, by ESTÈVE E. & GRANGE F.

Antimitotic agents are used in dermatology to treat lesions directly and avoid unnecessary systemic exposure of the patient to potentially toxic substances. Local chemotherapy has certain advantages including "targeted" administration, use of low doses, its extremely rare systemic effects and the fact that it can be applied in the home of the patient. The main limiting factor is the cutaneous adverse events or toxicity with which it is associated. When prescribing local chemotherapy, it is therefore essential for healthcare professionals to take the time to explain how they are to be handled and their potential side effects to their patients. In most cases, use during pregnancy and in children is contraindicated. Finally, the services of a nurse are often required when initiating treatment in the elderly or when treating specific areas of the body.

For the most part, the molecules used today have been available for a long time. They tend to be used empirically in a dermatological setting. There is often a disparity between the high level of evidence reported in the literature and the frequent off-label use of these products, for which the prescriber may be held responsible. Similarly, while treating patients in their homes has true advantages, the prescribing physician must respect the regulatory texts concerning the management of cytotoxic medicines.

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