Section Editor Prof. Dr. Jan C. Simon, Leipzig
Palliative treatment of skin metastases in dermato-oncology
Article first published online: 9 SEP 2013
© The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 11, Issue 11, pages 1041–1046, November 2013
How to Cite
Kähler, K. C., Egberts, F. and Gutzmer, R. (2013), Palliative treatment of skin metastases in dermato-oncology. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 11: 1041–1046. doi: 10.1111/ddg.12197
Conflicts of interest None.
Visible skin metastases are often very distressful for the patient. Excision is the first-line therapy for solitary skin metastases.
A main indication for palliative radiotherapy is not so much to reduce the size of the tumor (i.e., debulking) but rather to alleviate the symptoms as quickly as possible.
Radiotherapy already has an analgesic effect at low dosages of 8 Gy or more; it reaches its maximum two to four weeks after stopping radiation therapy.
Electrochemotherapy consists of combination therapy using electroporation along with administration of systemic cytostatic agents (bleomycin, cisplatin) for local treatment of cutaneous and subcutaneous skin tumors and metastases.
For bleomycin, the response rate ranges between 77–87%, depending on the tumor entity.
In patients with severe skin metastases, limb perfusion is an effective treatment option.
One option is intratumoral administration of interleukin-2, which is a highly effective local therapy for skin metastases in patients with melanoma.
If there is heavier bleeding, topical application of an astringent nasal spray may be effective.
A paste consisting of pulverized metronidazole tablets, or 2% chlorophyll solution, when applied directly to foul-smelling lesions, can also minimize the odor.
- Issue published online: 14 OCT 2013
- Article first published online: 9 SEP 2013
- Manuscript Accepted: 12 JUL 2013
- Manuscript Received: 24 MAY 2013