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Patient characteristics, expectations and willingness to pay for hair loss therapies: A survey of 1561 participants at a tertiary dermatological referral centre in Singapore

hypersensitivity reactions (Table S1). Half of those with EGFR inhibitor-related papulopustular eruption in our study could not continue with the same chemotherapy/immunotherapy. One patient requested to stop chemotherapy/immunotherapy because of eczematous dermatitis. This is testament to the significant negative impact that any cutaneous adverse drug reactions can have on a patient’s quality of life. The importance of prevention and limitation of cutaneous adverse drug reactions to avoid withdrawal or dose reduction of chemotherapy/immunotherapy cannot be over-emphasised. In our cohort, 68.2% of patients with cutaneous adverse drug reactions improved after specialist dermatologic evaluation and management. Over half (53.3%) of these patients could continue their chemotherapy/immunotherapy. Early review and ongoing specialist dermatologic support can be valuable in patients planned for chemotherapy/immunotherapy with higher risk of cutaneous adverse drug reactions. Dermatologic complaints unrelated to chemotherapy/immunotherapy comprised 86.7% of referrals. The majority could be classified into 4 major groups – eczematous dermatoses (n = 108), skin infections (n = 64), benign skin growths (n = 34) and cutaneous manifestations related to underlying haematologic/oncologic condition (n = 26) for example cutaneous metastases and cutaneous graft-versus-host-disease. The wide spectrum of dermatologic conditions referred highlights the importance of being vigilant to identify and address non-chemotherapy/immunotherapy-related concerns of the haematologic/oncologic patients and the significant role that the dermatologist has to play in the care of these patients. In conclusion, our study demonstrates the diversity of dermatologic conditions in this population and highlights potential yet-to-be-described reactions from the newer generations of chemotherapy/immunotherapy. Skin toxicities may result in discontinuation or dose reduction of chemotherapy/immunotherapy and may also decrease the quality of life in affected patients. As we understand the spectrum of such reactions more with clinical experience, it may be valuable for early dermatological input to prevent or manage potential dermatologic adverse events in patients receiving high-risk drugs for skin toxicity.