Amivantamab, an epidermal growth factor receptor (EGFR)-MET bispecific antibody, has demonstrated clinically meaningful benefits for patients with EGFR-mutated advanced non-small cell lung cancer (NSCLC). Consistent with EGFR and MET inhibition, amivantamab-containing regimens are associated with adverse events (AEs) including dermatologic AEs, edema, hypoalbuminemia, venous thromboembolism (VTE), and infusion-related reactions (IRRs). Here we provide practical consensus guidelines developed by a steering committee of 12 clinicians and supported by a literature review of current clinical recommendations, in addition to interviews with representatives of 2 patient advocacy groups, on managing the safety profile of amivantamab-containing regimens for clinicians in the Asia-Pacific (APAC) region. Consensus clinical guidelines recommend prophylactic anticoagulants, minocycline/doxycycline, and moisturizers as key management of common AEs associated with amivantamab, with detailed guidance provided for reactive management across AE grades. Guidance was based on published supportive care strategies for amivantamab and previous evidence on managing EGFR and MET tyrosine kinase inhibitor-related AEs. Prophylactic strategies and reactive treatments were summarized for skin-related AEs, paronychia, mucositis, and stomatitis. Recommendations for preventing and treating MET-related AEs, VTEs, and IRRs were also provided. Multidisciplinary team involvement in early intervention and management of AEs was encouraged. Patient advocacy groups advised clinicians to clearly explain the rationale for prophylactic and reactive treatments and to educate patients on how to appropriately and most efficiently utilize daily supportive care. Appropriate strategies based on these guidelines are encouraged and achievable for APAC clinicians to improve patient care during treatment with amivantamab-containing regimens.

Retronychia should be suspected in patients presenting with painful proximal nail fold inflammation of the great toe, particularly when nail growth has slowed or ceased. Early recognition prevents misdiagnosis as paronychia or onychomycosis. Complete nail plate avulsion remains the most effective treatment for symptom resolution.

MEK inhibitors (MEKi) have transformed the treatment of tumors such as melanoma and plexiform neurofibroma in neurofibromatosis type 1, but they are frequently associated with dermatological adverse effects that may affect quality of life and treatment adherence. This expert consensus reviews the evidence and provides practical recommendations for the prevention and management of the most common cutaneous toxicities associated with MEKi, including acneiform rash, eczematous dermatitis, xerosis, paronychia, photosensitivity, hair disorders, pruritus, edema, and mucositis. Most of these reactions are mild or moderate and can be controlled through preventive measures, topical or oral treatment, and patient education. Multidisciplinary collaboration between dermatology and oncology is key for early detection, individualized management, and optimization of clinical outcomes, minimizing treatment interruptions and improving the quality of life of patients receiving these therapies.

Thumb sucking is a behavior that can be grouped under a list of habits known as non–nutritive sucking habits. Within this group, we can also find the use of pacifiers, blankets, or sucking on other fingers as a comforting behavior. Thumb-sucking has been considered an activity that serves as an adaptive function by providing stimulation or self-soothing. Non-nutritive sucking habits are common in young children, and as they grow older, they tend to stop them. In most cases, this habit ceases spontaneously between 2 and 4 years of age. Nevertheless, if thumb sucking continues, negative consequences can occur, such as a deformity of the nail or paronychia. If the habit persists while the permanent dentition is erupting, malocclusion can occur. This condition can be managed with different approaches, from parental and patient advice, fitting a dental appliance, or behavior modification techniques such as positive reinforcement, calendar with rewards, and counseling, among others. Clinicians must be aware of the non-nutritive sucking habits, including thumb-sucking and their negative impact on oral health, as well as the complications that can arise with them. Referral to a pediatric dentist to evaluate dental complications can be considered when the non-nutritive sucking habits persist beyond the 4 years of age despite appropriate behavioral interventions.

Background: Antimicrobial resistance is one of the major challenges in healthcare, leading to more severe infections, higher mortality, and increased healthcare costs. Therefore, exploring new alternatives, such as plant extracts with antimicrobial properties helps to reduce bacterial resistance. Artemisia annua L., Hibiscus sabdariffa L., and Paronychia argentea Lam. are traditionally used for their biological properties, including antimicrobial activity. However, scientific evidence regarding their antibacterial effects against clinically important bacteria remains limited. Methods: Extracts were obtained from the mentioned plants and phytochemically characterized by GC/MS. Phytochemical analysis revealed the presence of fatty acids, phenolic compounds, aliphatic compounds, and terpenoids. Antibacterial activity was evaluated using the diffusion method with a modified Kirby-Bauer technique and the microdilution method employing the massive plate sealing drop approach. Results: All extracts exhibited bacterial inhibition, with H. sabdariffa L. showing the strongest activity against E. coli (256 mg/mL), K. pneumoniae (256 mg/mL), P. aeruginosa (128 mg/mL), Salmonella sp. (128 mg/mL), and S. aureus (64 mg/mL). Conclusions: Hydroethanolic extracts of A. annua L., H. sabdariffa L., and P. argentea Lam. exhibit antibacterial activity against clinically relevant bacteria and represent promising candidates for future preclinical studies.

Bart syndrome is a rare congenital disorder characterized by localized absence of skin, epidermolysis bullosa (EB), and nail abnormalities. We report the case of a female newborn presenting with congenital absence of skin on both feet, associated to multiple blisters in friction-prone areas and paronychia. Despite these findings, she remained clinically stable, was feeding normally, and exhibited no gastrointestinal symptoms. Based on the association of aplasia cutis and epidermolysis bullosa, a diagnosis of Bart syndrome was clinically suspected. The patient was treated with topical gentamicin 0.5% diluted in petroleum jelly, applied twice weekly, combined with a non-adhesive dressing. Clinical improvement was observed, with complete healing of the perineal lesions within three months and significant regression of limb involvement. Although spontaneous re-epithelialization is part of the natural course of the disease, the rapid and sustained clinical evolution raises the possibility of a beneficial effect of gentamicin. To the best of our knowledge, similar responses in this specific context have rarely been reported. Larger studies are required to confirm efficacy, define optimal treatment protocols, and evaluate long-term safety.

Amivantamab, a bispecific monoclonal antibody directed against the epidermal growth factor receptor (EGFR) and mesenchymal-epithelial transition factor (MET), has demonstrated significant clinical activity and is increasingly incorporated into frontline regimens for EGFR-mutant non-small cell lung cancer (NSCLC). Its increasing clinical use has, nevertheless, been paralleled by recognition of distinctive cutaneous adverse events, most commonly acneiform eruptions, paronychia, and xerosis among others. We present the first case of an erosive pustular dermatosis (EPD)-like reaction limited to a previously irradiated field in a patient receiving amivantamab for EGFR-mutant NSCLC. This case draws attention to the importance of recognizing EPD-like scalp ulcerations as a potential adverse event in patients receiving amivantamab, events that have not been recognized in clinical trials, particularly in the setting of recent or concurrent radiotherapy.