Immunotherapy causing skin rash

Hi Miranda t,

We hope that you are finding the support and information from the online community helpful

My name is Keith and I’m one of the Cancer Information Nurse Specialists

This really sounds like a difficult time for you both right now.

Its good your husbands  treatment of Avelumab is going well. But we are sorry to hear that the skin rash is still being troublesome even after antihistamines being prescribed by his consultant.

Avelumab can cause inflammation in the skin. This is usually mild, but if it is not treated it can become serious. If the antihistamine isn’t managing your husband’s situation his consultant may consider using creams, steroids or other medicines to manage this further. With this treatment any  skin changes during treatment, or after treatment ends, should be reviewed as soon as possible. We would always advise contacting his clinical team either via the chemo unit, specialist nurse or on the 24-hour number as soon as possible.

Skin changes can include: 

• a rash or bumps on the skin
• dry or itchy skin
• patches of white or paler skin.

During summer months you should  protect your  husbands skin from the sun, use sun cream with an SPF of at least 30. SPF stands for sun protection factor.  He should also Cover up with clothing and a hat. 

He should contact the hospital straight away on the 24-hour number if he has any of these symptoms:

• a rash that is spreading
• blistering or peeling skin
• flu-like symptoms, such as a high temperature and joint pain. 

The above symptoms can be a sign of a serious skin reaction that needs to be treated immediately in hospital.

 Looking through our online community, and in your area. may offer you additional support.

Sometimes you may just need a listening ear.

It may be worthwhile for you to  give us a call  where you can have a two-way conversation with one of our nurses  to discuss your situation in more detail. . We often find it is easier to discuss things over the phone when we can get a clearer idea of your situation.

 Or alternatively you can  contact us via our web chat platform

take care.

Keith, Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email.

 Ref KM/AM

Thanks, Keith! We’re happy on the whole with the immunotherapy: it’s been 18 months since the metastases were diagnosed and my husband is just happy to be alive. The fact that the oncologist isn’t especially concerned about the rash is reassuring, but I would love to hear any suggestions on ways of soothing the skin. We use a cream called Talquistina (Spanish), but maybe there is something else we could try that would be more effective? Aloe Vera? 

Hi Miranda t, I am Sharon, one of Keith’s colleagues, and a nurse on the Macmillan Cancer Support Line.

I’m glad your husband is doing well on his immunotherapy and that his consultant is not overly concerned about the rash. It must be such a relief to you both.

His consultant is best placed to ask what creams are appropriate. They may want to review the antihistamines if his symptoms are persisting.

We can’t recommend anything specific as we don’t have access to your husband’s medical history, but we can give you general information that may help give you ideas of what to ask his consultant. There are many skin products recommended by the NHS to soothe itching. Emollient creams moisturise and protect, so may help relieve itching caused by dry skin. They may not be enough alone, but as they have no ‘active’ ingredients in them they are safe to use as much as you need them.

The cream he is using (Talquistina) is calamine based. Calamine is used to relieve itching and has mild antiseptic properties. The cream also has ingredients that help hydrate the skin, so should also help maintain general skin ‘health’. Some people find Levomenthol cream (Menthol in aqueous cream) useful. Menthol has a cooling effect on the skin and aqueous cream protects and rehydrates the skin. Aloe Vera is a herbal remedy. Currently it is not approved for general use in the UK as there is insufficient evidence of its effectiveness, although some studies have shown aloe vera gel to be beneficial in some skin conditions. If you were considering using aloe vera it should be bought from a reputable source such as a pharmacy to avoid buying a sub-standard product.

Your husband’s consultant will be able to advise which products are suitable for him, but if the problem persists, they may decide to prescribe something stronger such as a steroid cream.

It is important that he checks with his hospital team before trying anything new as some products may interact with certain medications.

If your husband’s symptoms get worse at any time please seek immediate medical advice from his consultant, GP or 111.

I hope this information is helpful. We are here on the phone or webchat if you need us.

Take care,

Sharon

Cancer Information Nurse Specialist

You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or send us an email. 

Ref; SA/DW