# Contemporary management of treatment-related dermatologic toxicities in gynecologic cancers: a systematic review based on evidence from 2021 to 2025

**Authors:** Shanshan Wang, Rui Hou, Ruizhi Wang, Chu Liu, Shida Xu

PMC · DOI: 10.3389/fmed.2026.1751349 · 2026-02-20

## TL;DR

This review summarizes recent evidence on skin side effects from gynecologic cancer treatments and highlights new strategies to manage them effectively.

## Contribution

A systematic review of the latest evidence (2021–2025) on dermatologic toxicities in gynecologic cancer treatment and novel mitigation approaches.

## Key findings

- Subclinical skin damage from drugs like paclitaxel is an early, often asymptomatic effect.
- Radiotherapy-related skin issues and severe effects from novel targeted therapies are major concerns.
- 3D printed radiotherapy devices and multidisciplinary care models show promise in mitigating skin toxicities.

## Abstract

Gynecologic cancers are commonly managed with chemotherapy, radiotherapy, and targeted therapies, which are effective but frequently associated with significant skin side effects. These dermatologic toxicities substantially reduce patients’ quality of life and treatment adherence, highlighting the need for a comprehensive synthesis of the latest evidence to address this clinical challenge.

This systematic review summarizes the most up-to-date evidence (as of 2025) regarding treatment-induced skin damage in patients with gynecologic cancers. It focuses on synthesizing data related to the clinical manifestations, subclinical changes, risk factors, and management strategies of these skin toxicities.

Key findings include three critical areas of focus: subclinical skin damage (early, mostly asymptomatic changes induced by medications such as paclitaxel), radiotherapy-related skin issues, and severe skin effects associated with novel targeted therapies. Additionally, innovative technologies (e.g., 3D printed radiotherapy devices) were identified as potential tools for preventing and mitigating dermatologic toxicities.

The review emphasizes the importance of individualized intervention plans and multidisciplinary care models to effectively manage treatment-related skin toxicities. By synthesizing the latest evidence on manifestations, mechanisms, risk factors, and innovative mitigation strategies, this review aims to provide clinicians with optimal information to improve outcomes for gynecologic cancer patients experiencing skin toxicities, thereby enhancing treatment adherence and overall patient well-being.

## Linked entities

- **Chemicals:** paclitaxel (PubChem CID 36314)

## Full-text entities

- **Genes:** JAK2 (Janus kinase 2) [NCBI Gene 3717] {aka JTK10}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, EGFR (epidermal growth factor receptor) [NCBI Gene 1956] {aka ERBB, ERBB1, ERRP, HER1, NISBD2, NNCIS}, ERBB4 (erb-b2 receptor tyrosine kinase 4) [NCBI Gene 2066] {aka ALS19, HER4, p180erbB4}, IL13 (interleukin 13) [NCBI Gene 3596] {aka IL-13, P600}, HLA-A (major histocompatibility complex, class I, A) [NCBI Gene 3105] {aka HLAA}, IL4 (interleukin 4) [NCBI Gene 3565] {aka BCGF-1, BCGF1, BSF-1, BSF1, IL-4}, FN1 (fibronectin 1) [NCBI Gene 2335] {aka CIG, ED-B, FINC, FN, FNZ, GFND}, IL23A (interleukin 23 subunit alpha) [NCBI Gene 51561] {aka IL-23, IL-23A, IL23P19, P19, SGRF}, IL17A (interleukin 17A) [NCBI Gene 3605] {aka CTLA-8, CTLA8, IL-17, IL-17A, IL17, ILA17}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, ELN (elastin) [NCBI Gene 2006] {aka ADCL1, SVAS, WBS, WS}, PLA2G1B (phospholipase A2 group IB) [NCBI Gene 5319] {aka PLA2, PLA2A, PPLA2}, CD274 (CD274 molecule) [NCBI Gene 574058] {aka PDL1}, TGFB1 (transforming growth factor beta 1) [NCBI Gene 7040] {aka CAEND1, CED, DPD1, IBDIMDE, LAP, TGF-beta1}, MAP2K7 (mitogen-activated protein kinase kinase 7) [NCBI Gene 5609] {aka JNKK2, MAPKK7, MEK, MEK 7, MKK7, PRKMK7}, ACTA1 (actin alpha 1, skeletal muscle) [NCBI Gene 58] {aka ACTA, ASMA, CFTD, CFTD1, CFTDM, CMYO2A}, COL11A2 (collagen type XI alpha 2 chain) [NCBI Gene 1302] {aka DFNA13, DFNB53, FBCG2, HKE5, OSMEDA, OSMEDB}, CTLA4 (cytotoxic T-lymphocyte associated protein 4) [NCBI Gene 397286], TXK (TXK tyrosine kinase) [NCBI Gene 7294] {aka BTKL, PSCTK5, PTK4, RLK, TKL}, NFKB1 (nuclear factor kappa B subunit 1) [NCBI Gene 4790] {aka CVID12, EBP-1, KBF1, NF-kB, NF-kB1, NF-kappa-B1}, ERBB2 (erb-b2 receptor tyrosine kinase 2) [NCBI Gene 2064] {aka CD340, HER-2, HER-2/neu, HER2, MLN 19, MLN-19}, BRAF (B-Raf proto-oncogene, serine/threonine kinase) [NCBI Gene 673] {aka B-RAF1, B-raf, BRAF-1, BRAF1, NS7, RAFB1}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, STAT3 (signal transducer and activator of transcription 3) [NCBI Gene 6774] {aka ADMIO, ADMIO1, APRF, HIES}, AQP3 (aquaporin 3 (Gill blood group)) [NCBI Gene 360] {aka AQP-3, GIL}, TLR4 (toll like receptor 4) [NCBI Gene 7099] {aka ARMD10, CD284, TLR-4, TOLL}, CD44 (CD44 molecule (IN blood group)) [NCBI Gene 960] {aka CDW44, CSPG8, ECM-III, ECMR-III, H-CAM, HCELL}, IL1B (interleukin 1 beta) [NCBI Gene 3553] {aka IL-1, IL1-BETA, IL1F2, IL1beta}, XPC (XPC complex subunit, DNA damage recognition and repair factor) [NCBI Gene 7508] {aka RAD4, XP3, XPCC, p125}
- **Diseases:** dysfunction (MESH:D006331), Hypersensitivity (MESH:D004342), cervical, ovarian, and vaginal cancers (MESH:D010051), vaginal toxicity (MESH:D014627), dryness (MESH:D014987), breast cancer (MESH:D001943), mucositis (MESH:D052016), XP (MESH:D014983), cutaneous radiation toxicity (MESH:D011832), H (MESH:D000848), cutaneous reactions (MESH:D017445), erythema (MESH:D004890), necrosis (MESH:D009336), eczema (MESH:D004485), endometrial cancer (MESH:D016889), panniculitis (MESH:D015434), radiation dermatitis (MESH:D011855), anemia (MESH:D000740), blisters (MESH:D001768), lichen planus-like reactions (MESH:D008010), Symptoms (MESH:D012816), dry skin (MESH:D015352), Vascular damage (MESH:D057772), skin adverse reactions (MESH:D064420), dermatologic adverse (MESH:D000168), Reaction with (MESH:D006967), gynecological malignancies (MESH:D005833), infections (MESH:D007239), maculopapular eruptions (MESH:D003875), irAEs (MESH:D002318), thrombocytopenia (MESH:D013921), endocrine disruption (MESH:D004700), dermatitis (MESH:D003872), desquamation (MESH:D017490), cytotoxic T-cell-mediated hypersensitivity (MESH:D006969), acneiform rash (MESH:D005076), autoimmune disease (MESH:D001327), alopecia (MESH:D000505), obesity (MESH:D009765), itch (MESH:D011537), SJS (MESH:D013262), cervical, endometrial, and ovarian cancers (MESH:D002575), psoriasiform eruptions (OMIM:616834), BP (MESH:D007022), ischemia (MESH:D007511), psoriasis (MESH:D011565), paronychia (MESH:D010304), granulomatous skin (MESH:D016410), pain (MESH:D010146), lichenoid reactions (MESH:D017512), cervical cancer (MESH:D002583), papulopustular eruption (MESH:D012393), hyperpigmentation (MESH:D017495), Skin toxicities (MESH:D012871), skin injuries (MESH:D000069836), syndrome (MESH:D013577), Chronic wounds (MESH:D014947), Inflammation (MESH:D007249), melanoma (MESH:D008545), Chronic Fibrosis (MESH:D005355)
- **Chemicals:** lipids (MESH:D008055), niraparib (MESH:C545685), minocycline (MESH:D008911), Afatinib (MESH:D000077716), cytarabine (MESH:D003561), ROS (MESH:D017382), polyurethane (MESH:D011140), taxane (MESH:C080625), doxorubicin (MESH:D004317), tacrolimus (MESH:D016559), EGFRIs (-), olive oil (MESH:D000069463), proanthocyanidins (MESH:D044945), urea (MESH:D014508), pimecrolimus (MESH:C117268), water (MESH:D014867), 5-fluorouracil (MESH:D005472), metformin (MESH:D008687), HA (MESH:D006820), chitosan (MESH:D048271), oxygen (MESH:D010100), Diallyl disulfide (MESH:C028009), doxycycline (MESH:D004318), Paclitaxel (MESH:D017239)
- **Species:** Homo sapiens (human, species) [taxon 9606], Allium sativum (garlic, species) [taxon 4682]
- **Mutations:** V600E

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Source: https://tomesphere.com/paper/PMC12965135