Common Toxicity Criteria (CTC) for Dermatologic Adverse Events Associated with Cancer Therapy

alopecia

none

0

mild

1

pronounced

2

bruising in the absence of moderate to severe thrombocytopenia

none

0

localized or in dependent area

1

generalized

2

dry skin

normal

0

controlled with emollients

1

not controlled with emolients

2

erythema multiforme

absent

0

scattered but not generalized eruption

2

generalized rash or painful stomatitis; severe or requiring IV fluids

3

life-threatening exfoliative or ulcerating dermatitis, or requiring enteral or parenteral nutritional support

4

flushing

absent

0

present

1

hand-foot skin reaction

none

0

skin changes or dermatitis without pain

1

skin changes with pain, but not interfering with function

2

skin changes with pain, interfering with function

3

injection site reaction

none

0

pain, itching or erythema

1

pain or swelling with inflammation or phlebitis

2

ulceration or necrosis that is severe, prolonged or requires surgery

3

nail changes

normal

0

discoloration or ridging or pitting

1

partial or complete loss of nails

2

pain in nailbeds

2

photosensitivity

none

0

painless erythema

1

painful erythema

2

erythema with desquamation

3

pigmentation changes

none

0

localized pigmentation change

1

generalized pigmentation changes

2

pruritis

none

0

mild or localized; relieved spontaneously or by local measures

1

intense or widespread; relieved spontaneously or by systemic measures

2

intense or widespread and poorly controlled despite treatment

3

radiation dermatitis

none

0

faint erythema or dry desquamation

1

moderate to brisk erythema or a patchy moist desquamation, mostly confined to skin folds and creases; moderate edema

2

confluent moist desquamation >= 1.5 cm in diameter and not confined to skin folds; pitting edema

3

skin necrosis or ulceration of full thickness dermis; may include bleeding not induced by minor trauma or abrasion

4

radiation recall reaction

none

0

faint erythema or dry desquamation

1

moderate to brisk erythema or a patchy moist desquamation, mostly confined to skin folds and creases; moderate edema

2

confluent moist desquamation >= 1.5 cm in diameter and not confined to skin folds; pitting edema

3

skin necrosis or ulceration of full thickness dermis; may include bleeding not induced by minor trauma or abrasion

4

rash associated with chemotherapy or BMT

none

0

faint erythema or dry desquamation

1

moderate to brisk erythema or a patchy moist desquamation, mostly confined to skin folds and creases; moderate edema

2

confluent moist desquamation >= 1.5 cm in diameter and not confined to skin folds; pitting edema

3

skin necrosis or ulceration of full thickness dermis; may include bleeding not induced by minor trauma or abrasion

4

rash with desquamation

none

0

macular or papular eruption, or erythema without associated symptoms

1

macular or papular eruptions or erythema with pruritis or other associated symptoms covering < 50% of BSA; or localized desquamation or other lesions covering < 50% of BSA

2

symptomatic generalized erythroderma or macular, papular or vesicular eruption or desquamation covering >= 50% of BSA

3

generalized exfoliative dermatitis or ulcerative dermatitis

4

rash associated with GVHD

none

0

macular or papular eruption, or erythema covering < 25% of BSA without associated symptoms

1

macular or papular eruptions or erythema with pruritis or other associated symptoms covering 25-49% of BSA; or localized desquamation or other lesions covering 25-49% of BSA

2

symptomatic generalized erythroderma or macular, papular or vesicular eruption or desquamation covering >= 50% of BSA

3

generalized exfoliative dermatitis or ulcerative dermatitis or bulllous formation

4

urticaria

none

0

requires no medication

1

requires oral or topical treatment

2

requires IV medication or steroids for < 24 hours

2

requires IV medication or steroids for >= 24 hours

3

wound, infectious

none

0

cellulitis

1

superficial infection

2

requires IV antibiotics

3

necrotizing fasciitis

4

wound, noninfectious

none

0

incisional separation

1

incisional hernia

2

fascial disruption without evisceration

3

fascial disruption with evisceration

4

skin lesion, NOS

none

0

mild

1

moderate

2

severe

3

life-threatening or disabling

4