Skin toxicity – Grade 2-4

Low risk

• Alopecia < grade 2
• Bullous dermatitis grade 2 (affecting 10-30% BSA)
• Dry skin > grade 2
• Erythema multiforme grade 2 (affecting 10-30% BSA)
• Erythroderma grade 2 (covering >90% BSA)
• Pruritus > grade 2 with moderate with skin changes from scratching limiting instrumental ADL
• Rash grade 2 covering 10-30% BSA with/without symptoms, limiting instrumental ADL
• Skin atrophy > grade 2 (covering > 10% BSA)
• Skin induration > grade 2

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Medium risk

• Bullous dematitis grade 2 (affecting > 30% BSA)
• Erythema multiforme grade 3 (>30% BSA oral and genital erosions)
• Erythroderma grade 3 (>90% BSA)
• Rash grade > (3 covering >30% BSA) associated with superinfection requiring antibiotics

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High risk

• Steven Johnson syndrome
• Toxic epidermal necrolysis
• Bullous dermatis grade 4 (affecting > 30% BSA, blistering with electrolyte/fluid abnormalities)
• Erythema multiforme grade 4 (>30% BSA electrolyte/fluid abnormalities)
• Erythroderma grade 4 (>90% BSA Electrolyte/fluid abnormalities)

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