Adverse Event

Grade 1

Grade 2

Grade 3

Grade 4

Dry skin

Asymptomatic

Symptomatic, not interfering with ADL

Interfering with ADL

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Hair loss or alopecia (scalp or body)

Thinning or patchy

Complete

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Hyperpigmentation

Slight or localized

Marked or generalized

---

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Nail changes

Discoloration, ridging (koilonychias), pitting

Partial or complete loss of nail(s), pain in nail bed

Interfering with ADL

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Pruritus or itching

Mild or localized

Intense or widespread

Intense or widespread and interfering with ADL

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Rash or desquamation

Macular or popular eruption or erythema without associated symptoms

Macular or popular eruption or erythema with pruritus or other associated symptoms; localized desquamation or other lesions covering < 50% of BSA

Severe, generalized erythroderma or macular, popular, or vesicular eruption; desquamation covering &8805; 50% of BSA

Generalized exfoliative, ulcerative, or bullous dermatitis

Rash: hand-foot skin reaction

Minimal skin changes or dermatitis (eg, erythema) without pain

Skin changes (eg, peeling, blisters, bleeding, edema) or pain, not interfering with function

Ulcerative dermatitis or skin changes with pain interfering with function

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Dry eye syndrome

Mild, intervention not indicated

Symptomatic, interfering with function but not interfering with ADL; medical intervention indicated

Symptomatic or decrease in visual acuity interfering with ADL; operative intervention indicated

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Eyelid dysfunction (includes erythema and trichiasis)

Asymptomatic

Symptomatic, interfering with function but not ADL; requiring topical agents or epilation

Symptomatic; interfering with ADL; surgical intervention indicated

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Ocular surface disease (includes conjunctivitis)

Asymptomatic or minimally symptomatic but not interfering with function

Symptomatic, interfering with function but not interfering with ADL; topical antibiotics or other topical intervention indicated

Symptomatic, interfering with ADL; operative intervention indicated

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ADL = activities of daily living; BSA = body surface area
From: National Cancer Institute. Cancer Therapy Evaluation Program. Common Terminology Criteria for Adverse Events. (2006): Cutaneous Reactions. Available at: http://ctep.cancer.gov/forms/CTCAEv3.pdf. Accessed 9/18/08.