Acneiform rash, paronychia, and diarrhea often occur during afatinib treatment. Standardized management can relieve discomfort and help patients adhere to treatment.

I. Acneiform Rash

1. Manifestations

It is mostly seen on the face, chest, and back, presenting as erythema, papules, or pustules.

It often appears early in treatment, and sun exposure can worsen it.

2. Management Measures

Avoid sun exposure, and use sunscreen, hats, and long-sleeved clothing when going out.

Keep the skin clean, use mild moisturizers, and avoid scratching.

Apply topical antibiotics or corticosteroid ointments as prescribed by a doctor.

If the rash is severe or secondary infection occurs, seek medical attention promptly and adjust the dose if necessary.

II. Paronychia

1. Manifestations

Redness, swelling, and pain around the nails, which may suppurate in severe cases.

It mostly occurs in the nail folds of fingers or toes.

2. Management Measures

Keep hands and feet clean and dry, and avoid cutting nails too short or improper trimming.

Avoid squeezing, nail biting, or wearing tight shoes and socks.

Topical disinfectants or antibiotic ointments may be used locally as prescribed by a doctor.

If obvious redness, swelling, suppuration, or severe pain occurs, seek medical treatment promptly.

III. Diarrhea

1. Manifestations

It may present as loose or watery stools, often accompanied by abdominal pain or increased bowel movement frequency.

In severe cases, it can lead to dehydration and electrolyte imbalance.

2. Management Measures

Increase fluid intake, supplement electrolytes, and avoid dehydration.

Avoid spicy, greasy, and cold foods, and choose a light, easily digestible diet.

Use antidiarrheal medications as prescribed by a doctor, and do not misuse them on your own.

If severe diarrhea, fever, or signs of dehydration occur, seek medical attention immediately and consider adjusting the dose.

IV. Overall Management Recommendations

Strictly follow the doctor's instructions when taking the medication, and do not increase, decrease, or stop the dose on your own.

Record changes in symptoms and inform the doctor during follow-up visits.

Regularly monitor complete blood count, liver and kidney function, and electrolytes.

Strengthening nutrition and rest can help reduce side effects and maintain treatment.

If severe or persistent adverse reactions occur, contact the doctor promptly for management.