Hand foot syndrome (palmar-plantar erythrodysesthesia)


Most patients present with dysesthesia with tingling sensations of the palms and soles of the hands and feet.

Tingling sensations can progress over 3-4 days to burning pains with swelling and erythema of the hands and feet.

May present as painful erythematous, edematous palms, soles, with paresthesias, tingling or numbness.

The hands are affected more commonly than the feet.

Associated with capecitabine more than any other oral fluoropyrimidines, with a rate as high as 68%.

Associated with tingling, numbness, pain erythema, rash, dryness, swelling, pigmentation, and pruritus.

In some patients the hands may be the only site of involvement.

Desquamation may occur.

Painful hyperkeratotic areas, bullous lesions, blisters, skin cracking may be seen.

More common in elderly female patients with the use of 5 FU, but not with capecitabine.

Can arise with 5FU, capecitabine, doxorubicin, hydroxyurea, and sunitinib.

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