Synonym: Palmar Plantar Erythodysaesthesia Syndrome
Drugs causing the reaction:
(1) capecitabine
(2) cytosine arabinoside
(3) docetaxel
(4) doxorubicin
(5) etoposide
(6) hydroxyurea
(7) 5-fluorouracial (5-FU)
(8) methotrexate
(9) mercaptopurine
(10) paclitaxel
(11) tegafur
(12) vinorelbine
(13) irinotecan
(14) bleomycin
(15) idarubicin
Clinical features:
(1) affect the palms, fingers, and soles of the feet
(2) intense and well-demarcated erythema
(3) pain which may require intravenous narcotics for relief
(4) may be associated with numbness, tingling, dysesthesias or paresthesias
(5) may develop bullae, edema, desquamation, and/or ulceration
(6) pain may be worsened by cyclosporine infusions
Management:
(1) stop therapy and/or reduce drug dosage
(2) symptomatic relief with topical emollients
(3) pyridoxine (vitamin B6) may reduce the pain