The Hand Foot Syndrome (HF Syndrome, toxic acral erythema, palmar-plantar erythrodysthesia syndrome) is the most common toxic skin reaction to administration of polyethylene glycol-coated doxorubicin. This may range from a minor reaction to a serious and disabling condition.
The Hand Foot Syndrome may present as erythema of the palms, fingers and soles of the feet that later may become edematous and violaceous. The lesions may either dry out and desquamate, or blister with ulceration.
Additional patterns of skin reactions seen with liposomal doxorubicin:
(1) diffuse, follicular rash
(2) intertrigo-like eruption
(3) melanotic macules
Appearance |
Functional Impairment |
Grade |
none |
none |
0 |
asymptomatic and mild erythema, swelling or desquamation |
does not interfere with normal physical activity |
I |
painful erythema, swelling or desquamation |
does not interfere with normal physical activity |
II |
local blistering, ulceration, or swelling |
interferes with regular physical activities |
III |
diffuse blistering or ulceration; local blistering and ulceration causing infection |
marked interference with physical activities or bedridden |
IV |
modified from Toxic Effects Scale, page 1476
where:
• Regular physical activities includes the ability to wear clothing.
Specialty: Dermatology, Pharmacology, clinical
ICD-10: ,