Palmar-plantar erythrodysesthesia

Palmar-Plantar Erythrodysesthesia

Palmar-plantar erythrodysesthesia (PPE), also known as hand-foot syndrome, is a dermatological condition characterized by redness, swelling, and pain on the palms of the hands and the soles of the feet. It is commonly associated with certain chemotherapy treatments and targeted therapies used in cancer treatment.

Pathophysiology

PPE is believed to occur due to the leakage of chemotherapeutic agents from the capillaries in the palms and soles, leading to inflammation and damage to the skin. The exact mechanism is not fully understood, but it is thought that the high concentration of sweat glands and increased blood flow in these areas contribute to the condition.

Clinical Presentation

Patients with PPE typically present with:

• Redness (erythema) on the palms and soles
• Swelling (edema)
• Pain or tenderness
• Tingling or burning sensation
• In severe cases, blistering and peeling of the skin

The symptoms usually appear within days to weeks after starting chemotherapy and can vary in severity.

Diagnosis

Diagnosis of PPE is primarily clinical, based on the characteristic appearance of the skin changes and the patient's history of chemotherapy treatment. Other causes of similar symptoms, such as infections or allergic reactions, should be ruled out.

Management

Management of PPE involves both preventive and symptomatic treatments:

Preventive Measures

• Dose modification of the chemotherapeutic agent
• Cooling of hands and feet during chemotherapy infusion
• Avoiding hot water and friction on the affected areas

Symptomatic Treatment

• Topical emollients and moisturizers
• Pain relief with analgesics
• Topical corticosteroids to reduce inflammation

Prognosis

The prognosis for PPE is generally good, as symptoms often resolve after the discontinuation or dose adjustment of the offending chemotherapy agent. However, severe cases can lead to significant discomfort and may require treatment interruption.

Also see

• Chemotherapy
• Dermatology
• Adverse drug reaction
• Oncology

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Source: Data courtesy of the U.S. National Library of Medicine. Since the data might have changed, please query MeSH on Palmar-plantar erythrodysesthesia for any updates.

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