Chemotherapy-induced acral erythema

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Chemotherapy-induced acral erythema (also known as palmar-plantar erythrodysesthesia, hand-foot syndrome, or Burgdorf reaction) is a cutaneous condition characterized by redness, swelling, and pain on the palms of the hands and the soles of the feet. This condition is commonly associated with certain chemotherapy drugs used in the treatment of cancer.

Signs and Symptoms

The primary symptoms of chemotherapy-induced acral erythema include:

• Redness (erythema) of the palms and soles
• Swelling (edema)
• Pain or tenderness
• Tingling or burning sensation
• Blistering in severe cases

These symptoms typically appear within days to weeks after the initiation of chemotherapy and can vary in severity.

Causes

Chemotherapy-induced acral erythema is most commonly caused by the administration of certain chemotherapy agents, including:

• Capecitabine
• Doxorubicin
• Cytarabine
• Fluorouracil

The exact mechanism is not fully understood, but it is believed that these drugs cause damage to the small blood vessels in the hands and feet, leading to the characteristic symptoms.

Diagnosis

Diagnosis is primarily clinical, based on the appearance of the skin changes and the patient's history of chemotherapy. A dermatologist may be consulted for further evaluation.

Treatment

Management of chemotherapy-induced acral erythema includes:

• Dose reduction or discontinuation of the offending chemotherapy agent
• Topical corticosteroids to reduce inflammation
• Pain management with analgesics
• Cooling measures such as cold packs to alleviate symptoms
• Emollients to keep the skin moisturized

Prognosis

The prognosis for patients with chemotherapy-induced acral erythema is generally good. Symptoms usually resolve within a few weeks after the cessation of chemotherapy. However, in some cases, symptoms may persist or recur with subsequent chemotherapy cycles.

Prevention

Preventive measures include:

• Dose adjustment of chemotherapy drugs
• Use of cooling gloves and socks during chemotherapy administration
• Regular monitoring and early intervention at the first sign of symptoms

See Also

• Chemotherapy
• Dermatology
• Cutaneous conditions
• Cancer treatment