Clinical Medicine Reviews in Oncology

Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia, is a relatively frequent dermatologic toxic reaction associated with several chemotherapeutic drugs used in cancer treatment. The lesions are typically localised in the palmar and plantar surfaces of the hands and feet in patients who are taking oral capecitabine or other drugs as a cancer treatment. Usually, the hands are more commonly affected than the feet and might even be the only area affected in several patients. The syndrome is characterized by a tingling sensation and dysesthesia as the two first symptoms, which can progress to a burning pain, swelling and erythema with increased palmar and plantar temperature. Although it typically resolves in 1–2 weeks after stopping capecitabine, delay in its management progresses to blistering desquamation, ulceration, crusting and epidermal necrosis. In these cases, HFS would become an extremely painful and debilitating condition with secondary discomfort and significant impairment of function, leading to a deterioration in quality of life in these patients receiving capecitabine, which otherwise is very well-tolerated.