Chemotherapy-induced palmar-plantar erythrodysesthesia syndrome: etiology and emerging therapies

Palmar-plantar erythrodysesthesia, or hand-foot syndrome (HFS), is emerging as a common, dose-dependent toxicity of many newer chemotherapy drugs. Frequently, HFS is a dose-limiting toxicity requiring discontinuation of treatment, chemotherapy dose reductions, or delays. The spectrum of symptoms of HFS can be mild, with erythema of the distal extremities, or it can be severe enough to interfere with activities of daily living. Although the exact mechanism is unknown, there are several approaches to ameliorating the symptoms of this complication. These include antiinflammatory agents, vitamin products, and peripheral vasoconstricting agents.