PALMAR-PLANTAR ERYTHRODYSESTHESIA

PALMAR-PLANTAR ERYTHRODYSESTHESIA

What is palmar-plantar erythrodysesthesia?

Palmar plantar erythrodysesthesia (PAHL-mahr PLANN-tahr uh-RITH-roe-DISS-ess-THEE-zhuh) is also called hand-foot syndrome or acral erythema (ACK-ruhl AIR-uh-THEE-muh). It is an unpleasant or painful feeling in the palms of the hands and the soles of the feet. Sometimes, these areas are tender or swollen and patients have tingling or burning feelings. The skin of the palms and soles often turns red or dark pink at the same time. Patients may also have skin ulcers, blisters, or sores on the palms and soles, especially if these areas are under pressure or carry lots of weight. In some cases, the skin peels off of the palms and soles. Symptoms are often more severe in the hands than the feet.

Why would I have palmar-plantar erythrodysesthesia?

Some chemotherapy drugs build up in the tissue of the feet and hands because these tissues have fewer sweat glands and thicker skin than the rest of the body. As the medication builds up, it causes tissue damage and bothersome symptoms. Symptoms are more likely to occur in patients who get higher doses of chemotherapy.

Chemotherapy drugs that often cause palmar-plantar erythrodysesthesia are bleomycin, capecitabine, cytarabine, cyclophosphamide, docetaxel, doxorubicin, liposomal doxorubicin, etoposide, fluorouracil, hydroxyurea, mercaptopurine, methotrexate, mitotane, and thiotepa.

Palmar-plantar erythrodysesthesia from chemotherapy is temporary. Symptoms may occur within several days of starting chemotherapy and usually go away within 2-4 weeks after finishing chemotherapy or lowering the chemotherapy dose.

When should I call my doctor?

Call your doctor if you are worried or have questions about palmar-plantar erythrodysesthesia.

Call your doctor at once if you have any of the following symptoms:

Pain or discomfort that keeps you from eating, dressing, or sleeping
Open wounds, ulcers or sores on the palms or soles

What can I do while I have palmar-plantar erythrodysesthesia?

Skin Care

Keep the skin of your hands and feet clean and dry.
Inspect your hands and feet for cuts, scrapes, or sores every day. Tell your doctor or nurse right away if you notice any injuries.
Use lotion or cream to keep the skin of your hands and feet moisturized and free of cracks.
Wear gloves while cleaning if you use strong detergents or cleaning products since these things can dry out your skin.
Wear padded gloves when you reach into the oven or pick up hot pots and pans. Be careful not to burn yourself when cooking or ironing. Wear heavy work gloves when you dig in the garden or work around thorny plants.
Wear slippers or shoes with closed-toes, even around the house.
Keep your fingernails and cuticles trimmed and clean to avoid snags, hangnails, or scratches.
Be careful not to cut yourself when using knives, nail clippers, scissors, or tools.
Use cool or tepid water when bathing or showering. Bathing with hot water may dry out your skin.

Supportive Care

Apply cold, wet compresses to the affected areas several times a day.
Use pillows, armrests, or cushions to raise the affected areas above your heart as much as possible. Place cushions or pillows under your mattress to raise the affected area while you are sleeping.
Wear soft, loose clothing to reduce skin irritation. Wear shoes that are comfortable and well-ventilated.

What things should I AVOID while I have palmar-plantar erythrodysesthesia?

AVOID picking at sores, peeling off the skin, or breaking blisters on the affected areas. The skin could become infected and heal more slowly.
AVOID getting cuts or scrapes on your hands and feet.
AVOID drinking large amounts of alcoholic beverages, like beer, wine, or hard liquor. Alcohol can make you clumsy and you may hurt yourself.
AVOID contact sports or other activities where you could get hit or fall.
AVOID wearing tight or binding clothing, since your skin may get irritated more easily. This includes undergarments, like bras, girdles, or stockings.
AVOID putting pressure on the skin of your arms and legs. This includes kneeling, leaning on your elbows, or wearing tight jewelry.
AVOID putting tape, adhesive, or glue on your skin.
AVOID putting your hands and feet in hot water while bathing, washing dishes, or washing clothes.
AVOID very warm or hot places, including saunas, the outdoors, or near sunny windows.

What should I know about medicine for palmar-plantar erythrodysesthesia?

Medicine for palmar-plantar erythrodysesthesia is used to control symptoms and relieve pain. These medicines can be swallowed by mouth. Ask your doctor or pharmacist which type of medicine you need.

Take the dose of medicine your doctor prescribes. Ask your doctor, nurse or pharmacist before changing your dose if you need more or less medicine.

These patient information materials should be used in conjunction with verbal counseling. They are not intended as the sole source of information patients receive about managing cancer therapy complications.