Palmar plantar erythrodysesthesia medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mandana Chitsazan, M.D. [2]

Overview

Dose reduction, lengthening the interval between dose administration, and ultimately drug withdrawal are most effective strategies. Specific treatments include cooling the extremities during drug administration, vitamin B6, topical and oral corticosteroids, and topical 99% dimethyl-sulfoxide.

Medical Therapy

  • Dose reduction, lengthening the interval between drug administration, and ultimately drug withdrawal, if necessary, appear to be the most effective strategies.[1] [2] [3] [4][5] [6]
  • These strategies do not seem to affect the effectiveness of capecitabine, however, for other drug regimens this might affect efficacy. [7] [8][5] [9] [10]
  • Specific treatments include:
    • Cooling the extremities during drug administration (docetaxel, liposome encapsulated doxorubicin) [11] [12] [13] [14]
    • Potent topical corticosteroids (liposome encapsulated doxorubicin, fluorouracil, cisplatin, and docetaxel): the best results have been demonstrated when used in conjunction with cold compresses and emollients. [4], [26] [27] [17]
    • Oral corticosteroids (cytarabine , doxorubicin, fluorouracil , liposome encapsulated doxorubicin , bleomycin, methotrexate, and vinorelbine). [28] [29] [30] [31] [32]
    • Topical 99% dimethyl-sulfoxide: 4 times daily for 14 days (liposome encapsulated doxorubicin) [33]

References

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  2. Abushullaih S, Saad ED, Munsell M, Hoff PM (2002). "Incidence and severity of hand-foot syndrome in colorectal cancer patients treated with capecitabine: a single-institution experience". Cancer Invest. 20 (1): 3–10. PMID 11853000.
  3. Hansen RM, Quebbeman EJ, Ritch PS, Frick J, Anderson T (1987). "Continuous 5-fluorouracil infusion and pulse methotrexate/leucovorin for colorectal adenocarcinoma. A report of excessive toxicity". Am J Clin Oncol. 10 (3): 216–8. PMID 3496002.
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  11. Molpus KL, Anderson LB, Craig CL, Puleo JG (2004). "The effect of regional cooling on toxicity associated with intravenous infusion of pegylated liposomal doxorubicin in recurrent ovarian carcinoma". Gynecol Oncol. 93 (2): 513–6. doi:10.1016/j.ygyno.2004.02.019. PMID 15099971.
  12. Mangili G, Petrone M, Gentile C, De Marzi P, Viganò R, Rabaiotti E (2008). "Prevention strategies in palmar-plantar erythrodysesthesia onset: the role of regional cooling". Gynecol Oncol. 108 (2): 332–5. doi:10.1016/j.ygyno.2007.10.021. PMID 18083217.
  13. Zimmerman GC, Keeling JH, Burris HA, Cook G, Irvin R, Kuhn J; et al. (1995). "Acute cutaneous reactions to docetaxel, a new chemotherapeutic agent". Arch Dermatol. 131 (2): 202–6. PMID 7857119.
  14. Zimmerman GC, Keeling JH, Lowry M, Medina J, Von Hoff DD, Burris HA (1994). "Prevention of docetaxel-induced erythrodysesthesia with local hypothermia". J Natl Cancer Inst. 86 (7): 557–8. doi:10.1093/jnci/86.7.557. PMID 7907667.
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  18. Vukelja SJ, Baker WJ, Burris HA, Keeling JH, Von Hoff D (1993). "Pyridoxine therapy for palmar-plantar erythrodysesthesia associated with taxotere". J Natl Cancer Inst. 85 (17): 1432–3. doi:10.1093/jnci/85.17.1432. PMID 8102408.
  19. Hui YF, Giles FJ, Cortes JE (2002). "Chemotherapy-induced palmar-plantar erythrodysesthesia syndrome--recall following different chemotherapy agents". Invest New Drugs. 20 (1): 49–53. PMID 12003194.
  20. Fabian CJ, Molina R, Slavik M, Dahlberg S, Giri S, Stephens R (1990). "Pyridoxine therapy for palmar-plantar erythrodysesthesia associated with continuous 5-fluorouracil infusion". Invest New Drugs. 8 (1): 57–63. PMID 2345070.
  21. Banfield GK, Crate ID, Griffiths CL (1995). "Long-term sequelae of Palmar-Plantar erythrodysaesthesia syndrome secondary to 5-fluorouracil therapy". J R Soc Med. 88 (6): 356P–357P. PMC 1295248. PMID 7629773.
  22. Mortimer JE, Anderson I (1990). "Weekly fluorouracil and high-dose leucovorin: efficacy and treatment of cutaneous toxicity". Cancer Chemother Pharmacol. 26 (6): 449–52. PMID 2225317.
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  24. Hui YF, Cortes JE (2000). "Palmar-plantar erythrodysesthesia syndrome associated with liposomal daunorubicin". Pharmacotherapy. 20 (10): 1221–3. PMID 11034047.
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  26. Katoh M, Kadota M, Nishimura Y (2004). "A case of docetaxel-induced erythrodysesthesia". J Dermatol. 31 (5): 403–6. PMID 15187308.
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  32. Tsuboi H, Yonemoto K, Katsuoka K (2005). "A case of bleomycin-induced acral erythema (AE) with eccrine squamous syringometaplasia (ESS) and summary of reports of AE with ESS in the literature". J Dermatol. 32 (11): 921–5. PMID 16361756.
  33. Lopez AM, Wallace L, Dorr RT, Koff M, Hersh EM, Alberts DS (1999). "Topical DMSO treatment for pegylated liposomal doxorubicin-induced palmar-plantar erythrodysesthesia". Cancer Chemother Pharmacol. 44 (4): 303–6. doi:10.1007/s002800050981. PMID 10447577.