Palmar plantar erythrodysesthesia epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Palmar Plantar Erythrodysesthesia or Hand-Foot syndrome is a skin-related reaction involving the palms an soles. It commonly occurs due to a reaction to different kinds of chemotherapeutic agent used to treat cancer. The first s. PPE may be classified into grade1, grade 2, grade 3, or grade 4 depending on toxicity rating. The pathophysiologic mechanism of Palmar Plantar Erythrodysesthesia is under active investigation and different mechanisms have been postulated. Histologic biopsy is consistent with toxic reaction[1]. After extensive studies, it has been determined that Pegylated Liposomal doxorubicin deposits into the eccrine glands which is concentrated in the palms and soles which then causes a drug reaction and development of PPE.[2] Several Different types of Chemotherapeutic agents have been associated with the development of Palmar Plantar Erythrodysesthesia. PPE must be differentiated from Acute Graft Versus Host Response, Tinea manuum and Hand-Foot reaction due to tyrosine kinase inhibitor.
Epidemiology and demographics
PPE occurs in 6-42% of patients receiving chemotherapy.
Several authors have reported that the incidence of PLD-associated hand and foot syndrome for patients with any grade of PPE is about 50% and for patients with grade 3 and grade 4 PPE the incidence is about 20% [3], [4], for a PLD dose of 50 mg/m2 every 4 weeks. According to evidence, it has been determined that a dose of 40 mg/m2 every 4 weeks is at present considered equally effective and less toxic. This dose has become the preferred dosage[5].
References
- ↑ Baack BR, Burgdorf WH (1991). "Chemotherapy-induced acral erythema". J Am Acad Dermatol. 24 (3): 457–61. PMID 2061446.
- ↑ Lademann J, Martschick A, Kluschke F, Richter H, Fluhr JW, Patzelt A; et al. (2014). "Efficient prevention strategy against the development of a palmar-plantar erythrodysesthesia during chemotherapy". Skin Pharmacol Physiol. 27 (2): 66–70. doi:10.1159/000351801. PMID 23969763.
- ↑ O'Brien ME, Wigler N, Inbar M, Rosso R, Grischke E, Santoro A; et al. (2004). "Reduced cardiotoxicity and comparable efficacy in a phase III trial of pegylated liposomal doxorubicin HCl (CAELYX/Doxil) versus conventional doxorubicin for first-line treatment of metastatic breast cancer". Ann Oncol. 15 (3): 440–9. PMID 14998846.
- ↑ Gordon AN, Fleagle JT, Guthrie D, Parkin DE, Gore ME, Lacave AJ (2001). "Recurrent epithelial ovarian carcinoma: a randomized phase III study of pegylated liposomal doxorubicin versus topotecan". J Clin Oncol. 19 (14): 3312–22. doi:10.1200/JCO.2001.19.14.3312. PMID 11454878.
- ↑ Lorusso D, Di Stefano A, Carone V, Fagotti A, Pisconti S, Scambia G (2007). "Pegylated liposomal doxorubicin-related palmar-plantar erythrodysesthesia ('hand-foot' syndrome)". Ann Oncol. 18 (7): 1159–64. doi:10.1093/annonc/mdl477. PMID 17229768.