Palmar plantar erythrodysesthesia overview
|
Palmar plantar erythrodysesthesia Microchapters |
|
Differentiating Palmar plantar erythrodysesthesia from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Palmar plantar erythrodysesthesia overview On the Web |
|
American Roentgen Ray Society Images of Palmar plantar erythrodysesthesia overview |
|
Directions to Hospitals Treating Palmar plantar erythrodysesthesia |
|
Risk calculators and risk factors for Palmar plantar erythrodysesthesia overview |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Historical Perspective
In 1974, Zuehlke was the first to describe PPE in a patient receiving mitotane for hypernephroma.
Classification
A number of different classifications have been used for grading the severity of Palmar plantar erythrodysesthesia. The classifications suggested by the National Cancer Institute (NCI), and the World Health Organization are the two most commonly used.
Pathophysiology
The exact pathogenesis of palmar plantar erythrodysesthesia is not completely understood. It is thought that PPE is caused by direct toxic effect of the chemotherapeutic drugs against keratinocytes, excretion of the drugs in eccrine sweat glands, or type I allergic reaction. Unique characteristics of the palms and soles that justify their involvement in PPE. The pathological features of PPE are non-specific. However, since PPE involves a cytotoxic reaction primarily affecting keratinocytes the histopathologic findings are similar to histologic manifestation of direct toxic reactions.
Causes
Several different Chemotherapeutic agents have been associated with PPE. Most frequently associated drugs include cytarabine, docetaxel, doxorubicin, liposomal-encapsulated doxorubicin, 5-fluorouracil, and capecitabine.
Differentiating Palmar plantar erythrodysesthesia from Other Diseases
PPE must be differentiated from Graft-Versus-Host Disease (GVHD).
Epidemiology and Demographics
Estimated incidence of PPE is 6 to 64% of patients treated with chemotherapeutic drugs. However, the exact incidence of PPE is unknown, as most reports are isolated case reports or short case series.
Risk Factors
The most common and established risk factors are chemotherapeutic agents. The severity of the condition depends on the dose and frequency of the agent.
Screening
Natural History, Complications, and Prognosis
Prognosis is generally good and symptoms usually resolve within 1-2 weeks after stopping the causative chemotherapeutic agent.If left untreated, PPE can progress rapidly. PPE is not life threatening, but it can be very debilitating and impair quality of life.