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 the most effective strategies. Specific treatment strategies include cooling the extremities during drug administration, vitamin B6, topical and oral corticosteroids, and topical 99% dimethyl sulfoxide.

Medical Therapy

Treatment Strategy Causative Medication(s)
Cooling the extremities during drug administration[11] [12] [13] [14]
Pyridoxine (vitamin B6)[15] [16] [17] [18] [19] [20] [21] [22] [15] [23] [24] [4] [25]
Potent topical corticosteroids[4] [26] [27] [17]

(The best results have been demonstrated when used in conjunction with cold compressesion and emollients)

Oral corticosteroids[28] [29] [30] [31] [32]
Topical 99% dimethyl sulfoxide

References

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  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.
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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.