Palmar plantar erythrodysesthesia primary prevention: Difference between revisions

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==Primary prevention==
==Primary prevention==
The cooling of hands and feet may help prevent PPE (Baack and Burgdorf, 1991; Zimmerman et al, 1995).


* Dr Kuznecovs with his colleagues came to the conclusion that atorvastatin and polyprenol combination can prevent PPE due to capecitabine. https://www.medscape.com/viewarticle/848530
* ·       A number of measures have been suggested to prevent, delay onset and/or decrease the severity of PPE: ·       General measures include<sup>4,7,99,102</sup>:  ·      Avoiding  excessive manual work and walking, to prevent excessive pressure or friction to the skin  ·       Wound care to prevent infection  ·       Limb elevation to reduce edema  ·       Cold compresses  ·       Avoiding extremes of temperature<sup>8</sup> ·       Analgesics  ·       Creams and emollients
* Application of ointment containing antioxidants with high radical protection factors can effectively prevent the development of PPE.<ref name="pmid23969763">{{cite journal| author=Lademann J, Martschick A, Kluschke F, Richter H, Fluhr JW, Patzelt A et al.| title=Efficient prevention strategy against the development of a palmar-plantar erythrodysesthesia during chemotherapy. | journal=Skin Pharmacol Physiol | year= 2014 | volume= 27 | issue= 2 | pages= 66-70 | pmid=23969763 | doi=10.1159/000351801 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23969763  }}</ref>
* In a randomized control trial in patients that were using pegylated liposomal doxorubicin, it was proven that reduction of dose intensity can effectively prevent PPE. When the dose of PLD is not in excess of 10mg/m(2) weekly, PPE can be easily managed. As the literature support is limited, panel of experts advise patient education and supportive measures for prevention and treatment of PPE.<ref name="pmid18331788">{{cite journal| author=von Moos R, Thuerlimann BJ, Aapro M, Rayson D, Harrold K, Sehouli J et al.| title=Pegylated liposomal doxorubicin-associated hand-foot syndrome: recommendations of an international panel of experts. | journal=Eur J Cancer | year= 2008 | volume= 44 | issue= 6 | pages= 781-90 | pmid=18331788 | doi=10.1016/j.ejca.2008.01.028 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18331788 }}</ref>
* In another study, a group of patients were given topical ointment with PLD and observed for the development of PPE. Among the patients, 60% regularly applied cream and effectively did not develop PPE. The rest of the 40% of patients interrupted their application of ointment, from which, six developed PPE and thereafter resumed the application of ointment. As a result of restarting application, palmar plantar erythrodysesthesia completely disappeared or was strongly reduced.<ref name="pmid239697632">{{cite journal| author=Lademann J, Martschick A, Kluschke F, Richter H, Fluhr JW, Patzelt A et al.| title=Efficient prevention strategy against the development of a palmar-plantar erythrodysesthesia during chemotherapy. | journal=Skin Pharmacol Physiol | year= 2014 | volume= 27 | issue= 2 | pages= 66-70 | pmid=23969763 | doi=10.1159/000351801 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23969763  }}</ref>


==References==
==References==

Revision as of 14:31, 28 June 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Primary prevention

  • ·       A number of measures have been suggested to prevent, delay onset and/or decrease the severity of PPE: ·       General measures include4,7,99,102: ·      Avoiding  excessive manual work and walking, to prevent excessive pressure or friction to the skin ·       Wound care to prevent infection ·       Limb elevation to reduce edema ·       Cold compresses ·       Avoiding extremes of temperature8 ·       Analgesics ·       Creams and emollients

References

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