Palmar plantar erythrodysesthesia differential diagnosis

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

Overview

PPE must be differentiated from Graft-Versus-Host Disease (GVHD).

Differentiating palmar plantar erythrodysesthesia from other Diseases

Disease	Clinical manifestation	Histopathology	Additional diagnostic clues
Palmar plantar erythrodysesthesia	The areas of well-defined intense erythema and edema	A variable degree of epidermal (keratinocytes) necrosis Vacuolar degeneration of the basal cell layer of epidermis Spongiosis Hyperkeratosis Lymphohistiocytic infiltrates Superficial perivascular infiltration of dermis by lymphocytes and eosinophils Papillary dermal edema Neutrophilic eccrine hidradenitis Eccrine squamous syringometaplasia, in severe PPE (WHO grades 3 and 4)	History of chemotherapeutic agent use
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