Palmar plantar erythrodysesthesia history and symptoms: Difference between revisions

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{{Palmar plantar erythrodysesthesia}}
{{Palmar plantar erythrodysesthesia}}
{{CMG}}
{{CMG}}; {{AE}} {{MC}}
==Overview==
==Overview==
'''Palmar plantar erythrodysesthesia''' (PPE) is a swelling and numbness of the hands and feet that occurs with [[chemotherapy]], usually with [[fluorouracil]], [[capecitabine]], [[cytarabine]], and [[doxorubicin]].
The most common symptoms of PPE include [[tingling]], burning [[pain]], [[edema]], and [[erythema]]. Less common symptoms of PPE include [[sensory]] [[impairment]], [[paresthesia]], and [[pruritus]].
==History and symptoms==
The symptoms can occur anywhere between days to months after administration of the offending medication, depending on the dose and speed of administration (Baack and Burgdorf, 1991; Demirçay, 1997;). The patient first experiences tingling and/or numbness of the palms and soles that evolves into painful, symmetric, and well-demarcated swelling and red plaques. This is followed by peeling of the skin and resolution of the symptoms (Apisarnthanarax and Duvic 2003). Painful red swelling of the hands and feet in a patient receiving chemotherapy is usually enough to make the diagnosis.


==History and Symptoms==
===History===
[[Patients]] with PPE have a positive history of treatment with [[chemotherapeutic agents]].
=== Common Symptoms ===
The most common [[symptoms]] of PPE include:
* A [[prodrome]] of [[dysesthesia]], usually as a [[tingling]] [[sensation]] in the [[Finger|fingers]], [[Palms of the hands|palms]] and/or [[soles]], progressing to a burning pain in a few days
* A well-defined [[edema]] and symmetrical [[erythema]], more prominently over the [[Fat pad|fat pads]] of the [[distal]] [[phalanges]]
* Extension to the [[dorsal]] [[Surface area|surfaces]] of the [[extremities]], or over [[joint]] [[Surface area|surfaces]] can occur <ref name="pmid2061446">{{cite journal| author=Baack BR, Burgdorf WH| title=Chemotherapy-induced acral erythema. | journal=J Am Acad Dermatol | year= 1991 | volume= 24 | issue= 3 | pages= 457-61 | pmid=2061446 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2061446  }} </ref>
* Periungual [[skin]] involvement is also possible
* The [[Palms of the hands|palms]] of the hands are usually more frequently and more severely affected than the [[soles]] of the feet, and may be only are affected.<ref name="pmid2061446">{{cite journal| author=Baack BR, Burgdorf WH| title=Chemotherapy-induced acral erythema. | journal=J Am Acad Dermatol | year= 1991 | volume= 24 | issue= 3 | pages= 457-61 | pmid=2061446 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2061446  }} </ref> <ref name="pmid15341880">{{cite journal| author=Lassere Y, Hoff P| title=Management of hand-foot syndrome in patients treated with capecitabine (Xeloda). | journal=Eur J Oncol Nurs | year= 2004 | volume= 8 Suppl 1 | issue=  | pages= S31-40 | pmid=15341880 | doi=10.1016/j.ejon.2004.06.007 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15341880  }} </ref>
=== Less Common Symptoms ===
Less common [[symptoms]] include: <ref name="pmid11034047">{{cite journal| author=Hui YF, Cortes JE| title=Palmar-plantar erythrodysesthesia syndrome associated with liposomal daunorubicin. | journal=Pharmacotherapy | year= 2000 | volume= 20 | issue= 10 | pages= 1221-3 | pmid=11034047 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11034047  }} </ref> <ref name="urlwww.oncologynurseadvisor.com">{{cite web |url=https://www.oncologynurseadvisor.com/home/departments/ce-courses/prevention-and-management-of-hand-foot-syndromes/ |title=www.oncologynurseadvisor.com |format= |work= |accessdate=}}</ref>
*[[Sensory]] [[impairment]]
*[[Paresthesia]]
*[[Pruritus]]
* A [[bullous]] variant (a severe form of this entity) specifically occurs with [[cytarabine]] or [[methotrexate]].<ref name="pmid8624164">{{cite journal| author=Hellier I, Bessis D, Sotto A, Margueritte G, Guilhou JJ| title=High-dose methotrexate-induced bullous variant of acral erythema. | journal=Arch Dermatol | year= 1996 | volume= 132 | issue= 5 | pages= 590-1 | pmid=8624164 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8624164  }} </ref><ref name="pmid8420487">{{cite journal| author=Waltzer JF, Flowers FP| title=Bullous variant of chemotherapy-induced acral erythema. | journal=Arch Dermatol | year= 1993 | volume= 129 | issue= 1 | pages= 43-5 | pmid=8420487 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8420487  }} </ref>
Involvement of other parts of the body is rare, even though mild [[erythema]] or morbilliform [[Lesion|lesions]] might occasionally be seen on the [[trunk]], [[neck]], [[chest]], [[scalp]] and [[extremities]]. <ref name="pmid2061446">{{cite journal| author=Baack BR, Burgdorf WH| title=Chemotherapy-induced acral erythema. | journal=J Am Acad Dermatol | year= 1991 | volume= 24 | issue= 3 | pages= 457-61 | pmid=2061446 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2061446  }} </ref> <ref name="pmid2528937">{{cite journal| author=Kroll SS, Koller CA, Kaled S, Dreizen S| title=Chemotherapy-induced acral erythema: desquamating lesions involving the hands and feet. | journal=Ann Plast Surg | year= 1989 | volume= 23 | issue= 3 | pages= 263-5 | pmid=2528937 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2528937  }} </ref>
==References==
==References==
{{reflist|3}}
{{reflist|2}}

Latest revision as of 18:50, 16 July 2019

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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

The most common symptoms of PPE include tingling, burning pain, edema, and erythema. Less common symptoms of PPE include sensory impairment, paresthesia, and pruritus.

History and Symptoms

History

Patients with PPE have a positive history of treatment with chemotherapeutic agents.

Common Symptoms

The most common symptoms of PPE include:

  • Periungual skin involvement is also possible
  • The palms of the hands are usually more frequently and more severely affected than the soles of the feet, and may be only are affected.[1] [2]

Less Common Symptoms

Less common symptoms include: [3] [4]

Involvement of other parts of the body is rare, even though mild erythema or morbilliform lesions might occasionally be seen on the trunk, neck, chest, scalp and extremities. [1] [7]

References

  1. ↑ 1.0 1.1 1.2 Baack BR, Burgdorf WH (1991). "Chemotherapy-induced acral erythema". J Am Acad Dermatol. 24 (3): 457–61. PMID 2061446.
  2. ↑ Lassere Y, Hoff P (2004). "Management of hand-foot syndrome in patients treated with capecitabine (Xeloda)". Eur J Oncol Nurs. 8 Suppl 1: S31–40. doi:10.1016/j.ejon.2004.06.007. PMID 15341880.
  3. ↑ Hui YF, Cortes JE (2000). "Palmar-plantar erythrodysesthesia syndrome associated with liposomal daunorubicin". Pharmacotherapy. 20 (10): 1221–3. PMID 11034047.
  4. ↑ "www.oncologynurseadvisor.com".
  5. ↑ Hellier I, Bessis D, Sotto A, Margueritte G, Guilhou JJ (1996). "High-dose methotrexate-induced bullous variant of acral erythema". Arch Dermatol. 132 (5): 590–1. PMID 8624164.
  6. ↑ Waltzer JF, Flowers FP (1993). "Bullous variant of chemotherapy-induced acral erythema". Arch Dermatol. 129 (1): 43–5. PMID 8420487.
  7. ↑ Kroll SS, Koller CA, Kaled S, Dreizen S (1989). "Chemotherapy-induced acral erythema: desquamating lesions involving the hands and feet". Ann Plast Surg. 23 (3): 263–5. PMID 2528937.
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