Palmar plantar erythrodysesthesia pathophysiology

Palmar plantar erythrodysesthesia Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

The exact pathogenesis of [disease name] is not fully understood.

OR

It is thought that [disease name] is the result of / is mediated by / is produced by / is caused by either [hypothesis 1], [hypothesis 2], or [hypothesis 3].

OR

[Pathogen name] is usually transmitted via the [transmission route] route to the human host.

OR

Following transmission/ingestion, the [pathogen] uses the [entry site] to invade the [cell name] cell.

OR

[Disease or malignancy name] arises from [cell name]s, which are [cell type] cells that are normally involved in [function of cells].

OR

The progression to [disease name] usually involves the [molecular pathway].

OR

The pathophysiology of [disease/malignancy] depends on the histological subtype.

Pathophysiology

The exact pathogenesis of palmar plantar dysesthesia is not completely understood. Suggested explanations include:

• Direct toxic effect of the chemotherapeutic drug against epidermal cells (keratinocytes)

• Concentration and excretion of cytotoxic drug in eccrine sweat glands causing damage or alteration in these structures

• A type I (immunoglobulin E [IgE]-mediated) allergic reaction , suggested based on the occasional co-occurrence of facial erythema/edema, papular rash, and fever.

Unique characteristics of the palms and the soles which justify their involvement as the preferred sites of involvement include

·       High density of eccrine sweat glands⁹

·       Absence of folliculosebaceous units (hair follicles and sebaceous glands)⁹

·       Thick stratum corneum⁹

·       Wide dermal papillae⁹

·       High proliferative rate of epidermal basal cells

·       The temperature and pressure gradient

·       Gravitation forces

·       Vascular anatomy peculiar to these areas

·       In cases caused by capecitabine, higher expression of the capecitabine-activating enzyme thymidine phosphorylase in the skin of the palms¹⁰

Associated Conditions

Conditions associated with [disease name] include:

• [Condition 1]
• [Condition 2]
• [Condition 3]

Gross Pathology

On gross pathology, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].

Microscopic Pathology

On microscopic histopathological analysis, [feature1], [feature2], and [feature3] are characteristic findings of [disease name].