Hand-foot syndrome and hand-foot skin reaction
Redness, peeling, pain and cracking of the palms and soles caused by certain chemotherapy pills and by kinase inhibitors that block blood vessel growth. Rarely dangerous but can stop patients walking or using their hands.
Hand-foot syndrome from capecitabine, 5-FU infusion and liposomal doxorubicin is a diffuse painful erythema; hand-foot skin reaction from VEGFR multikinase inhibitors (sorafenib, regorafenib, cabozantinib, lenvatinib) is more localised hyperkeratotic callus over pressure points. Both are dose-dependent, managed by dose interruption and reduction, urea creams, and avoiding friction and heat; celecoxib and pyridoxine have weak evidence. It is one of the most common reasons for dose reduction of oral therapies and a leading contributor to quality-of-life loss on long-term TKIs.
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