A Paclitaxel-Induced Variant of Hand-Foot Syndrome Affecting Dorsal Surfaces. Journal Article

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Authors: Zelman, B; Lee, K; Reserva, J; Speiser, J
Article Title: A Paclitaxel-Induced Variant of Hand-Foot Syndrome Affecting Dorsal Surfaces.
Abstract: Hand-foot syndrome (HFS), also known as palmar-plantar erythrodysesthesia (PPE), is a localized cutaneous adverse event (CAE) associated with a variety of chemotherapeutic agents, such as doxorubicin, fluorouracil, cytarabine, and docetaxel. HFS is characterized by painful erythema, edema, and desquamation of the skin, most prominently involving the hands and soles of the feet. However, HFS primarily affecting the dorsal hands and feet (also called periarticular thenar erythema and onycholysis or PATEO) is known to occur as a class-based effect with the taxane chemotherapeutic drug class. A 58-year-old African American female with breast cancer began to develop a pruritic bilateral dorsal hand eruption four weeks into a weekly regimen of paclitaxel. On exam, desquamative erythematous and violaceous plaques on the dorsal hands were noted, which were debilitatingly painful and necessitated treatment interruption. Histopathologic sections showed a focal interface dermatitis with keratinocyte apoptosis, dyskeratosis, and atypical mitoses with abnormal maturation. Clinicopathologic correlation strongly supported a diagnosis of taxane-induced HFS. Increased awareness of this HFS variant that preferentially affects dorsal acral sites may improve early identification and/or prevention of this cutaneous adverse reaction. This article is protected by copyright. All rights reserved.
Journal Title: Journal of cutaneous pathology
ISSN: 1600-0560; 0303-6987
Publisher: Unknown  
Date Published: 2021