Palmar-Plantar Erythrodysesthesia: How to Relieve Symptoms During Therapy

Palmar-plantar erythrodysesthesia, also known as hand-foot syndrome, is a reaction caused by anticancer drugs. To date, it has been observed in patients undergoing chemotherapy as well as those on targeted therapies. [1]

After alopecia and mucositis, it is the most common dermatological adverse event during chemotherapy, with an incidence ranging from 3% to 64%. [2]

Certain chemotherapy drugs are more likely to cause this side effect, especially in patients who already have skin conditions on their hands and feet prior to treatment. [3]

Symptoms usually appear between the second and twelfth day after starting therapy. Initially, there is numbness and tingling in the hands and/or feet, which can progress within days to burning pain, erythema, and swelling. In more severe cases, blisters, peeling, and subsequent ulceration can develop.

Without proper treatment, it can cause serious skin lesions that lead to a deterioration in quality of life and, in some cases, the interruption of therapy. [4]

To prevent such interruptions, patients should be informed before starting treatment on how to recognize early symptoms and implement preventive measures to reduce skin friction on the palms and soles. [1]

The Italian Society of Dermatology (SIDeMAST) recommends several measures to reduce symptoms:

• Keep the skin clean to prevent possible infections;
• Regularly moisturize the skin with a hydrating cream, especially after washing;
• Wear comfortable shoes and avoid high heels;
• Protect hands with work gloves;
• Avoid activities that require significant hand effort (cleaning, hobbies, occasional work);
• Protect the skin from moisture by wearing white cotton gloves that absorb sweat;
• Wear cotton socks to absorb moisture and help prevent fungal infections and skin maceration;
• Avoid hot baths and use gloves and slippers to protect hands and feet from the cold;
• Care for skin wounds that may develop. [3]

To support patients’ skin during oncological treatment, Welcare’s research laboratories have developed the Jalosome line, which includes:

• Jalosome Soothing Gel, containing hyaluronic acid, to soothe the skin during treatment, creating the most favorable conditions for tissue repair, and reducing the intensity of localized pain.
• Jalosome Hydrating Cream, formulated with Aloe Barbadensis, vegetable oils, and panthenol (Vitamin B5), to continue skin care after therapy, reducing redness and burning at the end of the treatment cycle.

Thanks to its properties and active ingredients, the Jalosome line is a valid solution for treating lesions caused by palmar-plantar erythrodysesthesia and for maintaining the care of hands and feet even after completing therapy.

1.        Gialaim Purcino Dos Reis, F. C., Menêses, A. G., Mazoni, S. R., Pereira Silveira, R. C. C., Diniz Dos Reis, P. E., & Vasques, C. I. (2023). Topical interventions for preventing hand-foot syndrome resulting from antineoplastic therapy: A scoping review. Revista da Escola de Enfermagem da U S P, 57, e20220107. https://doi.org/10.1590/1980-220X-REEUSP-2023-0107en
2.        Braghiroli, C. S., Ieiri, R., Ocanha, J. P., Paschoalini, R. B., & Miot, H. A. (2017). Do you know this syndrome? Hand-foot syndrome. Anais brasileiros de dermatologia, 92(1), 131–133. https://doi.org/10.1590/abd1806-4841.20174602
3.        Sindrome mano piede e reazione cutanea mano-piede - blog dermatologico - Dermatologia - SIDeMaST
4.        Qiao, J., & Fang, H. (2012). Hand-foot syndrome related to chemotherapy. CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 184(15), E818. https://doi.org/10.1503/cmaj.111309