Hand-and-foot syndrome

Hand-and-foot syndrome (HFS): Description, Causes and Risk Factors: Alternative Name: Hand-Foot syndrome, palmar-plantar erythrodysesthesia, and sickle cell dactylitis. Abbreviation: HFS. Hand-and-foot syndromeHand-and-foot syndrome is a side effect of some chemotherapy drugs. Hand-and-foot syndrome first appears as a slight tingling, burning or itching of the palms of the hands and/or soles of the feet. If it gets worse, the palms or soles may become reddened or mottled in appearance, and may become swollen and painful with blistering and peeling of the skin. In some cases, other areas of the body many be affected, such as the elbows, armpits, groins and other areas where friction or heat may occur. Grades: Grade 1: No symptoms or only slight dysaesthesia, with mild redness.
  • Grade 2: Dysaesthesia but no pain, severe redness and/or swelling.
  • Grade 3: Dysaesthesia with pain, severe redness and/or swelling.
  • Grade 4: Pain and impaired function in the activities of daily living, desquamation, blistering and ulceration.
HFS occurs when small amounts of medication leak outside of the capillaries and cause damage to exposed tissue. Most people who have HFS develop mild effects, but some can suffer severe effects, making daily living activities nearly impossible. Hand-and-foot syndrome is may be associated with the drug such as Xeloda (capecitabine), 5-FU (fluorouracil), Cytosar-U (cytarabine), Adriamycin (doxorubicin), continuous infusion, FUDR (floxuridine), Doxil (liposomal doxorubicin), Idamycin (idarubicin), Nexavar (Sorafenib), Sutent (Sunitinib). Symptoms of hand-foot syndrome usually do not occur until after you have received several weeks of therapy, but they may occur sooner. Friction, pressure and heat to the hands and feet increase the possibility of this side effect. Symptoms: In mild to moderate Hand-and-foot syndrome, the following symptoms may occur on the palms and/or soles: Redness (similar to a sunburn). Symptoms of severe hand-foot syndrome include the following: Cracked, flaking, or peeling skin.
  • Blisters, ulcers, or sores on the skin.
  • Severe pain.
  • Difficulty walking or using the hands.
Diagnosis: The diagnosis is usually made clinically. However if a skin biopsy is taken it may show a variable degree of scattered individual skin cell death, inflammation at the junction of the epidermis and dermis and opening up of blood vessels. Treatment: If you develop severe hand-foot syndrome, your doctor may reduce your chemotherapy dose or alter your chemotherapy schedule. If necessary, your doctor may temporarily stop your chemotherapy until your symptoms improve. The following medications may be used to treat hand-foot syndrome: Oral or topical (applied to the skin) corticosteroids to reduce inflammation.
  • Topical dimethyl sulfoxide to help reduce leakage of chemotherapy from the capillaries.
  • Vitamin B6 (pyridoxine) to help reduce symptoms.
  • Over-the-counter pain relievers, such as acetaminophen (Tylenol), to help relieve pain.
Preventive Measures May Include: Limit exposure of hands and feet to hot water when washing dishes or bathing.
  • Take cool showers or baths.
  • Avoid exposure to sources of heat, including saunas, sitting in the sun, or sitting in front of a sunny window.
  • Avoid activities that cause unnecessary force or friction on the feet, such as jogging, aerobics, and long walks.
  • Avoid contact with harsh chemicals used in laundry detergents or household cleaning products.
  • Avoid the use of rubber gloves to clean with hot water, as rubber traps heat against your skin.
  • Avoid using tools or household items that require you to press your hand against a hard surface, such as garden tools, knives, and screwdrivers.
  • Cool your hands and feet with ice packs or cool compresses (wet towel) for 15 to 20 minutes at a time. (Avoid applying ice directly to the skin).
  • Elevate your hands and feet when sitting or lying down.
  • Carefully pat your skin dry after washing or bathing — try not to rub your skin with a towel.
  • Gently apply mild skin care creams to keep your hands moist. Avoid rubbing or massaging lotion into your hands and feet, as this creates friction.
  • Wear loose, well-ventilated (air moves through easily) shoes and clothes.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Reference and Source are from: DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.


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