Acral erythema is also known as palmoplantar erythrodysesthesia or hand-foot syndrome. It manifests as painful erythema (redness of the skin) of the palms and soles, with or without bullae (large blisters). These symptoms can be preceded by dysaesthesia (altered sensation of the skin). The pain from this rash may be so severe that daily activities are limited.
If recognised early, the usual course of acral erythema is desquamation (shedding of the outer layers of the skin) followed by re-epithelialization (re-growth of the outer layers of the skin).
The exact mechanism is unknown, but it is postulated that the skin of the hands and feet favour a higher level of certain chemotherapy drugs which causes direct toxicity to the skin cells.
The most associated drugs include:
Cytarabine
Docetaxel
Doxorubicin
Fluorouracil
Cyclophosphamide
Daunorubicin
Vincristine
Vinblastin
Etoposide
Mecaptopurine
Methotrexat