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Hand and Foot Syndrome (HFSR): Palm-plantar bluntness or acral erythema caused by chemotherapy, is a skin toxicity (median appearance time is 79 days, ranging from 11 to 360 days), mainly occurs in the compressed area . Cancer patients may appear during chemotherapy or molecular targeted therapy. HFSR is characterized by numbness, dullness, paresthesia, tingling sensation, no pain or pain, swelling or erythema of the skin, desquamation, palate, indurated blisters, or severe pain.

Hand-foot syndrome

It is palm-foot bluntness or erythema caused by chemotherapy. It is a kind of skin toxicity, which mainly occurs in the compressed area. Cancer patients may appear during chemotherapy or molecular targeted therapy. Features are numbness, dullness, paresthesia, tingling sensation, no pain or pain, swelling or erythema of the skin, scaling, chapped, indurated blisters, or severe pain.

Hand and Foot Syndrome

Hand and Foot Syndrome (HFSR): Palm-plantar bluntness or acral erythema caused by chemotherapy, is a skin toxicity (median appearance time is 79 days, ranging from 11 to 360 days), mainly occurs in the compressed area . Cancer patients may appear during chemotherapy or molecular targeted therapy. HFSR is characterized by numbness, dullness, paresthesia, tingling sensation, no pain or pain, swelling or erythema of the skin, desquamation, palate, indurated blisters, or severe pain.

Hand-foot syndrome classification

Level 1: It is characterized by any of the following phenomena: numbness of the hands and / or feet / bluntness / paresthesia, painless swelling or erythema, and / or discomfort that does not affect normal activity.

Grade 2: Painful erythema and swelling of the hands and / or feet and / or discomfort affecting the patient's daily activities.

Level 3: Wet desquamation of hands and / or feet, ulcers, blisters or severe pain and / or severe discomfort that prevents the patient from working or performing daily activities. Strong pain, loss of skin function, is relatively rare.

Hand and foot syndrome prevention and treatment

Clinical statistics show that most patients have only first-level symptoms, some patients have second-level symptoms, and very few patients have third-level symptoms. The occurrence of hand-foot syndrome is not terrible, as long as the following points are achieved, it can be prevented and controlled:

1. Try to avoid friction between hands and feet and contact with high-temperature items in daily life. For example, patients should not wear tight and incompatible shoes, avoid friction and pressure on hands and feet, avoid intense exercise and physical labor, and reduce The number of times the hands and feet are exposed to hot water, including dishwashing and hot baths, and wearing dishwashing gloves will not reduce injuries, as rubber stores heat and damages the skin of the palms.

2. Use shock-absorbing insoles, wear slippers at home, and place hands and feet higher when sitting or lying down to prevent hand-foot syndrome.

3. Oral use of vitamin B6 and celecoxib under the guidance of a doctor.

4. Keeping the skin of hands and feet moist can help prevent and heal the lesions as soon as possible. Soak your hands and feet with warm water for 10 minutes, wipe them dry, and then apply skin cream, such as Vaseline ointment. This will effectively adsorb moisture to the skin.

5. Avoid exposure to sunlight. When hand-foot syndrome occurs, you should wear sunscreen with a sun protection index of at least 30 when going out. You can only bask in the sun behind a window in the winter.

6. Avoid eating spicy and irritating food.

7. Applying sheep's oil-containing cream on hands and feet can reduce skin desquamation, ulcers, and pain.

8. If necessary, use antifungal or antibiotic treatment under the guidance of a doctor.

9. If blister appears, ask medical staff to deal with it. Do not tear by hand when peeling occurs, you can use sterilized scissors to cut off the lifted part.

Patients with Grade 1 HFSR can continue to use the original dose while taking the above measures. Grade 2-3 HFSR needs to be discontinued and consult a doctor, and then return to the original dose after the toxic response has decreased to grade 1 or returned to normal.

Examples of hand-foot syndrome

Chemotherapy drugs: Xeloda and others. Xeloda (Capecitabine Tablets) is a new generation of oral pyrimidine drugs, mainly for the treatment of advanced breast cancer and colorectal cancer, with positive effects, mild bone marrow toxicity, and well tolerated patients, but also has hand and foot syndrome. And other adverse reactions, the incidence of more than 50%, affecting the treatment of some patients. However, from the current clinical point of view, among patients with cancer, patients with hand-foot skin reactions are better afterwards. The key is to deal with this situation.

Molecular targeted therapy drugs: Molecular targeted drugs targeting VEGF are more common adverse reactions, such as sunitinib, sorafenib and so on. HFSR usually occurs at the beginning of treatment, and is usually the most serious at 2 weeks after treatment. After that, it will gradually decrease. Pain will generally be significantly reduced or even disappeared after treatment to 6-7 weeks. With the extension of treatment time, HFSR The incidence has also decreased. The results of the phase III clinical study showed that the incidence of HFSR in sunitinib and sorafenib was 20% and 30%, respectively.