Overcoming severe hand and foot syndrome: presentation of a clinical observation

Palmar-plantar syndrome (LPS, palmar-plantar erythrodysesthesia) is a toxic reaction with an isolated lesion of the skin of the palms and soles that occurs as a result of the use of cytostatics. Due to the lack of a single universal approach to prevention and treatment, this manifestation of chemotherapy toxicity remains one of the variants of adverse reactions and complications that pose a major problem for clinical oncology,In the present case study, a patient undergoing first-line treatment of colorectal cancer under the XELOX regimen with capecitabine developed severe toxicity in the form of a grade 4 palmar dermal syndrome. According to the instructions for use of capecitabine, this degree of toxicity requires temporary discontinuation of the drug, which leads to non-compliance with the timing and intervals of treatment, which, in turn, is reflected in the reduction of effectiveness up to the progression of the disease. This case demonstrated that replacing one fluoropyrimidine drug with another, a tablet form of capecitabine with an infusion form of 5-fluorouracil, did not decrease the effectiveness of treatment, but contributed to the relief of hand-foot syndrome.