Docetaxel-induced Hand and Foot Syndrome in a Patient with Metastatic Breast Carcinoma
A 52-yr-old female patient with metastatic breast carcinoma was referred with painful red skin lesions and tingling sensation over the palms and soles for four days duration. She presented with extensive metastasis over the liver and lungs. After surgical removal of the tumor by modified radical mastectomy, the patient received salvage chemotherapy using docetaxel regimen. She successfully completed two cycles of weekly chemotherapy regimen with injection docetaxel 60 mg/m2 after premedication with injection dexamethasone, injection ranitidine, and anti-histamines. Ten days after her second dose, she reported severe erythema and tingling sensation over the palms and soles. On examination, symmetrical diffuse erythema and swelling with tenderness was noted in the palms and soles [Figures -]. There was no blistering, ulceration, and limitation of movements. Nails were normal. Based on the clinical findings, a diagnosis of grade 3 HFS was made according to WHO grading system []. Subsequently, the patient received parenteral steroids and the chemotherapy regimen to be restarted after resolution of her symptoms. Her symptoms resolved in a period of four days. Unfortunately, the patient rapidly succumbed to the disease before the next drug cycle could be restarted because of extensive metastasis in the lungs and liver.