Which cutaneous reaction is most commonly seen with 5-FU and Capecitabine?

Palmar-plantar erythrodysesthesia, also known as hand-foot syndrome, is a common cutaneous reaction associated with the use of 5-fluorouracil (5-FU) and its oral prodrug, capecitabine. This condition manifests as redness, swelling, and peeling of the skin on the palms of the hands and the soles of the feet. The symptoms occur due to the accumulation of the chemotherapy agents in the superficial vascular and epithelial tissues, leading to localized inflammation and discomfort.

The unique nature of this syndrome, specifically its localization to the palms and soles, distinguishes it from other cutaneous reactions. Patients may experience significant discomfort or pain, which can interfere with daily activities. Understanding this reaction is critical in the management of patients undergoing treatment with these agents, as it requires monitoring and potential intervention to alleviate symptoms.

While other cutaneous reactions, such as rash, pruritus, and dermatitis, can occur with various chemotherapy agents, they are less specifically associated with 5-FU and capecitabine compared to palmar-plantar erythrodysesthesia. Recognizing this condition helps in promptly identifying the cause of skin toxicity and in advancing patient care through early intervention and supportive measures.