HYPERKERATOTIC Hand and Foot Syndrome

   

TYPE OF TREATMENT PROACTIVE
(PREVENTION/STEP 0) 		REACTIVE
(MANAGEMENT IN CASE OF AE)
  • Targeted therapy: RAS-BRAF-MEK-ERK inhibitors, multikinase inhibitors
  • Gentle cleanser with pH ~ 5
  • Moisturizer with urea 10% (2-3 times per day)
  • Remove hyperkeratosis before the start of treatment (pedicure)
  • Soft/padded footwear, avoid walking barefoot, avoid high heels
  • Clobetasol
  • Continue Step 0
  • Topical urea based 10-40% emollient (2-3 times per day on hyperkeratotic areas)
  • Refer to podiatrist
  • Lidocaine patches/cream (as needed for pain)
  • Painkillers, NSAIDs
  • Potent topical corticosteroids
  • Oncologist may reduce, interrupt, or discontinue treatment at higher grades