INFLAMMATORY HAND AND FOOT SYNDROME


TYPE OF TREATMENT PROACTIVE
(PREVENTION/STEP 0) 		REACTIVE
(MANAGEMENT IN CASE OF AE)
    Conventional chemotherapy
  • Liposomal doxorubicin
  • Mitotic inhibitors (taxanes)
    • Capecitabine (5-FU)
  • Moisturizer with urea 10%
  • For doxorubicin and taxane infusions - cooling gloves/socks during infusions including 15 min before and 30 min after
    • Optional

  • Oral steroids for doxorubicin HFS, celecoxib for capecitabine
  • Continue Step 0
  • Moisturizing cream and balms
  • Monitor for change in severity
  • TCS (once-twice per day for a maximum of 4 weeks) including under occlusion
  • Oral dexamethasone
  • For capecitabine, on/off regimens can help reduce HFS
  • Oncologists may reduce, interrupt, or discontinue treatment at higher grades