Table 2.

Preventive and symptomatic treatment options for hand-foot syndrome.

Preventative measures
Avoid mechanical stress/trauma (i.e. friction, pressure, tight footwear)
Avoid exposure to high temperatures around administration (e.g. bathing with hot water, vigorous exercise, wearing tight clothing and shoes)
Maintenance of good hygiene with regular visits to the podiatrist in case of corns and calluses
Referral to dermatologist for treatment of pre-existing dermatologic conditions
Moisturizing with urea-based cream three times per day (avoid excessive rubbing)
Local hypothermia (regional cooling) at time of administration (only for short-term infusions of PLD and docetaxel)
Symptomatic treatment
Pain: analgesics or topical anesthetics (lidocaine patches)
Inflammation: topical high-potency corticosteroids
Hyperkeratosis: topical keratolytics
Erosions: petroleum/lanolin-based ointments
NCI-CTC grade 2 or higher: oral celecoxib*
Other°: oral vitamin B6 (Pyridoxine) 400 mg, oral vitamin E, topical 99% dimethylsulfoxide (DSMU), topical sildenafil, oral corticosteroids

PLD, pegylated liposomal doxorubicin; NCI-CTC, National Cancer Institute criteria for classification.

*Potential side effects include cardiovascular risks and upper gastrointestinal bleeding

°Limited or conflicting data.