Serpentine supravenous hyperpigmentation and an atypical presentation of hand-foot syndrome in the setting of docetaxel therapy

Serpentine supravenous hyperpigmentation (SSH) and hand-foot syndrome (HFS) are well-described cutaneous complications associated with cytotoxic chemotherapy agents such as docetaxel.1 SSH is a rare and distinctive cutaneous eruption associated with peripheral infusion of certain antineoplastic agents. HFS is a more common adverse reaction that typically presents as painful erythema of the palms and soles.2 However, in cases of docetaxel-induced HFS, the eruption characteristically involves the dorsal aspects of the hands.