Hand-and-Foot Syndrome or Reaction: The Upper Hand of Clinical Morphology in a Patient Receiving Multiple Chemotherapy Agents

Abstract Various chemotherapy-induced reaction patterns are described; collectively called ‘toxic erythema of chemotherapy’. Although temporal association of chemotherapeutic agent in a patient with cancer makes the diagnosis easy, especially when they present with an acute eruption; identification of the offending agent when they are receiving a concoction of chemotherapeutic agents makes it challenging. With the advent of newer agents like small-molecule FLT3 kinase inhibitors, reaction secondary to these agents (hand foot skin reaction) must be differentiated from the conventional chemotherapeutic agent induced reactions (hand foot syndrome). We hereby present a case of sorafenib-induced hand foot skin reaction and highlight how morphology of the early skin reaction was adequate in differentiating it from hand foot syndrome.