Palmar plantar erythrodysesthesia history and symptoms

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mandana Chitsazan, M.D. [2]

The most common symptoms of PPE include tingling, burning pain, edema, and erythema. Less common symptoms of PPE include sensory impairment, paresthesia, and pruritus.

Patients with PPE have a positive history of treatment with chemotherapeutic agents.

The most common symptoms of PPE include:

• A prodrome of dysesthesia, usually as a tingling sensation in the fingers, palms and/or soles, progressing to a burning pain in a few days

• A well-defined edema and symmetrical erythema, more prominently over the fat pads of the distal phalanges

• Extension to the dorsal surfaces of the extremities, or over joint surfaces can occur ^[1]

• Periungual skin involvement is also possible

• The palms of the hands are usually more frequently and more severely affected than the soles of the feet, and may be only are affected.^{[1] [2]}

Less common symptoms include: ^{[3] [4]}

• Sensory impairment

• Paresthesia

• Pruritus

• A bullous variant (a severe form of this entity) specifically occurs with cytarabine or methotrexate.^[5][6]

Involvement of other parts of the body is rare, even though mild erythema or morbilliform lesions might occasionally be seen on the trunk, neck, chest, scalp and extremities. ^{[1] [7]}