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Correspondence |

Palmar-Plantar Erythrodysesthesia Secondary to Sunitinib Treatment Resulting in Necrotic Foot Syndrome Aggravated by Background Diabetic Vascular Disease

Emmanuella Guenova, MD; Hans Oliver Weber, MD; Bogmil Voykov, MD; Gisela Metzler, MD; Vanyo Mitev, MD, PhD; Mark Berneburg, MD; Wolfram Hoetzenecker, MD, PhD; Martin Röcken, MD
Arch Dermatol. 2008;144(8):1081-1082. doi:10.1001/archderm.144.8.1081.
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Sunitinib malate is a novel, molecularly targeted therapeutic agent, recently approved for the treatment of metastatic renal cell carcinoma (RCC) and gastrointestinal stromal tumors.1

Rock  EPGoodman  VJiang  JX  et al.  Food and Drug Administration drug approval summary: sunitinib malate for the treatment of gastrointestinal stromal tumor and advanced renal cell carcinoma. Oncologist 2007;12 (1) 107- 113
PubMed Link to Article[[XSLOpenURL/10.1634/theoncologist.12-1-107]]
Motzer  RJHutson  TETomczak  P  et al.  Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med 2007;356 (2) 115- 124
PubMed Link to Article[[XSLOpenURL/10.1056/NEJMoa065044]]
Suwattee  PChow  SBerg  BCWarshaw  EM Sunitinib: a cause of bullous palmoplantar erythrodysesthesia, periungual erythema, and mucositis. Arch Dermatol 2008;144 (1) 123- 125
PubMed Link to Article[[XSLOpenURL/10.1001/archderm.144.1.123]]
Nagore  EInsa  ASanmartin  O Antineoplastic therapy-induced palmar plantar erythrodysesthesia (‘hand-foot’) syndrome: incidence, recognition and management. Am J Clin Dermatol 2000;1 (4) 225- 234
PubMed Link to Article[[XSLOpenURL/10.2165/00128071-200001040-00004]]
Tsai  KYYang  CHKuo  TTHong  HSChang  JW Hand-foot syndrome and seborrheic dermatitis-like rash induced by sunitinib in a patient with advanced renal cell carcinoma. J Clin Oncol 2006;24 (36) 5786- 5788
PubMed Link to Article[[XSLOpenURL/10.1200/JCO.2006.08.6868]]
Motzer  RJRini  BIBukowski  RM  et al.  Sunitinib in patients with metastatic renal cell carcinoma. JAMA 2006;295 (21) 2516- 2524
PubMed Link to Article[[XSLOpenURL/10.1001/jama.295.21.2516]]
Robert  CSoria  JCSpatz  A  et al.  Cutaneous side-effects of kinase inhibitors and blocking antibodies. Lancet Oncol 2005;6 (7) 491- 500
PubMed Link to Article[[XSLOpenURL/10.1016/S1470-2045(05)70243-6]]
Yang  CHLin  WCChuang  CK  et al.  Hand-foot skin reaction in patients treated with sorafenib: a clinicopathological study of cutaneous manifestations due to multitargeted kinase inhibitor therapy. Br J Dermatol 2008;158 (3) 592- 596
PubMed Link to Article[[XSLOpenURL/10.1111/j.1365-2133.2007.08357.x]]
Eich  DScharffetter-Kochanek  KEich  HTTantcheva-Poor  IKrieg  T Acral erythrodysesthesia syndrome caused by intravenous infusion of docetaxel in breast cancer. Am J Clin Oncol 2002;25 (6) 599- 602
PubMed Link to Article[[XSLOpenURL/10.1097/00000421-200212000-00015]]
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Figure.

Necrotic foot syndrome in a 62-year-old male patient with metastatic renal cell carcinoma who received treatment with sunitinib malate. A and B, Clinical photographs of the patient's right foot.

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