Palmar-plantar erythrodysesthesia secondary to docetaxel chemotherapy: a case report

We report the case of a 66-year-old Caucasian woman who received adjuvant docetaxel monotherapy for invasive breast cancer. She developed palmar-plantar erythrodysesthesia following her first cycle of treatment, which necessitated a change in management.Palmar-plantar erythrodysesthesia is a relatively common side effect of cytotoxic chemotherapy, particularly with drugs such as 5-fluorouracil, capecitabine and liposomal doxorubicin. Docetaxel is commonly used both alone and in combination with a number of these agents for the management of various malignant conditions. We would like to highlight the occurrence of palmar-plantar erythrodysesthesia as a result of docetaxel monotherapy so that it can be considered as a potential cause in patients receiving combination treatment with chemotherapeutic agents better known to cause this toxicity.Docetaxel is a frequently used chemotherapeutic agent belonging to the taxane family. It was first discovered in 1986 and is a semi-synthetic compound derived from the needles of the European yew (Taxus baccata) [1]. It exerts its anti-cancer effect by promoting microtubule stabilization, leading to mitotic arrest and subsequent cell death [2]. It is used alone or in combination with other chemotherapeutic agents for the management of various malignant conditions including breast, prostate, gastric, head and neck and non-small cell lung cancer [3]. Docetaxel is known to cause a number of side effects including hypersensitivity reactions, alopecia, nausea, vomiting, peripheral neuropathy, myelosuppression, diarrhea, mucositis, fluid retention, myalgia, arthralgia, nail changes and cutaneous reactions [3]. A number of skin reactions have been described in association with docetaxel, of which limb and/or palmar-plantar erythematous (PPE) reactions and fixed plaque erythrodysesthesia are amongst the more common [4].A 66-year-old Caucasian woman was referred to us for further investigation after noticing a lump in her right breast. Ini