Palmar-plantar syndrome: treatment and prevention

Palmar-plantar syndrome is one of the most common complications of chemotherapy prescribed for the treatment of cancer. In some cases, complications become very painful for patients, as a result of which the doctor is forced to reduce the dosage of the drug administered during the procedure. Next, questions will be discussed about what is chemotherapy and the consequences of such treatment.

What is chemotherapy?

Chemotherapy is one of the main types of cancer treatment. During the procedure, agents are used that help stop the growth of cancer cells and destroy them.

The use of chemotherapy always entails a number of serious consequences, namely: hair loss, excessive dryness of the skin, problems with the gastrointestinal tract, deterioration of the general condition of the patient. Based on this, many patients refuse this method of therapy, which is fundamentally wrong. Since not always and not all tumors are amenable to surgical or radiation removal, in these cases the use of chemicals to fight the disease is simply necessary.

Patients who have been diagnosed with an oncological disease need to know that this is chemotherapy and the consequences of such treatment, as well as in what specific cases such drugs should be used.

Indications for chemotherapy are:

1. Reduction of tumor size before surgery.
2. Malignant tumors that are only subject to the use of chemotherapy - leukemia, chorionocarcinoma, rhabdomyosarcoma, hemoblastosis.
3. If this is indicated by indications, then chemotherapy is used during surgical and radiation treatment.
4. Postoperative chemotherapy is used for suspected metastases in other organs. The introduction of chemicals after surgery prevents further proliferation of metastases and the re-emergence of a malignant tumor.
5. Chemotherapy is necessary if a malignant tumor affects the lymph nodes, in this case, this procedure is carried out regardless of the size of the formation.

The principle of operation of the procedure is that chemicals that enter the blood are then carried throughout the body. Thanks to this, a systemic effect on the body is produced, as a result of which cancer cells and metastases are destroyed regardless of where the lesion site is located.

The doctor usually prescribes several chemicals, each of which the principle of action is always different from the other. Thus, chemicals begin to affect the biochemical processes that occur in cancer cells, inhibiting and stopping cell division and tumor growth.

The procedure with the introduction of chemicals can last from one to several days. Then a short break is needed, which can last from 7 to 30 days, after the break the patient undergoes a new course of chemotherapy. In total, the patient may need from 6 to 8 courses of chemotherapy treatment, the duration of which is from 3 to 9 months, taking into account the breaks. They must be done between courses without fail, since the injected drugs are toxic, and the body needs to recover.

The doctor prescribes the dosage, drugs and number of courses, based on the severity of the cancer.

Causes of occurrence

Palmar-plantar syndrome occurs when a drug administered during chemotherapy begins to leak through small vessels to the surface of the epithelium. After the drug has leaked, damage to areas of tissue that are in close proximity to the seepage site begins. The main lesions during the leakage of chemicals during therapy are the palms and feet, and the elbows and knees are much less likely to be affected.

The main chemicals that can affect the palms of the hands and soles of the feet during chemotherapy are:

• Xeloda (capecitabine);
• Cytosar-U (Cytarabine);
• FUDR (Phloxuridine);
• 5-Fu (Fluorouracil);
• Idamycin (idarubicin);
• Doxil (Liposomal Doxorubicin).

What you need to know and do before starting chemotherapy

Before starting chemotherapy, it is important to familiarize yourself with all the side effects and recommendations that will help the patient more easily bear all the unpleasant consequences of the procedure.

1. Before the procedure, you need to do manicure and pedicure, remove all keratinized and roughened areas of the epithelium.
2. It is recommended to completely abandon the use of soap, since many of them dry the skin, you need to use only gels and softening foams.
3. In order to avoid injury and rubbing of hands and feet, all narrow and tight clothing and shoes should be removed from the wardrobe for a while.
4. After each hand and foot wash, lubricate them with a moisturizer.

Main symptoms

The main symptoms of the disease are:

1. Red dots on the palms and soles of the feet that resemble a sunburn.
2. Hands and feet begin to swell strongly.
3. If the medicine came out with the introduction, then in these places a strong burning sensation and tingling begins, in some cases necrosis of the epidermal tissue is possible.
4. The sensitivity of the upper and lower extremities increases.
5. Sores appear on the palms and feet, which over time can begin to itch and bleed, thereby causing significant discomfort to the patient.

Other symptoms of the syndrome

In the event that the pathology has moved to a more severe stage, the patient has signs such as:

1. Peeling on the feet and hands, gradually begins to peel off the skin on the palms and soles of the feet, cracks appear.
2. The appearance of pulling pain, which intensifies over time, as a result of which a person loses the ability to perform any work with his hands and walk.
3. The appearance of red spots on the feet, eventually turning into bleeding wounds.

Treatment

In order to eliminate the dire consequences of chemotherapy, doctors prescribe additional treatments. In some cases, if the complications are especially painful for the patient, the doctor may decide to reduce the dosage of the drug administered. It is extremely rare that a doctor makes a decision to cancel chemotherapy for a while, after an acute period has passed, treatment continues.

Usually, in combination with chemotherapy, the doctor may prescribe a parallel treatment to prevent serious consequences from the procedure. The main drugs that doctors prescribe with chemotherapy are:

1. Corticosteroids, which are applied to the surface of the epithelium, thereby relieving inflammation.
2. In order to prevent chemicals from leaking onto the surface of the skin through the capillaries, the use of the drug - "Dimethyl sulfoxide" is prescribed.
3. Vitamin B6 is prescribed to strengthen the body's immune system and to reduce the general symptoms of chemotherapy.
4. How to anesthetize palmar-plantar syndrome? For this, non-narcotic analgesics are used.
5. The skin of the upper and lower extremities should be regularly lubricated with moisturizers so that the skin does not dry out.

Treatment of palmar-plantar syndrome should be carried out under the supervision of a doctor, and not self-medicate.

Folk remedies

Treatment with traditional medicine should be carried out in combination with drug therapy and only with the permission of the attending physician:

1. Aloe. Fresh leaves of aloe must be thoroughly washed, dried and ground to a pulp state. The resulting product must be applied to the affected areas of the skin at night in the form of a compress. During the dressing, you should not tightly wrap and tie a bandage - the main thing is that the bandage holds. Such a compress helps to soften the epithelium and easier to exfoliate tissues that are already dead.
2. Apple cider vinegar and onion peel. To prepare the product, 200 g of onion peel must be poured with apple cider vinegar and leave to infuse for 2-3 weeks. At the end of the prescribed period, strain the product and apply to the affected areas, having previously moistened a cloth or a piece of gauze in the product. This tool effectively removes red spots on the feet and palms.
3. Propolis. An effective tool in the treatment of palmar-plantar syndrome is the use of propolis. A piece of propolis is ground on a grater and a small cake is made, which is then applied to those places where there are areas of dead tissue. The compress must be held for 30-60 minutes, then remove and wash your hands and feet under cold running water. It is important to remember that you can’t wipe yourself, but you just need to wet the wet areas with a soft towel.

Prevention

The appearance of points on the palms can be prevented if you follow simple tips:

1. Hot water should not be allowed on hands and soles of feet. Therefore, wash your face, take a bath and do your homework preferably with cool water.
2. In no case should you go to the sauna or bathhouse, it is forbidden to be in direct sunlight, you can’t even sit by the open window during the hot season.
3. It is advisable to move as much as possible, but it is important to remember that the load during physical activity should be distributed evenly. As sports activities, doctors recommend running, gymnastics, aerobics and hiking. Shoes should be comfortable and soft, running and walking should preferably be carried out only in the shade.
4. Avoid the use of any aggressive chemicals when doing homework, for example, some means for cleaning the toilet or washing sinks.
5. Many mistakenly believe that the use of rubber gloves will help prevent skin from getting hot water when washing dishes. Gloves should not be worn in any case, since from their use the skin will begin to heat up much faster than without them.
6. If there is a risk of palmar-plantar syndrome during chemotherapy, then you should abandon the use of items that require additional pressing. Such items include: screwdrivers, scissors, pliers, wire cutters.

Additional methods of prevention

Additionally, the following actions are allowed:

1. As additional preventive measures of the palmar-plantar syndrome, doctors allow the use of cold, in particular, these may be ice packs that need to be applied for some time to the hands and feet. It is worth noting that ice should be applied only to skin areas affected by the syndrome, ice should not fall onto a healthy epithelium.
2. In the supine position, you can raise the upper and lower limbs.
3. After taking a shower or bath, you can’t wipe yourself, but just get your body wet with a soft towel.
4. Shoes and clothes should be soft and comfortable, well ventilated. No friction or rubbing should be allowed.
5. It is very important to ensure that the skin of the hands is constantly moistened with special creams, especially in the state of exacerbation.

Tips for applying and choosing moisturizing skin creams

Cream on the palms of the hands and soles of the feet should be applied with extreme care, being careful not to rub too much, as excessive friction can injure the affected skin of the hands and feet.

When choosing a cream, you should carefully read the instructions and choose one that not only effectively moisturizes the skin, but also contributes to its healing and restoration.

With palmar-plantar syndrome, you need to use moisturizers daily several times a day. Only in this way can the skin of the hands and feet begin to gradually soften and recover.

It is very important to remember that palmar-plantar syndrome during chemotherapy is one of the most common consequences of the procedure. It is necessary to prepare in advance for the fact that such consequences are inevitable, but the risk of life when refusing chemotherapy is much greater, so patients need to gain strength and patience and withstand all the necessary procedures to the end.