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Purpose.Palmar-plantar erythrodysestehsia(PPE)is a potentially serious toxicity of a nu mber of cytotoxic chemotherapeutic agents,includin g liposomal doxorubicin.Activities that may increase the ris k of this toxicity should be avoided.Case report.A patient wi th platinum-resistant ovarian cancer,responded to,and to lerated(including no skin rash)an initial cycle of liposomal doxoru bicin(40mg /m 2 ).Unfortunately,several days before her next scheduled cycle,she developed sign ificant sunburn(intense erythemawithout blisterin g).Despite an additional1-week delay(total of 5weeks from the prior liposo maldoxorubicin),and complete visual recovery from t he effects of the sunburn,the patient developed severe(grade 3)PPE involving both hands(pain,pronounced erythema,blistering,without ulceration),and a slightly less exten-sive reaction of both feet,followin g subsequent treatmen-twith a 25%reduced dose of the agent (30mg /m 2 ).Conclusion.Caution is advised when considering the ad-ministration of liposomal doxorubi cin following a major sunburn,despite total resolution o f the visible effects on the skin.A delay of several weeks may be appropriate to avoid exacerbation by the chemotherapeutic agent of per-sistent subclinical damage to norma l epithelial cells.
Purpose. Palmar-plantar erythrodysestehsia (PPE) is a potentially serious toxicity of a nu mber of cytotoxic chemotherapeutic agents, includin g liposomal doxorubicin. Activities that may increase the ris k of this toxicity should be avoided. Case Report. A patient wi th platinum -resistant ovarian cancer, responded to, and to lerated (including no skin rash) an initial cycle of liposomal doxoru bicin (40 mg / m 2). Unfortunately, several days before her next scheduled cycle, she developed significant sunburn (intense erythemawithout blisterin g) .Despite an additional 1-week delay (total of 5 weeks from the prior liposo maldoxorubicin), and complete visual recovery from t he effects of the sunburn, the patient developed severe (grade 3) PPE involving both hands (pain, pronounced erythema, blistering, without ulceration), and a little less exten-sive reaction of both feet, followin g subsequent treatmen-twith a 25% reduced dose of the agent (30 mg / m 2) .Conclusion. Caution is advised when considering the ad-ministra tion of liposomal doxorubi cin following a major sunburn, despite total resolution o f the visible effects on the skin. A delay of several weeks may be appropriate to avoid exacerbation by the chemotherapeutic agent of per-sistent subclinical damage to norma l epithelial cells.