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August 18, 2008

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

Arch Dermatol. 2008;144(8):1081-1082. doi:10.1001/archderm.144.8.1081

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

Herein, we report the case of a 62-year-old male patient with metastatic RCC and severe necrotic foot syndrome (NFS) (Figure), a result of palmar-plantar erythrodysesthesia (PPE), with extensive tissue damage and aggravated by background diabetic vascular disease. The NFS developed predominantly in the patient's right foot 3 weeks after initiation of first-line therapy with sunitinib malate at a therapeutic regimen of 50 mg/d. Other common adverse effects of sunitinib2 (eg, anemia, hypertension, and dysgeusia) were also present and fully cleared after immediate discontinuation of the sunitinib treatment.

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