The pathogenetic mechanism of anthracycline-induced palmar-plantar erythrodysesthesia.
BACKGROUND
Anthracyclines, such as pegylated liposomal doxorubicin (PLD) and epirubicin (EP), are effective for the treatment of malignant tumors. Unfortunately, their implementation in therapy is limited due to severe side-effects such as palmar-plantar erythrodysesthesia (PPE).


METHODS
As the exact pathogenesis of PPE still remains unclear, laser scanning microscopy was utilized to detect PLD, EP and their metabolites in and on the skin surface of patients.


RESULTS
It was shown that PLD was significantly more frequently detectable on the skin than was EP (p<0.05), whereas both substances were most frequently seen in the palms and soles. Additionally, it has been visualized that the substances reach the skin surface via sweat, where they distribute and then penetrate back into the skin.


CONCLUSIONS
It was concluded that a high density of sweat glands and a thick stratum corneum might represent important predestined factors for the development of PPE. These findings will help to develop efficient prevention and therapy strategies for PPE.
Martschick
A
A
Department of Gynecology and Obstetrics, Charité Campus Virchow Klinikum, Charité - Universitaetsmedizin Berlin, 10117 Berlin, Germany.
Sehouli
J
J
Patzelt
Alexa
A
Richter
H
H
Jacobi
U
U
Oskay-Ozcelik
G
G
Sterry
W
W
Lademann
J
J
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D003875:Drug Eruptions / Q000209:etiology*; D005260:Female; D005533:Foot Dermatoses / Q000139:chemically induced*; D006229:Hand Dermatoses / Q000139:chemically induced*; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000188:drug therapy / Q000473:pathology*; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects*; D011379:Prognosis; D011446:Prospective Studies
C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D004317:Doxorubicin