Hand-foot syndrome caused by capecitabine: incidence, risk factors and the role of dermatological evaluation.

Hand-foot syndrome (HFS), or palmar-plantar erythrodysesthesia, is characterised by erythema, oedema and dysesthesia, which can progress to blistering and ulceration. This condition is described as a common adverse effect of the chemotherapeutic agent capecitabine. The study set out to evaluate real-world incidences; assess severity based on clinical criteria, such as local symptoms, dyschromia, erythema, oedema and ulcerations; and associated factors, such as type of solid tumour, chemotherapy regimen, number of cycles, sex, age and Eastern Cooperative Oncology Group Performance Scale of HFS, related to the use of capecitabine. This is a single-centre prospective cohort study carried out jointly by the departments of clinical oncology and dermatology of a university hospital in the southeast of Brazil. The study showed a 34% incidence of HFS, with most cases classified as mild. There was statistical significance in the correlation of the syndrome with sex and performance scores. HFS is the most common and limiting adverse reaction to capecitabine, and causes significant functional and quality impairments in patients with cancer. With this study, we have reinforced the importance of multidisciplinary assessment for early diagnosis and adequate follow-up.

Fibrohistiocitoma maligno de face: uma apresentação rara / Malignant fibrohistiocytoma of face: a rare presentation

Contexto: O fibrohistiocitoma maligno é um sarcoma de tecidos moles muito agressivo, com rara apresentação limitada à pele e tecido subcutâneo em face. O diagnóstico é anatomopatológico com auxílio da imuno-histoquímica. Descrição do caso: Este artigo relata o caso de um paciente com diagnóstico de fibrohistiocitoma maligno restrito à face com boa resposta terapêutica após exérese cirúrgica. Discussão: Tendo em vista a raridade dessa afecção, dificuldade diagnóstica devido ao quadro inespecífico e com rápida evolução, é importante lembrar desse possível diagnóstico e atuar precocemente. Conclusões: O diagnóstico precoce interfere de forma significativa na evolução do quadro, sendo necessária a manutenção do acompanhamento oncológico e dermatológico com o intuito de detectar precocemente recidivas locais e metástases a distância.