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Dermatologic Cancer Pain Syndromes

  • Katerina SvigosEmail author
  • Viswanath Reddy Belum
  • Mario E. Lacouture
Chapter

Abstract

Pain and pruritus are common symptom that dermatologic patients experience. The skin is comprised of three layers interspersed with sensory receptors that specialize in detecting changes or disruptions to the skin. The body’s response to various irritations (e.g., inflammation), or iatrogenic introduced foreign bodies (e.g., needles), can affect the skin and be perceived by the brain as pain.

Common painful skin syndromes experienced by cancer patients include injection site reactions, postherpetic neuralgia, and palmar-plantar erythrodysesthesia (hand-foot syndrome/hand-foot skin reaction). Injection site reactions include phlebitis (inflammation of the blood vessels) and extravasation (leakage of drug into the extravascular space). Postherpetic neuralgia is persistent nerve pain confined to a dermatome after an episode of herpes zoster. Palmar-plantar erythrodysesthesia results in changes in sensation of the hands and feet, secondary to epithelial cell and capillary damage caused by chemotherapy. The location and quality of pain, and appearance of the skin on physical exam, can help distinguish each of these syndromes. It is important to recognize these conditions early and institute appropriate interventions, to minimize dose interruptions and reduce impairments in patients’ health-related quality of life.

Keywords

Cancer Extravasation Hand-foot syndrome Hand-foot skin reaction Injection site Palmar-plantar erythrodysesthesia Pain Phlebitis Postherpetic neuralgia Postherpetic neuralgia Dermatologic cancer pain 

Abbreviations

APC

Antigen-presenting cell

DPD

Dihydropyrimidine dehydrogenase

HFS

Hand-foot syndrome

HFSR

Hand-foot skin reaction

HZ

Herpes zoster

MHC

Major histocompatibility complex

NSAID

Nonsteroidal anti-inflammatory drug

PHN

Postherpetic Neuralgia

PPES

Palmar-Plantar Erythrodysesthesia Syndrome

TS

Thymidylate synthase

UV

Ultraviolet

VZV

Varicella-zoster virus

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Katerina Svigos
    • 1
    Email author
  • Viswanath Reddy Belum
    • 2
  • Mario E. Lacouture
    • 2
  1. 1.New York University School of MedicineNew YorkUSA
  2. 2.Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA

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