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Dermatologic Cancer Pain Syndromes

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Essentials of Interventional Cancer Pain Management

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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.

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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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Author information

Authors and Affiliations

  1. New York University School of Medicine, New York, NY, USA

    Katerina Svigos

  2. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Viswanath Reddy Belum & Mario E. Lacouture

Authors
  1. Katerina Svigos
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  2. Viswanath Reddy Belum
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  3. Mario E. Lacouture
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Corresponding author

Correspondence to Katerina Svigos .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Amitabh Gulati

  2. Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Vinay Puttanniah

  3. Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Brian M. Bruel

  4. Midwest Neuroscience Institute, Center for the Relief of Pain, Kansas City, MO, USA

    William S. Rosenberg

  5. Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Joseph C. Hung

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Svigos, K., Belum, V.R., Lacouture, M.E. (2019). Dermatologic Cancer Pain Syndromes. In: Gulati, A., Puttanniah, V., Bruel, B., Rosenberg, W., Hung, J. (eds) Essentials of Interventional Cancer Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-319-99684-4_15

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  • DOI: https://doi.org/10.1007/978-3-319-99684-4_15

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