Palmar-Plantar Erythrodysesthesia (Hand-Foot Syndrome) in a Paclitaxel-Treated Lung Cancer Patient: A Rare Case Report With Literature Review

Palmar-plantar erythrodysesthesia (PPE), commonly termed Hand-Foot Syndrome (HFS), is a dose-dependent cutaneous toxicity associated with certain chemotherapeutic agents. While it is well-established with capecitabine, 5-fluorouracil, and liposomal doxorubicin, its occurrence with paclitaxel is uncommon. We report the case of a 26-year-old male with metastatic carcinoma of the left lung who developed Grade 2 PPE following six cycles of carboplatin and paclitaxel chemotherapy. The syndrome manifested during the fourth chemotherapy cycle as tingling, burning, dryness, peeling, cracking, and dark discoloration of the palms. Concurrent adverse drug reactions (ADRs) included Grade 1 monocytopenia, Grade 3 neutropenia, and reduced serum creatinine, classified per Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Management with pyridoxine (vitamin B6) and emollients, along with paclitaxel dose adjustment in the sixth cycle, led to symptomatic improvement. This case underscores the importance of recognizing paclitaxel-associated PPE and implementing timely pharmacovigilance measures.