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A 25-year-old man undergoing chemotherapy with cyclophosphamide, vincristine, doxorubicin, and dexamethasone for acute lymphoblastic leukemia arrives in urgent care because he’s developed a painful, burning palmar eruption. On examination, tender, shiny, erythematous papules and plaques were seen on the palms and fingers as well as the soles of his feet.

toxic erythema of chemotherapy

View the image above and consider what your diagnosis and next steps would be. Resolution of the case is described on the following page.

25-Year-Old With Hand Rash