Abstract

GONZALEZ-FREIRE, L; BOULLOSA-LALE, S; DAVILA-POUSA, MC  and  CRESPO-DIZ, C. Treatment of palmoplantar erythrodysesthesia with a compounding of urea 20% + triamcinolone acetonide 0.2% + lidocaine 2%. Rev. OFIL·ILAPHAR [online]. 2022, vol.32, n.3, pp.301-303.  Epub Sep 25, 2023. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699714x20220003000016.

Palmoplantar erythrodysesthesia is a relatively frequent adverse cutaneous reaction secondary to chemotherapy treatment. It produces redness, swelling, burning and sensitivity. In the most severe cases it produces skin desquamation, blisters and intense pain affecting patients' ambulation and quality of life. We present the case of a woman on a capecitabine treatment who during the third cycle of treatment presents palmoplantar erythrodysesthesia, worsening during the eighth cycle. The Dermatology Department requested the Pharmacy Department the elaboration of a 6% allantoin cream. The Pharmacy Department proposes the addition of a corticosteroid, due to its anti-inflammatory properties, and the addition of an anesthetic for pain relief. 7 days after having started the treatment, the patient describes a slight improvement, but she still presents feet desquamation. Therefore, the Pharmacy Department proposed changing allantoin for urea and introducing a stronger corticosteroid. Lidocaine is maintained and the base is changed from O/W to W/O to favor the penetration of the drugs in the palmar and plantar áreas.

The final composition of the compounding is (100 g): urea 20 g, lidocaine 2 g, triamcinolone acetonide 0.2 g, glycerin 3 g, allantoin 1 g, argan oil 5 g, stringy vaseline 9 g, preservative water 35 mL and PR W/O absorption base 25 g.

Afer 45 days of treatment with the proposed compounding, the patient shows a very good evolution and improvement from the symptomatic point of view. Moreover, she has significantly improved the ambulation and can return to normal life.

Keywords : Capecitabine; hand-foot syndrome; adverse effects; treatment; drug compounding; triamcinolone acetonide; allantoin; urea; lidocaine.

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