{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:55:47Z","timestamp":1791212147501,"version":"4.1.0"},"reference-count":15,"publisher":"PAGEPress Publications","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatol Reports"],"abstract":"<jats:p>Hand and foot skin reaction (HFSR), usually associated with tyrosine kinase inhibitors, is characterized by painful erythema and hyperkeratosis at palmoplantar pressure points. HFSR differs from the more widely recognized chemotherapy-induced hand-foot syndrome (HFS) in terms of both clinical and histopathological features. Here we present the case of a 79-year-old man with advanced lung adenocarcinoma who developed grade 3 HFSR after receiving pembrolizumab, a\u00a0PD-1 inhibitor. The patient initially presented with erythema, desquamation, and hyperkeratotic plaques on the palms and soles, followed by the development of vesiculobullous lesions. Histopathological findings supported the clinical diagnosis. Treatment included discontinuation of pembrolizumab, along with systemic and topical corticosteroids and salicylic acid, with marked improvement and resolution after about 2 months. Given the impact on quality of life and treatment continuity, clinicians should monitor for HFSR in patients receiving immune checkpoint inhibitors (ICIs) to allow for timely intervention.<\/jats:p>","DOI":"10.4081\/dr.2026.10184","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:35:05Z","timestamp":1791210905000},"source":"Crossref","is-referenced-by-count":0,"title":["Pembrolizumab-related hand and foot skin reaction"],"prefix":"10.4081","author":[{"given":"Francesca","family":"Ambrogio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmelo","family":"Laface","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo","family":"Castronovi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Bortone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edoardo","family":"Mortato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5014-1122","authenticated-orcid":false,"given":"Fortunato","family":"Cassalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Cazzato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2549","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"44207","doi-asserted-by":"crossref","unstructured":"1. Yu Y, Feng L. Hand-Foot Skin Reaction. J Cutan Med Surg 2023;27:79.","DOI":"10.1177\/12034754221147288"},{"key":"44208","doi-asserted-by":"crossref","unstructured":"2. McLellan B, Ciardiello F, Lacouture ME, et al. Regorafenib-associated hand\u2013foot skin reaction: practical advice on diagnosis, prevention, and management. Ann Oncol 2015;26:2017-26.","DOI":"10.1093\/annonc\/mdv244"},{"key":"44209","doi-asserted-by":"crossref","unstructured":"3. Miller KK, Gorcey L, McLellan BN. Chemotherapy-induced hand-foot syndrome and nail changes: a review of clinical presentation, etiology, pathogenesis, and management. J Am Acad Dermatol 2014;71:787-94.","DOI":"10.1016\/j.jaad.2014.03.019"},{"key":"44210","doi-asserted-by":"crossref","unstructured":"4. Li J, Gu J. Hand-foot skin reaction with vascular endothelial growth factor receptor tyrosine kinase inhibitors in cancer patients: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2017;119:50-8.","DOI":"10.1016\/j.critrevonc.2017.09.016"},{"key":"44211","doi-asserted-by":"crossref","unstructured":"5. Chanprapaph K, Rutnin S, Vachiramon V. Multikinase Inhibitor-Induced Hand-Foot Skin Reaction: A Review of Clinical Presentation, Pathogenesis, and Management. Am J Clin Dermatol 2016;17:387-402.","DOI":"10.1007\/s40257-016-0197-1"},{"key":"44212","doi-asserted-by":"crossref","unstructured":"6. Ai L, Xu Z, Yang B, et al. Sorafenib-associated hand-foot skin reaction: practical advice on diagnosis, mechanism, prevention, and management. Expert Rev Clin Pharmacol 2019;12:1121-7.","DOI":"10.1080\/17512433.2019.1689122"},{"key":"44213","doi-asserted-by":"crossref","unstructured":"7. Freites-Martinez A, Santana N, Arias-Santiago S, Viera A. Using the Common Terminology Criteria for Adverse Events (CTCAE - Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies. Actas Dermosifiliogr (Engl Ed) 2021;112:90-2. English, Spanish.","DOI":"10.1016\/j.adengl.2019.05.021"},{"key":"44214","doi-asserted-by":"crossref","unstructured":"8. Baxevanis CN, Perez SA, Papamichail M. Cancer immunotherapy. Crit Rev Clin Lab Sci 2009;46:167-89.","DOI":"10.1080\/10408360902937809"},{"key":"44215","doi-asserted-by":"crossref","unstructured":"9. Tan F, Zhou L, Huang G, et al. Analysis of Immune-Related Adverse Events of Pembrolizumab Using FAERS Database. Oncology 2025;103:1147-59.","DOI":"10.1159\/000543520"},{"key":"44216","doi-asserted-by":"crossref","unstructured":"10. Fattore D, Lauletta G, Pages C, et al. Update on dermatological toxicities of immune checkpoint inhibitors. Presse Med 2026;55:104330.","DOI":"10.1016\/j.lpm.2025.104330"},{"key":"44217","doi-asserted-by":"crossref","unstructured":"11. Itamoto S, Imafuku K, Miyazawa H, et al. Hand-foot syndrome histopathologically presenting eccrine squamous syringometaplasia due to pembrolizumab after lenvatinib treatment. J Cutan Pathol 2023;50:932-5.","DOI":"10.1111\/cup.14493"},{"key":"44218","doi-asserted-by":"crossref","unstructured":"12. Zribi A, Al Riyami K, Al Zahibi HS, Burney IA. Managing the Adverse Events Associated with Pembrolizumab and Lenvatinib Therapy in Endometrial Cancer. Sultan Qaboos Univ Med J 2024;24:293-7.","DOI":"10.18295\/squmj.9.2023.057"},{"key":"44219","doi-asserted-by":"crossref","unstructured":"13. Bi Y, Yang X, Lu Y, et al. Pembrolizumab With Anlotinib in Advanced Oral Mucosal Melanoma: A Retrospective Trial. Oral Dis 2026;32:1308-14.","DOI":"10.1111\/odi.70206"},{"key":"44220","doi-asserted-by":"crossref","unstructured":"14. Lacouture ME, Reilly LM, Gerami P, Guitart J. Hand foot skin reaction in cancer patients treated with the multikinase inhibitors sorafenib and sunitinib. Ann Oncol 2008;19:1955-61.","DOI":"10.1093\/annonc\/mdn389"},{"key":"44221","doi-asserted-by":"crossref","unstructured":"15. Young JN, Eversman A, Poplausky D, et al. A Case of Hand-Foot Skin Reaction-like Eruption Associated with Pembrolizumab. SKIN J Cutan Med 2024;8:1464-7.","DOI":"10.25251\/skin.8.2.21"}],"container-title":["Dermatology Reports"],"original-title":[],"link":[{"URL":"https:\/\/journals.pagepress.net\/dr\/article\/download\/10184\/10103","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.pagepress.net\/dr\/article\/download\/10184\/10103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T14:35:10Z","timestamp":1791210910000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.pagepress.net\/dr\/article\/view\/10184"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,5]]},"references-count":15,"URL":"https:\/\/doi.org\/10.4081\/dr.2026.10184","relation":{},"ISSN":["2036-7406","2036-7392"],"issn-type":[{"value":"2036-7406","type":"electronic"},{"value":"2036-7392","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10,5]]}}}