Toxic Erythema of Chemotherapy Quiz

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Redness of the skin

My skin is dry

Yellow nails

There are blisters

Red spots on skin

Skin peeling

Causing a blister

Not seeing your symptoms? No worries!

What is Toxic Erythema of Chemotherapy?

This is a side effect of some cancer chemotherapy drugs that can cause redness, swelling, and blistering on the palms of the hands and soles of the feet. It tends to appear within the first 2 to 3 months of treatment.

Typical Symptoms of Toxic Erythema of Chemotherapy

Diagnostic Questions for Toxic Erythema of Chemotherapy

Your doctor may ask these questions to check for this disease:

  • Are you currently on chemotherapy?
  • Are you experiencing toe pain?
  • Do you experience numbness in your fingers?
  • Did your nail color change?
  • Do you have dry and flaky skin?

Treatment of Toxic Erythema of Chemotherapy

Treatment is mainly symptomatic with the help of oral painkillers and numbing creams, ointments. Sometimes, the dosage of chemotherapy may be adjusted if required.

Reviewed By:

Unnati Patel, MD, MSc

Unnati Patel, MD, MSc (Family Medicine)

Dr.Patel serves as Center Medical Director and a Primary Care Physician at Oak Street Health in Arizona. She graduated from the Zhejiang University School of Medicine prior to working in clinical research focused on preventive medicine at the University of Illinois and the University of Nevada. Dr. Patel earned her MSc in Global Health from Georgetown University, during which she worked with the WHO in Sierra Leone and Save the Children in Washington, D.C. She went on to complete her Family Medicine residency in Chicago at Norwegian American Hospital before completing a fellowship in Leadership in Value-based Care in conjunction with the Northwestern University Kellogg School of Management, where she earned her MBA. Dr. Patel’s interests include health tech and teaching medical students and she currently serves as Clinical Associate Professor at the University of Arizona School of Medicine.

Yukiko Ueda, MD

Yukiko Ueda, MD (Dermatology)

Dr. Ueda graduated from the Niigata University School of Medicine and trained at the University of Tokyo Medical School. She is currently a clinical assistant professor at the Department of Dermatology, Jichi Medical University, and holds several posts in the dermatology departments at Kyoto Prefectural University of Medicine, Komagome Hospital, University of Tokyo, and the Medical Center of Japan Red Cross Society.

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Content updated on Sep 2, 2025

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Symptoms Related to Toxic Erythema of Chemotherapy

Diseases Related to Toxic Erythema of Chemotherapy

FAQs

Q.

Fearful of Chemotherapy? Why Your Body Reacts + Medically Approved Steps

A.

Feeling fearful of chemotherapy is common and understandable; your body reacts because chemo targets fast-growing cells that also exist in hair, gut, bone marrow, skin, and nerves, and your brain mounts a protective stress response that can include anticipatory nausea. There are several factors to consider, and medically approved steps can ease the journey, including scheduled anti-nausea medicines, skin and infection precautions, light activity, nutrition and CBT support, plus clear guidance on urgent symptoms and when to call your doctor, with many more actionable details and tools like a hand-foot syndrome symptom check outlined below.

References:

* Alimohammadi N, Azarbarzin M, Alipour R, Dehghan M. The Effect of Relaxation Techniques on Fear of Chemotherapy and Chemotherapy-Induced Nausea and Vomiting: A Systematic Review. Iran J Nurs Midwifery Res. 2023 Jul 26;28(4):397-405. doi: 10.4103/ijnmr.ijnmr_107_22. PMID: 37601662; PMCID: PMC10435887.

* St-Pierre P, Hachem M, Kopek N. The Psychological Impact of Chemotherapy on Cancer Patients: A Narrative Review. Curr Oncol. 2022 Mar 22;29(3):1927-1937. doi: 10.3390/curroncol29030160. PMID: 35323214; PMCID: PMC8946765.

* Kim S, Lee J, Kim H. Effects of psychoeducational interventions on anxiety, depression, and quality of life in patients receiving chemotherapy: A systematic review and meta-analysis. Eur J Oncol Nurs. 2022 Feb;56:102073. doi: 10.1016/j.ejon.2021.102073. Epub 2021 Dec 2. PMID: 34863920.

* Zhang F, Li D, Yu N, Zhao Q. Effect of an evidence-based education program on self-efficacy and self-management behaviors of patients with breast cancer undergoing chemotherapy: A randomized controlled trial. J Clin Nurs. 2021 Aug;30(15-16):2272-2282. doi: 10.1111/jocn.15783. Epub 2021 Apr 22. PMID: 33886121.

* Aapro M, Molassiotis A, Rossler J. Management of chemotherapy-induced nausea and vomiting: An update of the 2016 MASCC/ESMO Antiemetic Guideline. Cancer Treat Rev. 2017 Aug;59:22-26. doi: 10.1016/j.ctrv.2017.06.002. Epub 2017 Jun 24. PMID: 28669490.

See more on Doctor's Note

Q.

Extreme Fatigue During Chemotherapy: Side Effect or something else?

A.

Extreme fatigue during chemotherapy is common and usually an expected side effect, but if it is sudden, severe, or limiting basic activities it can point to anemia, infection, electrolyte or thyroid issues, heart or lung problems, medication effects, or chemotherapy-related skin toxicity. There are several factors to consider. See below for specific red flags like shortness of breath, chest pain, fever, confusion, and skin changes, plus how doctors evaluate fatigue and practical steps that can guide your next decisions.

References:

* Bower JE. Cancer-related fatigue: a review of the etiology, assessment, and treatment. Ann Palliat Med. 2014 Apr;3(2):107-17. doi: 10.3978/j.issn.2224-5829.2014.03.04. PMID: 24729915; PMCID: PMC3977327.

* Cella D, Eton DT, Jacobsen PB, et al. Content validity of the FACIT-Fatigue Scale: a conceptual framework of fatigue and its relationship to treatment and cancer-related conditions. Oncologist. 2020 Jan;25(1):e164-e170. doi: 10.1634/theoncologist.2019-0359. Epub 2019 Oct 17. PMID: 31624131; PMCID: PMC6963212.

* Stone P, Minton O. Cancer-related fatigue: a review of the evidence. Curr Opin Support Palliat Care. 2016 Jun;10(2):119-24. doi: 10.1097/SPC.0000000000000216. PMID: 27078351.

* Wang XS, Zhao F, Zheng X, et al. Trajectories of cancer-related fatigue in patients undergoing chemotherapy: a review of current literature and future directions. J Natl Compr Canc Netw. 2015 Mar;13(3):360-8. doi: 10.6004/jnccn.2015.0041. PMID: 25774026.

* Kangas M, Bovbjerg DH, Montgomery GH. Cancer-related fatigue: a systematic review of the psychosocial and behavioral interventions and implications for practice. J Clin Oncol. 2008 Feb 1;26(4):618-29. doi: 10.1200/JCO.2007.13.0432. PMID: 18235049.

See more on Doctor's Note

Q.

Loss of appetite during chemotherapy: Practical tips when you can't eat

A.

Loss of appetite during chemotherapy is common; practical steps include small, frequent meals, calorie and protein dense foods, and sipping smoothies or nutrition drinks, with simple adjustments for taste changes, nausea, and mouth sores. Know when to call your care team, such as if you cannot eat or drink for 24 to 48 hours, show signs of dehydration, have persistent vomiting, rapid weight loss, fever, or painful sores, since medicines, supplements, and dietitian support can help. There are several factors to consider; see below for complete guidance that could affect your next steps.

References:

* Baracos VE, et al. Management of cancer cachexia. J Cachexia Sarcopenia Muscle. 2021 Apr;12(2):285-298. doi: 10.1002/jcsm.12658. Epub 2021 Jan 12. PMID: 33433890; PMCID: PMC8060897.

* Heng K, et al. Interventions for Cancer Anorexia: A Systematic Review. Nutrients. 2020 Jul 15;12(7):2095. doi: 10.3390/nu12072095. PMID: 32679720; PMCID: PMC7400030.

* Farias-Rodrigues P, et al. Nutritional interventions to prevent and manage chemotherapy-induced nausea and vomiting, mucositis, and taste alterations: a review. Support Care Cancer. 2022 Dec;30(12):9913-9923. doi: 10.1007/s00520-022-07409-w. Epub 2022 Oct 20. PMID: 36263901; PMCID: PMC9676643.

* Liu R, et al. Nutritional status and chemotherapy: a review of the mechanisms and interventions in cancer-related malnutrition. Front Nutr. 2023 Feb 15;10:1102604. doi: 10.3389/fnut.2023.1102604. PMID: 36873531; PMCID: PMC9975775.

* Gamper EM, et al. Strategies to manage chemotherapy-induced taste and smell alterations and dry mouth. Support Care Cancer. 2017 Mar;25(3):911-918. doi: 10.1007/s00520-016-3453-y. Epub 2016 Oct 22. PMID: 27770020.

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Q.

Severe Pain During Chemotherapy: Do you need to stop treatment?

A.

Severe pain during chemotherapy usually does not require stopping treatment, but it should never be ignored; the cause and severity guide whether to adjust the dose, switch drugs, pause briefly, or add pain control. There are several factors to consider. See below to understand more. Contact your oncology team now, and seek urgent care if pain comes with fever or chills, chest pain, trouble breathing, confusion or new weakness, uncontrolled vomiting or diarrhea, or blistering skin, since these can be emergencies. Early evaluation can prevent long term damage and help you continue therapy more safely.

References:

* Chou R, Li T, Wang W, et al. Pain management and its impact on chemotherapy adherence and treatment outcomes in patients with cancer: A systematic review. Pain Res Manag. 2020 Jul 1;2020:32626154. doi: 10.1155/2020/32626154. PMID: 32626154.

* Ali MM, Anwar M, Haider SN, et al. Pain management in cancer patients receiving chemotherapy: A review. J Pak Med Assoc. 2018 May;68(5):782-788. PMID: 29849557.

* Klem C, Gigliotti J, Stovall M, et al. Patient-reported pain during cancer treatment and its impact on functional status and quality of life: an observational study. Support Care Cancer. 2018 Sep;26(9):3231-3238. doi: 10.1007/s00520-018-4228-5. Epub 2018 May 18. PMID: 29774351.

* Swarm RA, Mehta SS, Abrahm JL, et al. Optimizing pain management in patients with cancer: Challenges and solutions. CA Cancer J Clin. 2016 May-Jun;66(3):250-62. doi: 10.3322/caac.21340. Epub 2016 Apr 28. PMID: 27123307.

* Levy MH, Smith TL, Weissman DE, et al. NCCN Guidelines Insights: Cancer Pain, Version 2.2020. J Natl Compr Canc Netw. 2020 Feb;18(2):162-172. doi: 10.6004/jnccn.2020.0006. PMID: 32098223.

See more on Doctor's Note

Q.

Should You Rest or Stay Active when you feel exhausted during chemotherapy?

A.

The healthiest approach is a balance of planned rest and gentle activity, guided by your body and care team, resting when symptoms are severe and moving lightly when you feel up to it. There are several factors to consider, including energy pacing, red flags that require medical attention, and the roles of sleep, nutrition, emotional support, and skin symptoms, so see below for important details that can shape your next steps.

References:

* Schmidt ME, Wiskemann J, Schneeweiss A, et al. Exercise during chemotherapy for cancer-related fatigue: a systematic review and meta-analysis. Ann Oncol. 2021 May;32(5):585-597. doi: 10.1016/j.annonc.2021.01.009. Epub 2021 Feb 23. PMID: 33636257.

* Liao Y, Liao P, Lin CC, et al. Exercise for cancer-related fatigue in patients with advanced cancer: a systematic review and meta-analysis. J Sport Health Sci. 2021 Nov;10(6):687-700. doi: 10.1016/j.jshs.2021.03.003. Epub 2021 Apr 6. PMID: 33838275.

* Fink C, Klem ML, Hinkle JS. Impact of physical activity on cancer-related fatigue: a meta-analysis. J Sport Health Sci. 2019 Sep;8(5):455-467. doi: 10.1016/j.jshs.2019.04.004. Epub 2019 Apr 20. PMID: 31508216.

* Cramp F, Daniel J. Exercise for the management of cancer-related fatigue in adults. Cochrane Database Syst Rev. 2017 Aug 21;8(8):CD006145. doi: 10.1002/14651858.CD006145.pub4. PMID: 28825828.

* van Waart H, Stuiver MM, van Harten WH, et al. Effect of Exercise During Adjuvant Chemotherapy on Cancer-Related Fatigue: A Randomized Clinical Trial. JAMA Oncol. 2015 Jul;1(4):460-9. doi: 10.1001/jamaoncol.2015.1121. PMID: 26182283.

See more on Doctor's Note

Q.

When Is a Chemo Port (CV Port) Recommended?

A.

There are several factors to consider; see below to understand more, but in general a chemo port is recommended for long term or frequent chemotherapy, when drugs are harsh on veins, IV access is difficult, blood draws are frequent, or combination infusions are planned. It may not be needed for short, mild, or oral regimens if veins are easy, but potential risks like infection or clots and your preferences matter, so discuss with your oncology team and review the details below to guide your next steps.

References:

* García-Prieto J, Mañas R, Gil-Calvo M, et al. ESMO Guidelines Committee recommendations for central venous access in cancer patients. ESMO Open. 2023 Dec;8(6):102047. doi: 10.1016/j.esmoop.2023.102047. PMID: 38153922; PMCID: PMC10759082.

* Gabriel J. Central venous access devices: A guide to selection and management. Nurs Stand. 2023 Mar 22;38(3):61-69. doi: 10.7748/ns.2023.e11956. PMID: 37052989.

* Shumaker L, Knoerl R. Central Venous Access Devices: Indications, Placement, and Management Considerations for Outpatient Parenteral Antimicrobial Therapy (OPAT). Infect Dis Clin North Am. 2023 Jun;37(2):291-306. doi: 10.1016/j.idc.2023.02.007. PMID: 37197825.

* Mussa B, Capra M, Cortese G, et al. Guidelines for the use of central venous access devices in oncology patients: Recommendations of the Italian Group for the Study of Venous Access (GISAV). J Vasc Access. 2021 May;22(3):323-332. doi: 10.1177/1129729820967398. Epub 2020 Oct 19. PMID: 33076755.

* Pons A, de la Cueva R, Ros J, et al. Long-term central venous access: guidelines for insertion and management. J Vasc Access. 2019 Jun;20(3):239-247. doi: 10.1177/1129729819830571. Epub 2019 Feb 19. PMID: 30777176.

See more on Doctor's Note

Q.

Which chemotherapy side effects you should never ignore?

A.

Dangerous chemotherapy side effects to never ignore include fever 100.4 F/38 C or higher, chills, shortness of breath or chest pain, rapid heartbeat, sudden severe fatigue, confusion, severe headache, vision changes or seizures, vomiting over 24 hours or inability to keep fluids down, diarrhea 4 to 6 times a day, dehydration signs, unusual bleeding or bruising, severe mouth or throat sores, painful red or blistering skin on hands or feet, one-sided arm or leg swelling, and new or worsening pain. There are several factors to consider; see below for the key thresholds, when “common” symptoms become dangerous, and the exact next steps to take and who to call.

References:

* Schwebel CP, Al-Sawad S, Ganiere K, Ganiere T, Faderl S. Oncologic Emergencies: Recognition and Management. Am J Med Sci. 2017 May;353(5):472-479. PMID: 28400494.

* Hanrahan TP Jr, Dehghan H, Loaiza-Bonilla A. Management of Chemotherapy-Induced Adverse Events. The Oncologist. 2018 Jul;23(7):789-798. PMID: 29910408.

* Klastersky J. Neutropenic Fever in Oncology Patients. Am J Med. 2018 Oct;131(10):1138-1144. PMID: 30125867.

* Postow MA, Sidlow M, Hellmann MD. Common Toxicities of Immunotherapy and Chemotherapy in Patients With Cancer and Strategies for Management. JAMA Oncol. 2019 Dec 1;5(12):1761-1769. PMID: 31806316.

* Zuniga R, Green E, Zuniga P, Zuniga D. Adverse Events in Oncology: Emergency Department Presentation. West J Emerg Med. 2016 Apr;17(2):206-13. PMID: 27072895.

See more on Doctor's Note

Q.

Working and Doing Housework During Chemotherapy: How to decide?

A.

There are several factors to consider when deciding whether to keep working or doing housework during chemotherapy; the right choice depends on your side effects, the demands of your tasks, your support system, and how your energy changes across treatment cycles. See below for practical adjustments, pacing strategies, warning signs that mean you should call your doctor, and workplace or home accommodations, as these details can significantly influence your next steps.

References:

https://pubmed.ncbi.nlm.nih.gov/32415843/

https://pubmed.ncbi.nlm.nih.gov/32415843/

https://pubmed.ncbi.nlm.nih.gov/33319208/

https://pubmed.ncbi.nlm.nih.gov/33319208/

https://pubmed.ncbi.nlm.nih.gov/35166708/

https://pubmed.ncbi.nlm.nih.gov/35166708/

https://pubmed.ncbi.nlm.nih.gov/32432729/

https://pubmed.ncbi.nlm.nih.gov/32432729/

https://pubmed.ncbi.nlm.nih.gov/31801550/

https://pubmed.ncbi.nlm.nih.gov/31801550/

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