 Hi, my name is Nancy Ainslie. I'm a urology research nurse at MD Anderson Cancer Center, and I'm going to talk to you about one of the side effects affecting the skin called hand-foot syndrome. This short presentation is intended to inform you and your loved ones about strategies for managing the side effects associated with targeted therapies. There are many side effects which may affect your skin and hair while on these targeted therapies. These are referred to as dermatologic side effects. These side effects will vary from patient to patient and will also vary depending on the type of targeted therapy that you are taking. The most common side effects that may affect your skin and hair are hand-foot syndrome, rash, photosensitivity, scars and sores that take longer to heal, splinter-like lines under the nails, skin or hair color changes, and alopecia which is a thinning or loss of hair. Hand-foot syndrome may present with redness, numbness, entangling, swelling, pain or tenderness, dryness, blisters, calluses or cracking of the palms of the hands or the soles of the feet. In this slide you'll see signs of dry peeling skin, redness, calluses on the soles of the feet. These sore, tender areas and breakdown of skin may be so painful that it will interfere with your activities of daily living such as walking, any type of exercise or wearing shoes. Some patients may experience all of these side effects or you may only experience the redness or the numbness and tingling. On this slide you can see a patient with signs and symptoms affecting both the hands and the feet. Some patients experience one or the other or both. These symptoms may interfere with activities such as walking, exercise, gardening, buttoning of clothing. You should inform your health care provider as soon as you see any signs of these symptoms developing. Prevention and management of hand-foot syndrome is important to minimize the condition. If a patient has pre-existing calluses, they may be more likely to develop calluses or worsening calluses while they are on therapy. They should have a pedicure prior to starting therapy to remove existing calluses. If a patient is diabetic, they should consult with their physician prior to starting treatment and maintain good glycemic control. You should notify your physician immediately with any signs of skin breakdown or infection. The best prevention and management is to keep skin well-moisturized prior to and throughout therapy by using lotions or creams. You may use such products as bag balm, a vino, utterly smooth or utter cream, lube or derm gold bond or vaseline. You should avoid vigorous rubbing when applying the lotions. You should avoid walking barefoot. You should wear comfortable shoes and socks. Some patients find that gel soles are helpful. You should not expose your skin to heat or hot water such as hot showers or washing dishes in hot water. You should avoid vigorous exercise that may put pressure on sore and tender areas such as walking, jogging or gardening. You should avoid tight dressings or band-aids or adhesive tape to the skin. Some patients find that soaking their hands and feet in lukewarm water several times a day helps to relieve symptoms. You should keep your legs raised whenever possible. If calluses do develop, use urea-containing lotions such as carousal, carol or carolec and apply these lotions only to the callused area. Some patients have also found that placing your skin, the affected areas on an ice pack or in cool water several times a day relieves pain. You should alternate this on and off 10 to 15 minutes at a time. Use pain reliever such as Tylenol as needed or consult with your health care provider about another type of pain reliever. There are topical steroids that may be available to use such as regenicare or lidocaine. You would need to speak to your health care provider for prescription for these. If peeling or cracking skin occurs, watch for signs of infection and you may need a consult with a dermatologist or podiatrist if symptoms are interfering with activities of daily routine. In summary, you should communicate with your doctor or nurse when side effects occur so that they can evaluate and help you to manage your symptoms. Preventive care and management can minimize the severity of symptoms and increase treatment compliance and increase your quality of life while on these therapies. Thank you.