PMC9937683_01
Hyperkeratotic desquamating plaques over the (A) left fifth metatarsal, (B) right great toe, and (C) right fourth metatarsophalangeal joint.
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FIG1
On clinical examination, the patient had hyperkeratotic tender plaques with overlying superficial desquamation over the plantar surfaces of the right great toe, left fifth metatarsal, and bilateral fourth metatarsophalangeal joints (Figure 1A-1C).
HFSR (A) before and (B) after treatment with topical keratolytics, topical steroids, and brief cessation of axitinib.. HFSR: hand-foot skin reaction
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FIG2
Given the prompt improvement in pain and lesion size within one week of cessation (Figure 2A-2B), the patient was successfully able to restart axitinib at a decreased dose of 3 mg twice daily instead of 5 mg twice daily.