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A 67-year-old woman presented with painful hands and feet with intense redness and peeling skin. The patient had a medical history of transitional-cell bladder cancer. Treatment with the chemotherapeutic drug capecitabine had begun one month prior to our consultation. Exam revealed symmetric, well-demarcated erythematous plaques with edema over the distal finger pads of all 10 digits. Intense erythema, edema, and palpable warmth were observed on all 10 distal toe pads. Tactile sensations were intact.

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