Influence of Chemotherapy on the Antioxidant Status of Human Skin

Anticancer Res. 2016 Aug;36(8):4089-93.


Background: Palmoplantar erythrodysesthesia is a frequent dermal side-effect during chemotherapy. Previous investigations showed radical formation subsequent to doxorubicin infusion and preventative and therapeutic effects of an antioxidant-containing ointment.

Patients and methods: Using a non-invasive vivomeasuring system (Biozoom®; Biozoom Services GmbH, Kassel, Germany) changes in the antioxidant status (as measured by relative carotenoid concentration) of the skin prior to and after intravenous administration of paclitaxel, docetaxel and 5-fluorouracil were investigated in 42 patients with cancer.

Results: A significant decrease of antioxidant concentration subsequent to intravenous administration was found for all investigated chemotherapeutic agents. The mean concentration of carotenoids decreased from 3.59±1.26 arbitrary units (a.u.) to 3.41±1.28 a.u. (p<0.001) after paclitaxel administration, from 6.33±2.43 to 5.63±2.29 a.u. after docetaxel (p=0.027) and from 4.26±1.81 to 3.98±1.53 a.u. (p=0.042) after 5-fluorouracil infusion.

Conclusion: Oxidative stress might play a significant role in the pathomechanism of palmoplantar erythrodysesthesia associated with paclitaxel, docetaxel and 5-fluorouracil. Therefore, an antioxidant-containing ointment might serve as preventative and therapeutic option.

Keywords: Hand–foot syndrome; antioxidants; dermal toxicity; palmar plantar erythrodysesthesia.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Antioxidants / metabolism*
  • Carotenoids / metabolism*
  • Docetaxel
  • Doxorubicin / adverse effects
  • Doxorubicin / therapeutic use
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / therapeutic use
  • Hand-Foot Syndrome / etiology
  • Hand-Foot Syndrome / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / drug therapy
  • Paclitaxel / adverse effects
  • Paclitaxel / therapeutic use
  • Skin / metabolism*
  • Taxoids / adverse effects
  • Taxoids / therapeutic use


  • Antineoplastic Agents
  • Antioxidants
  • Taxoids
  • Docetaxel
  • Carotenoids
  • Doxorubicin
  • Paclitaxel
  • Fluorouracil