Toxic erythema of chemotherapy (TEC) refers to a range of nonallergic cutaneous eruptions that develop in the setting of chemotherapy. Key clinical features include formation of erythematous or edematous patches and plaques on the hands, feet, and intertriginous areas associated with dysesthesia, pain, and pruritus. Elbows and knees and ears are less frequently involved. Affected skin may appear violaceous, and bulla formation may occur in severe cases. The lesions are self-limited and will desquamate and resolve spontaneously.

The eruptions develop 2 days to 3 weeks after chemotherapy administration. Commonly associated chemotherapies include cytarabine, anthracyclines (doxorubicin), 5-fluorouracil, capecitabine, taxanes (docetaxel, paclitaxel), and methotrexate.

TEC is thought to result from a toxic effect of chemotherapy agents on eccrine cells and on the epidermis as the chemotherapy is extravasated from eccrine ducts. TEC may recur and worsen on drug rechallenge.

The range of entities classified under TEC is broad and includes acral erythema (palmar-plantar erythrodysesthesia, hand-foot syndrome), intertriginous eruption of chemotherapy, and neutrophilic eccrine hidradenitis, among others.