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 (axillae, groin, scrotum), associated with dysesthesia, pain, and pruritus. Elbows, knees, and ears may also be 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 within a few days or weeks after chemotherapy administration. Commonly associated chemotherapies include anthracyclines (doxorubicin), capecitabine and 5-fluorouracil analogues, cytarabine, taxanes (docetaxel, paclitaxel), and methotrexate, among others.

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 (malignant intertrigo), and neutrophilic eccrine hidradenitis, among others.