Grade 1:
Numbness, dysaesthesia/paraesthesia. Tingling, painless swelling or erythema of the hands or feet that does not affect the patient’s daily activities.

Grade 1:
Maintain TKI dose. The patient should be encouraged to apply moisturiser.

Grade 1:
Instruct the patient to use a solid moisturiser and provide advice (see below).

Grade 2:
Painful erythema and swelling of the hands and/or feet that affects the patient’s daily activities.

Grade 2:
1st occurrence: Pause TKI until grade 0 or 1. Resume at same dose 2nd occurrence: Pause TKI until grade 0 or 1. Resume TKI at reduced dose.

Grade 2:
See above. Use: 1) Low-potency topical steroids (group 1 or 2) 2) Oil of Life (taken orally and/or applied to the body) 3) Urea-containing cream 4) Soft/relieving soles in shoes 5) Pedicure

Grade 3:
Moist desquamation, ulceration, blistering, or severe pain in the hands and/or feet that renders the patient unable to work or perform daily activities

Grade 3:
1st occurrence: Pause TKI until grade 0 or 1. Resume TKI at reduced dose 2nd occurrence: Pause TKI until grade 0 or 1. Resume TKI at further reduced dose.

Grade 3:
See above. Consider topical antibiotics. Consider painkillers.