Table 11 Grading of hand-foot syndrome and skin toxicity of targeted therapy for renal cell carcinoma

Severity grading Hand-foot syndrome Rash
Grade I Mild painless skin changes or skin inflammation (e.g., erythema, edema, hyperkeratosis) Patchy rash, papules, or erythema without other symptoms
Grade II Painful skin changes (e.g., flaking, blistering, bleeding, edema, hyperkeratosis) that interfere with activities of daily living Patchy, papular or erythematous rash without other symptoms, localized flaking and lesions involving <50% of the body surface area
Grade III Severe skin changes (exfoliation, blistering, bleeding, edema, hyperkeratosis) with pain, interfering with one’s activities of daily living. Generalized red rash, macules, papules or herpes, flaking and lesions covering >50 % of the body surface
Grade IV Generalized exfoliative, ulcerative, or blistering dermatitis
Class V Death

Note: The National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE 4.0) was used for grading hand-foot syndrome, and NCI-CTCAE 3.0 was used for grading skin rash.