Trying to perform a transaction at her bank, a 65-year-old Mexican woman was unceremoniously turned down. Disbelieving, she tried again; after all, she knew she had enough money in her account. Much to her embarrassment (and the annoyance of others waiting in line), the machine refused to grant her access once again. Turns out, the bank's response had nothing to do with her credit report and everything to do with her hands.

The touch screen no longer recognized her fingerprints, she discovered. In fact, she had none. How could this be?

The woman’s doctor soon provided an explanation and then published her case study in a venerable medical journal. For three months, she had undergone treatment for breast cancer with capecitabine (Xeloda) and bevacizumab (Avastin). Her oncologist had chosen these specific drugs to treat her triple-negative tumor. The name refers to the lack of expression of three key elements: an estrogen receptor, progesterone receptor, and human epidermal growth factor receptor type 2 [HER2]).

During the first cycle of her chemo treatments, she had developed grade one hand-foot syndrome. Medically, this is known as palmar-plantar erythrodysesthesia, and it is a known side effect of some chemo drugs.

Hand-foot syndrome includes redness, swelling, numbness, rash, and pain on the palms of the hands or soles of the feet. In the worst of cases, the skin can become cracked, flaking, or peeling while blisters, ulcers, and sores appear on the surface. Causing intense pain, hand-foot syndrome may make it difficult or nearly impossible to walk or use your hands.

On her thoughtful blog, breast cancer patient Lisa Bonchek Adams writes about her own ordeal with hand-foot syndrome. “I continue with frequent moisturizing of my hands and feet (at least 10 times a day) with a variety of lotions including shea butter, Eucerin, Aquaphor, and more. I stay away from water, do not apply heat on hands/feet, wear socks and soft shoes/slippers, and wear gloves as much as possible.”

In the case of the Mexican woman who lost her fingerprints, her oncologist told her, No worries! At first, her hand-foot syndrome was successfully treated with topical ointments and creams. However, after she underwent a third cycle of chemotherapy, the symptoms worsened. In fact, they became so toxic, she could not perform her usual, daily activities.

It is not uncommon for breast cancer patients to be forced to discontinue treatment when side effects become debilitating. Luckily for the Mexican woman without fingerprints, her treatment had already accomplished a lot so her oncologist delayed one dose and then subsequently gave her a reduced dose at scheduled sessions. Though the side effects from the medicine ended, she was left without fingerprints on her thumb and fingers. They had become completely erased.

No fingerprints
No fingerprints Courtesy of Chavarri-Guerra and Soto-Perez-de-Celis.

Source: Chavarri-Guerra Y, Soto-Perez-de-Celis E. Loss of Fingerprints. NEJM. 2015.