Hand foot syndrome is difficult to treat. Topical 1% sildenafil cream is well-tolerated, feasible to administer, and may help mitigate hand-foot syndrome, results of a randomized, double-blind, placebo-controlled pilot study presented at the Oncology Nursing Society (ONS) 38^th Annual Congress. However, this report has not yet been peer reviewed as it was published as an abstract. Results were very modest. Of the 9 patients evaluable for safety and efficacy, no improvement was observed in hand-foot syndrome CTCAE grading, the primary end point. A trend was noted, however, “for relative improvement for pain and skin changes,” and no treatment-related adverse events were reported.

Meadows KL et al,  Treatment of palmar-plantar erythrodysesthesia (PPE) with topical sildenafil: a pilot study. Support Care Cancer. 2014 Oct 24.