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Sorafenib is a Food and Drug Administration-approved multikinase inhibitor, used for the treatment of thyroid, renal, and hepatocellular carcinomas. Hand–foot syndrome also known as palmoplantar erythrodysesthesia is a common side effect of the drug. Here, we present one such case report.

A 60-year-old male patient, diagnosed with poorly differentiated papillary carcinoma of the thyroid with metastasis to lungs and cervical lymph nodes, was initiated on chemotherapy with sorafenib at 800 mg/day posttotal thyroidectomy and radical neck dissection. 6 weeks later, the patient presented to the oncologist with complaints of burning and pain of the palms and soles and peeling of the skin. The patient was then prescribed emollients and dose of sorafenib was reduced to 600 mg daily. During the follow-up visit 8 weeks later, the patient had worsening of the palmoplantar lesions with desquamation and bulla formation of both heel region [Figure 1] and well to ill-defined erythematous scaly plaques on palms[Figure 2] and soles [Figure 3]. The lesions were tender, and the patient had difficulty in walking. With a history of sorafenib intake and clinical examination, a diagnosis of hand–foot syndrome secondary to sorafenib was considered. The patient did not agree to get a biopsy done. Sorafenib was discontinued, and the patient was initiated on emollients and potent topical steroids. Subsequently, the patient was lost to follow-up.