We present the case of a 73-year-old man, diagnosed with metastat ic kidney cancer, who had been receiving oral sunit inib monotherapy 375 mg/ d for 4 years, with an acceptable level of disease cont rol. The pat ient was referred to our department for assessment of a painful, asymptomat ic, erythematous-violaceous, moderately indurated, confluent dermatosis that was present bilaterally and was most intense over the metacarpophalangeal j oints and, to a lesser extent , the interphalangeal j oints. This inflammatory process followed a linear dist ribut ion over the extensor tendons of the hands and feet (Figure 1, A and B). St rikingly, the palms of the hands and soles of the feet were completely unaffected.

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