Toxic erythema of chemotherapy (TEC) is a general term for skin changes arising in connection with treatment with certain chemotherapeutic agents on the basis of an intensified toxic reaction.[1][2] Among the frequent clinical variants of TEC is localized acral erythema characterized by the development of painful erythematous lesions mainly on the palms and soles.[1][2] Acral erythema occurs in up to 53% of patients treated with chemotherapy.[1] A case is described of a 73-year-old patient with colon cancer and liver metastases who developed acral erythema after a fifth course of adjuvant chemotherapy with capecitabine (Xeloda).[1] Capecitabine is indicated for the adjuvant treatment of patients after surgery for stage III (Dukes stage C) colon cancer.[1] Acral erythema induced by chemotherapy is reversible and always affects the skin of the hands and feet bilaterally in varying degrees of development.[1]