SummaryBackground: Capecitabine is an oral antineoplastic agent classifi ed as a pyrimidin analogue. It is widely used in diff erent types of cancers. Unfortunately, it does not come without a cost, as the drug may have adverse eff ects -largely diarrhea, but also hand-foot syndrome and loss of fi ngerprints in extreme cases. Case: We report a case of a 47-year-old male, which had been dia gnosed with metastatic rectal cancer and received capecitabine, developing a severe hand foot syndrome which led him to lose his fi ngerprints in spite of complete resolution of the syndrome after stoppage of the drug. Conclusion: This case highlights a rare condition that, even though not precisely a disease per se, may hinder patient's quality of life and must be recognised by the treating physician as an treatment related side eff ect.