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This hypothesis is supported by the appearance of lesions of HFSR specifically in areas chronically exposed to friction and with preexisting hyperkeratosis.20 Recently, the existence of a genetic predisposition to develop sorafenib-induced HFSR has been described in patients with hepatocellular carcinoma.21 Dranitsaris et al.22 developed and validated a predictive model for the onset of HFSR in patients receiving treatment with sorafenib.23,24 The management of HFSR is summarized in Table 3

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Accordingly, guidelines consider Li-ESWT an optional or investigational therapy in diabetes-associated ED, emphasising the lack of standardisation and the limited evidence in patients with advanced neuropathic involvement [36,42,55]