Gefitinib-Induced Paronychia

Abstract

Background: Paronychia has been reported in as many as 10% of patients treated with gefitinib. Although conservative management and treatment with topical or systemic antibiotics are beneficial, no effective method exists for intractable cases. Platelet-rich plasma (PRP) consists of a high concentration of platelets that promote wound healing through chemotaxis, cell proliferation, angiogenesis, and tissue remodeling. Observations: We herein report a refractory case of gefitinib-induced paronychia successfully treated with autologous PRP. A 68-year-old woman who had been diagnosed as having lung adenocarcinoma with multiple bone and brain metastases initiated gefitinib therapy at an oral dose of 250 mg/d. After 1 month, multiple paronychia with periungual granulation appeared on the nail fold of the first, second, and third toenails of both feet. Because the paronychia recurred repeatedly despite use of a topical antibiotic, topical corticosteroid, and shortterm systemic antibiotic, she started PRP treatment. After 3 months, the lesion showed marked improvement with minimal pain or discharge. Conclusion: This case highlights the therapeutic challenges of using PRP to promote tissue repair in intractable gefitinib-induced paronychia and merits further investigation.

Onkolojide Moleküler Hedefli Tedaviler

“…İleri evre, RET füzyonu pozitif KHDAK' de, sistemik tedaviye ihtiyaç duyan RET mutasyonu pozitif 12 yaş ve üstü ileri evre medüller tiroid kanseri ve radyoaktif iyot tedavisine yanıt vermeyen veya radyoaktif iyot tedavisi için uygun olmayan RET füzyonu pozitif sistemik tedavi gerektiren 12 yaş ve üzerindeki RET füzyon pozitif ileri evre tiroid kanseri tedavisinde kullanılır. Önerilen selperkatinib dozu 50 kg'ın altındaki hastalar için 120 mg ve 50 kg veya üzeri hastalar için 160 mg' dır (104). Plazma proteinlerine %97 oranında bağlanır.…”

Dermatologic conditions in women receiving systemic cancer therapy

“…Propranolol 1% cream and 0.5% topical timolol gel have been used more recently (Cubiró et al, 2018, Piraccini et al, 2016). One study demonstrated efficacy with platelet-rich plasma in treatment of recalcitrant paronychia from EGFR inhibitor therapy (Kwon et al, 2012). In refractory cases, nail plate avulsion or surgical debridement may be required for painful ingrown nails (Gilbar et al, 2009).…”