Nail pigmentation due to hydroxycarbamide

Abstract

A 47-year-old male developed both longitudinal melanonychia and periungual hyperpigmentation 6 months after initiation of hydroxycarbamide (synonym: hydroxyurea) therapy for chronic myeloproliferative disease. Based on the clinical symptoms observed in this patient, the broad differential diagnostic spectrum of hyperpigmentation of the nails is briefly reviewed here. In individuals who undergo hydroxycarbamide treatment, melanonychia might sometimes be seen as side effect and always has to be differentiated from subungual malignant melanoma.

Melanonychia secondary to hydroxyurea

“…Melanonychia can be of infections, melanocytic, and exogenous origin, caused by metabolic disorders, or reflect an adverse effect of therapy with specific drugs [1]. Hydroxyurea is a cytostatic agent used to treat myeloproliferative disorders, and long-term treatment is associated with mucocutaneous adverse events and nail hyperpigmentation [2,3].…”

“…Hydroxyurea is a cytostatic agent used to treat myeloproliferative disorders, and long-term treatment is associated with mucocutaneous adverse events and nail hyperpigmentation [2,3]. Cases of hydroxyurea-induced melanonychia are uncommon [1][2][3].…”

Non‐melanoma Hutchinson's sign: a reappraisal of this important, remarkable melanoma simulant

“…Two years after the first lesions occurred, the patient developed Addison's disease. 33,34 Mycologic and bacterial pigmentation Black moulds A distolateral onychomycosis due to Phialophora spp was reported by de Carvalho 35 in a 77-year-old male 29 Drugs Polydactylous and monodactylous periungual pigmentation may result from minocycline, 30 zidovudine, 31 amlodipine 32 and hydroxycarbamide.…”

A Case of Longitudinal Melanonychia Secondary to Hydroxyurea

“…One mechanism of action is thought to be based on its reduction of production of deoxyribonucleotides via inhibition of the enzyme ribonucleotide reductase. 9,10 The exact mechanisms leading to activate melanocytes, have not been clarified yet. Toxicity impairing the nail bed or nail matrix, focal stimulation of nail-matrix, melanocytes, and photosensitization are possible causes.…”