Onycholysis as a complication of systemic chemotherapy

Abstract

BACKGROUND Onycholysis has been reported in association with the use of several noncytotoxic drugs and with chemotherapy in 135 patients. Onycholysis may be precipitated by exposure to ultraviolet radiation. METHODS The authors studied 91 patients who received paclitaxel and 187 patients who received doxorubicin. RESULTS Onycholysis occurred in 5 of 21 patients who received > 6 courses of weekly paclitaxel, developing in the summer months in all 5 patients. It did not occur in patients who received fewer weekly paclitaxel courses or those who were treated every 3 weeks. Onycholysis did not occur in 187 patients who received doxorubicin. Review of the literature revealed that onycholysis is nearly exclusively associated with anthracycline and taxane therapy. CONCLUSIONS Prolonged weekly paclitaxel, other taxanes, and anthracyclines cause onycholysis in some patients, which may be precipitated by exposure to sunlight. Patients receiving these drugs should protect their nails from sunlight. Cancer 2000;88:2367–71. © 2000 American Cancer Society.

Chemotherapy-associated paronychia treated with 2% povidone–iodine: a series of cases

“…These structural disruptions, in combination with the inherent immunosuppression of the patient, allow for the nail apparatus to become secondarily infected. Numerous case reports and case series document secondary bacterial, fungal, and yeast infections of both the nail plate and periungual soft tissue structures 2,9–15…”

Onycholysis Associated with Capecitabine in Patients with Breast Cancer

“…The great toenail is the most often involved, alone or with other digits. 9 Onycholysis is often seen in conjunction with palmar-plantar syndrome. However, onycholysis associated with the novel agent capecitabine is reportedly rare.…”

Chemotherapy-Induced Nail Changes: An Unsightly Nuisance

“…Chemotherapeutic agents that have documented onycholysis as a side effect include anthracyclines, taxanes, and topical 5-fluorouracil (Hussain et al, 2000). In addition, docetaxel and paclitaxel can cause onycholysis.…”