Subungual myiasis: An unusual complication of taxane chemotherapy

Two cases of subungual myiasis in predisposed patients

“…1 Additionally, the subungual area is a rarely reported infestation site. A thorough literature search identified only 5 individual cases of subungual myiasis worldwide, [2][3][4][5][6] which are summarized in Table I.…”

“…First, taxane-based chemotherapy induces onycholysis as a direct toxic effect while causing peripheral neuropathy, impairing microcirculation, which ultimately inflicts nail bed damage. 6 The microdamage on the nail plate and bed provides a suitable habitat for maggots. Second, peripheral neuropathy due to diabetes, edema, or venous dysfunction can impair microcirculation; hence, they also serve as risk factors for subungual myiasis with a mechanism similar to that of the taxane.…”

“…Based on the previous case reports, the most common agents were from the family Sarcophagidae. [2][3][4][5][6] In case 1, further identification of larvae was unavailable because they were discarded after the treatment. The larvae from case 2 measured approximately 10 mm in length and exhibited typical sarcophagid features with posterior spiracles lying within a hollow.…”

“…The larvae from case 2 measured approximately 10 mm in length and exhibited typical sarcophagid features with posterior spiracles lying within a hollow. 6 Treatment of subungual myiasis involves manual removal of the larvae with or without extraction of the affected nail plate. [2][3][4][5][6] Footbaths with antiseptic solution or systemic antibiotics to prevent secondary infection can be considered.…”

“…6 Treatment of subungual myiasis involves manual removal of the larvae with or without extraction of the affected nail plate. [2][3][4][5][6] Footbaths with antiseptic solution or systemic antibiotics to prevent secondary infection can be considered. In addition to the removal of larvae, it is important to identify and modify the predisposing factors and properly educate the patients.…”