Onycholysis as a complication of systemic chemotherapy: report of five cases associated with prolonged weekly paclitaxel therapy and review of the literature.
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.
Hussain
S
S
Department of Medicine, Health Sciences Center at Brooklyn, State University of New York, 11203-2098, USA.
Anderson
D N
DN
Salvatti
M E
ME
Adamson
B
B
McManus
M
M
Braverman
A S
AS
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D004317:Doxorubicin / Q000009:adverse effects; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D009260:Nail Diseases / Q000139:chemically induced*; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects*; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects*
D000970:Antineoplastic Agents; D000972:Antineoplastic Agents, Phytogenic; D011838:Radiation-Sensitizing Agents; D004317:Doxorubicin; D017239:Paclitaxel