Docetaxel-induced onycholysis: the role of subungual hemorrhage and suppuration.
Nail changes are common side effects of taxane chemotherapeutic agents. Docetaxel (Taxotere) is known to cause a great incidence of nail change. Various types of nail changes have previously been reported as a result of treatment with taxanes. We describe 2 cases of severe nail changes induced by docetaxel. The patients had previously been diagnosed with breast cancer and advanced gastric cancer, respectively. During the course of treatment with docetaxel, nail changes became apparent in both patients. Initially, they complained of nail bed purpura. Subungual hematomas with hemopurulent discharge were later observed in several fingers. Drainage of the hemopurulent material occurred spontaneously in our cases, leading to onycholysis. Following drainage, the pain in the nail with subungual hemoprulent material was relieved immediately and spontaneous healing of the patients' nails was noticed after few months. Subungual hemorrhage and suppuration therefore are considered causes of onycholysis and the pain in these patients. Although systemic or topical antibiotics were not used to treat these patients, antibiotics may be also worthwhile to hasten the drainage of the subungual hematomas and suppuration in patients for quick relief of pain.
Roh
Mi Ryung
MR
Department of Dermatology, Yonsei University College of Medicine, Yongdong Severance Hospital, 146-92 Dogok-dong, Kangnam-gu, Seoul 135- 720, Korea.
Cho
Jae Yong
JY
Lew
Wook
W
D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy; D000077143:Docetaxel; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009260:Nail Diseases / Q000139:chemically induced* / Q000473:pathology; D013274:Stomach Neoplasms / Q000188:drug therapy; D013492:Suppuration / Q000139:chemically induced / Q000473:pathology; D043823:Taxoids / Q000009:adverse effects* / Q000627:therapeutic use
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel