Nail changes due to docetaxel--a neglected side effect and nuisance for the patient.
OBJECTIVE
The objective of this study is to estimate the frequency and severity of nail changes due to treatment with the cytotoxic drug docetaxel and, secondly, to estimate how the nail changes effects the patients cosmetically and functionally in their daily activities. Finally, we want to clarify whether fungal infection could contribute in causing the nail changes.


METHODS
Fifty-five patients with metastatic breast cancer in treatment with the cytotoxic drug docetaxel participated in the study. They filled out two questionnaires about their experience with possible nail changes. The frequency of fungal infection was examined. At each of the two visits, information about the number of treatment cycles, dose of docetaxel the patient received, frequency of lymph oedema, previous treatment with chemotherapy and the reason of discontinuance of treatment, if relevant, were registered. Finally, photos were taken to document the nail changes in hands and feet.


RESULTS
Fifty-eight percent had some degree of nail changes and an increase to 88.5% was seen after three additional cycles. A large proportion of the patients experienced the nail changes as a cosmetic nuisance, and more than 32% had functional problems.


CONCLUSIONS
Nail changes occur more frequently than previous studies have shown. Furthermore, our study indicates that the nail changes are affecting a large proportion of the patients, both cosmetically and functionally, which may lead to a decrease in their quality of life. No significant association was found according to the possible relation between nail changes and fungal infection.
Winther
Dorte
D
Section of Clinical Research, Department of Oncology, Aarhus Sygehus, Nørrebrogade 44, 8000 Aarhus C, Denmark.
Saunte
Ditte Marie
DM
Knap
Marianne
M
Haahr
Vera
V
Jensen
Anders Bonde
AB
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000494:pharmacology; D003718:Denmark; D000077143:Docetaxel; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009264:Nails, Malformed / Q000139:chemically induced* / Q000473:pathology; D043823:Taxoids / Q000009:adverse effects* / Q000494:pharmacology
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel