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Nail Changes

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There are several changes that can occur in the nail (nail diseases). This is due to direct toxicity of the chemotherapy drug to the nail plate.

Beau's line – a transverse groove in the nail plate
Onycholysis – separation of the nail plate from the underlying nail bed
Onchomadesis – loss of the entire nail
Nail pain, thickening and/or thinning
Hyper- or hypo-pigmentation – pale or dark streaks in the nail plate
Paronychia

 

Which drugs are responsible?

Two groups of chemotherapy drugs are particularly prone to cause nail changes:

Taxanes e.g. docetaxel and paclitaxel
Anthracyclines e.g. doxorubicin, idarubicin and epirubicin

Nail changes may also be seen with hydroxyurea.

Paronychia has also been observed and they occur with an incidence of 10-15% with EGFR therapy and < 1% with capecitabine therapy. Although supportive therapy is the best form of treatment, there has been some success with the use of doxycycline. In its most severe form a pyogenic granuloma can occur.

 

Management of chemotherapy-induced nail changes

Often nail changes disappear when the damaged nail is replaced by the growth of new nails. The optimal management may need to include pain killers as some of these nail changes can be exquisitely painful.  Zoya offers a nail kit that can reverse and protect the nails from many of these changes.