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2.
Taiwan J Obstet Gynecol ; 58(5): 709-711, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31542098

RESUMO

OBJECTIVE: Nail change after chemotherapy is relatively unfamiliar with gynecological oncologist. It often occurs after docetaxel treatment. For gynecological tract cancers, paclitaxel might be most frequently used but nail change after paclitaxel treatment is seldom reported before. CASE REPORT: Two patients treated with the postoperative dose-dense weekly schedule of paclitaxel 80 mg/m2 plus cisplatin 20 mg/m2 every three weeks were complicated with nail problems during the treatment. They included onycholysis, subungual hemorrhage, proximal white subungual collections of pus obscuring the lunula (onychophosis), dystrophy, Beau's lines, pigmentation, and melanonychia. Topical use of anti-fugal cream and oral antibiotics stopped the nail disease progression and both patients had completed their chemotherapy without interruption. CONCLUSION: Clinicians should be aware of paclitaxel-induced nail toxicities. Adequate information, detailed preventive intervention, and early use of prophylactic and/or therapeutic agents to minimize the occurrence of severe morbidity, such as cellulitis and subsequent sepsis is important for women who need the continuous dose-dense paclitaxel chemotherapy.


Assuntos
Antineoplásicos Fitogênicos/efeitos adversos , Carcinoma/tratamento farmacológico , Doenças da Unha/induzido quimicamente , Neoplasias Ovarianas/tratamento farmacológico , Paclitaxel/efeitos adversos , Adulto , Feminino , Humanos , Pessoa de Meia-Idade
3.
Saudi J Kidney Dis Transpl ; 30(4): 978-981, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31464259

RESUMO

Melanonychia is described as a brown to black pigmentation of nail, due to stimulation and hyperplasia of nail matrix. Various systemic disorders, trauma, inflammatory disorders, fungal infections, drugs, benign melanocytic hyperplasia, etc., are responsible for this condition, and most of them are benign. A number of chemotherapeutic agents can cause melanonychia. Cases of cyclophosphamide-induced melanonychia are not frequent. We report a 38-year-old female, a known case of steroid dependent nephrotic syndrome, who developed melanonychia on starting treatment with cyclophosphamide. It is a benign condition, which resolves on discontinuation of the drug.


Assuntos
Ciclofosfamida/efeitos adversos , Melaninas/metabolismo , Doenças da Unha/induzido quimicamente , Unhas/efeitos dos fármacos , Síndrome Nefrótica/tratamento farmacológico , Transtornos da Pigmentação/induzido quimicamente , Esteroides/uso terapêutico , Adulto , Feminino , Humanos , Doenças da Unha/diagnóstico , Doenças da Unha/metabolismo , Unhas/metabolismo , Síndrome Nefrótica/diagnóstico , Transtornos da Pigmentação/diagnóstico , Transtornos da Pigmentação/metabolismo
4.
Eur J Cancer Care (Engl) ; 28(5): e13118, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31184794

RESUMO

OBJECTIVE: This meta-analysis was performed to assess the efficacy of cryotherapy and nail solution (NS) use in preventing nail toxicity (NT) induced by taxane-based chemotherapy. METHODS: PubMed, EMBASE, Cochrane Library and ClinicalTrials.gov registry databases were searched for relevant studies published up to December 2018. The primary outcome was taxane-induced NT. Secondary outcomes were skin toxicity (ST), time to toxicity and patient comfort. RESULTS: We reviewed three randomised control trials and six prospective studies with 708 patients. For meta-analysis, taxane-induced NT grading was compared. NT and ST were significantly lower in the cryotherapy patients than in the controls (grade 1 NT: risk ratio [RR] = 0.51, 95% confidence interval [CI] = 0.30-0.89; grade 2-3 NT: RR = 0.36, 95% CI = 0.11-1.12; total NT: RR = 0.49; 95% CI = 0.30-0.79; ST: RR = 0.46, 95% CI = 0.33-0.64). The NS-treated patients exhibited significantly lower NT than the controls. CONCLUSIONS: Nail solution-treated or cryotherapy patients exhibited lower NT incidence and severity associated with taxane-based chemotherapy than the controls. For patients who can afford and comply with NS use or cryotherapy, these measures represent effective prophylactic management for taxane-induced NT and improve their quality of life and functional statuses. Further studies are needed to establish the routine usage protocols, long-term efficacy and safety for these interventions.


Assuntos
Crioterapia/métodos , Doenças da Unha/prevenção & controle , Neoplasias/tratamento farmacológico , Óleos Voláteis/uso terapêutico , Óleos Vegetais/uso terapêutico , Taxoides/efeitos adversos , Ceras/uso terapêutico , Docetaxel/efeitos adversos , Humanos , Doenças da Unha/induzido quimicamente , Onicólise/induzido quimicamente , Onicólise/prevenção & controle , Paclitaxel/administração & dosagem , Paroniquia/induzido quimicamente , Paroniquia/prevenção & controle , Transtornos da Pigmentação/induzido quimicamente , Transtornos da Pigmentação/prevenção & controle
5.
Actas Dermosifiliogr ; 110(6): 448-459, 2019.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31010573

RESUMO

Although the arrival of new chemotherapy drugs and combinations has brought progress in terms of cancer patient survival, they entail many adverse effects that can compromise treatment, and hence prognosis, of the disease. Cytostatic agents can cause dermatological toxicity, among other side effects. The most familiar adverse effect of chemotherapy is alopecia. Although not serious, this changes the outward appearance of cancer patients. Other adverse effects include hypersensitivity and photosensitivity reactions, hand-foot syndrome, epidermal necrolysis, recall reactions, scleroderma-like reactions, Raynaud's phenomenon, eccrine squamous syringometaplasia, neutrophilic eccrine hidradenitis, nail abnormalities, pigmentation changes and extravasation injuries. Onset of these adverse effects often causes dose reduction and/or delayed treatment, which can affect patient survival and quality of life. It is therefore important to prevent their occurrence and treat them promptly, which requires cooperation between medical oncologists and dermatologists. This article reviews chemotherapy-associated dermatological toxicity, along with its diagnosis and therapeutic management.


Assuntos
Antineoplásicos/efeitos adversos , Erupção por Droga/etiologia , Alopecia/induzido quimicamente , Antineoplásicos/classificação , Gerenciamento Clínico , Erupção por Droga/terapia , Hipersensibilidade a Drogas/etiologia , Humanos , Doenças da Unha/induzido quimicamente , Neoplasias/complicações , Neoplasias/tratamento farmacológico , Transtornos de Fotossensibilidade/induzido quimicamente , Transtornos da Pigmentação/induzido quimicamente , Encaminhamento e Consulta , Índice de Gravidade de Doença , Espanha
6.
J Eur Acad Dermatol Venereol ; 33(7): 1398-1404, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30848521

RESUMO

BACKGROUND: Nail changes due to systemic drugs are common, especially with anticancer treatments due to involvement of nail plate, nail bed and periungual area. OBJECTIVE: To study the pattern of nail changes occurring due to chemotherapy in patients suffering from various malignancies. MATERIALS AND METHODS: A prospective, observational study was conducted at various health care centres, Nashik, India, for 15 months. The timing of administration of chemotherapy and onset of nail changes were recorded and evaluated by a dermatologist at regular interval. RESULTS: A total of 129 diagnosed cases of various malignancies who received chemotherapy were included. The most common malignancy noted was breast cancer, that is n = 42 (32.5%) followed by oral cancer, that is n = 24 (18.6%). Chemotherapy agents included taxanes (n = 54), cyclophosphamide (n = 42) and prednisolone (n = 28). Nail changes were noted in 92 patients (71.3%). The most common nail changes observed were chromonychia (n = 70, 54.26%), followed by nail dystrophy (n = 38, 29.45%). CONCLUSION: Nail toxicity is quite common side effect of anticancer agents. Nail changes due to chemotherapy depend on the nail structure involved and the severity of insult. Awareness among dermatologists and oncologists of these nail changes and their culprit agent can promote early diagnosis and may avoid inadvertent measures.


Assuntos
Antineoplásicos/efeitos adversos , Doenças da Unha/induzido quimicamente , Unhas Malformadas/induzido quimicamente , Neoplasias/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
8.
Clin Exp Dermatol ; 44(6): 599-605, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30793352

RESUMO

Nail cosmetics are used by millions worldwide and the variety of products available is expanding. They are relatively safe, but complications can occur, and patients experiencing complications may present to dermatologists. The physical processes can cause nail thinning and onycholysis, poor technique can promote infection, and consumers may develop allergic contact dermatitis. Ultraviolet nail lamps are widely used for curing gel nails, but their use is unregulated and they are readily accessible in salons or for home use. There is concern about potential carcinogenesis; however, the risk is negligible and can be further reduced with the use of sunscreen. Despite the potential complications, nail cosmetics may be a useful adjunct in treating nail disorders. Familiarity with the procedures will enable the dermatologist to recognize problems and advise on safe use.


Assuntos
Cosméticos/efeitos adversos , Doenças da Unha/induzido quimicamente , Unhas/patologia , Acrilatos/efeitos adversos , Carcinogênese , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Metacrilatos/efeitos adversos , Doenças da Unha/patologia , Onicólise/etiologia , Raios Ultravioleta/efeitos adversos
14.
Lupus ; 28(1): 129-132, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30428763

RESUMO

Hydroxychloroquine is an antimalarial agent, most commonly prescribed in the treatment of several rheumatic diseases. Although generally well tolerated, a variety of mucocutaneous adverse effects have been reported. Besides the familiar adverse effects, longitudinal melanonychia is rarely seen. Although the incidence is extremely low, systemic lupus erythematosus may also cause nail pigmentation in its own right. We report the case of a 55-year-old woman who was diagnosed with systemic lupus erythematosus and presented with longitudinal melanonychia of all 10 fingernails after 3 years of treatment with hydroxychloroquine, without mucocutaneous hyperpigmentation. The pigment of the nail lasted for more than 15 years. To the best of our knowledge, this is first published report of hydroxychloroquine-induced melanonychia without mucocutaneous hyperpigmentation. This case demonstrates that hydroxychloroquine treatment and the primary disease should be considered in the case of multiple nail changes in patients with systemic lupus erythematosus.


Assuntos
Hemorragia/induzido quimicamente , Hidroxicloroquina/efeitos adversos , Hiperpigmentação/induzido quimicamente , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Doenças da Unha/induzido quimicamente , Cor , Feminino , Humanos , Hidroxicloroquina/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Pessoa de Meia-Idade
16.
Pediatr Dermatol ; 36(1): e60-e61, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30548576

RESUMO

Transverse melanonychia is a rare finding often secondary to chemotherapy, orally ingested medications, or other iatrogenic interventions. A 19-month-old boy with hemophagocytic lymphohistiocytosis treated with biweekly etoposide and dexamethasone developed transverse bands of pigment in all toenail and fingernail units consistent with transverse melanonychia. We review the literature for reported cases of transverse melanonychia and summarize suspected etiologies.


Assuntos
Antineoplásicos/efeitos adversos , Etoposídeo/efeitos adversos , Doenças da Unha/induzido quimicamente , Transtornos da Pigmentação/induzido quimicamente , Antineoplásicos/uso terapêutico , Dexametasona/uso terapêutico , Etoposídeo/uso terapêutico , Humanos , Lactente , Linfo-Histiocitose Hemofagocítica/tratamento farmacológico , Masculino
18.
Bull Cancer ; 105(12): 1173-1182, 2018 Dec.
Artigo em Francês | MEDLINE | ID: mdl-30078546

RESUMO

BACKGROUND: Docetaxel is frequently used for the treatment of metastatic prostate cancer patients. Nail toxicity is a commonly described side effect, but no precise recommendation exists concerning its management. We experimented the integration of a podiatrist in routine cancer care. METHODS: Patients having received docetaxel for a metastatic prostate cancer since the arrival of the podiatrist were studied. RESULTS: Fifty-six patients were included, half had docetaxel-induced nail toxicity and 18 were referred to the podiatrist. The integration of the podiatrist in routine care was feasible and allowed characterizing nail toxicity. The main lesions observed were non-coagulated nail hematomas, coagulated nail hematomas and onycholysis. This experience led to propose an integrated care for docetaxel-induced nail toxicity. CONCLUSION: The integration of podiatrist care is feasible in routine cancer care and can help improving the management of docetaxel-induced nail toxicity in metastatic prostate cancer patients.


Assuntos
Antineoplásicos/efeitos adversos , Docetaxel/efeitos adversos , Hematoma/terapia , Doenças da Unha/terapia , Onicólise/terapia , Podiatria/organização & administração , Neoplasias da Próstata/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Hematoma/induzido quimicamente , Humanos , Masculino , Pessoa de Meia-Idade , Doenças da Unha/induzido quimicamente , Onicólise/induzido quimicamente , Fotografação , Estudos Retrospectivos
20.
Dermatol Online J ; 24(4)2018 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-29906006

RESUMO

5-fluorouracil, a fluoropyrimidine antineoplastic drug, is used to topically treat actinic keratoses. Local skin reactions to the medication are common and anticipated. However, severe adverse events from topical 5-fluorouracil are rare and unexpected. A 69-year-old man with a lower lip actinic keratosis developed severe neutropenia on day 11 of topical 5-fluorouracil treatment - after 14 applications. After receiving a subcutaneous injection of filgrastim, his neutrophil count normalized. The PubMed database was used to search the following terms: agranulocytosis, cream, 5-fluorouracil, granulocytopenia, neutropenia, severe, systemic, topical, and toxicity. The papers, and relevant cited references, generated were reviewed. Systemic reactions to topical 5-fluorouracil included angioedema, melanonychia, neurologic conditions (such as acute cerebellar syndrome, headaches, and peripheral neuropathy exacerbation), taste alteration, and systemic toxicity requiring hospitalization (including severe neutropenia). One of the individuals (a man with severe neutropenia and other symptoms) also had a deficiency of dihydropyrimidine dehydrogenase, the enzyme that catalyzes the rate-limiting step in 5-fluorouracil metabolism. Evaluation for dihydropyrimidine dehydrogenase deficiency is not routinely performed in patients receiving systemic or topical 5-fluorouracil. Also, the incidence of potentially severe 5-fluorouracil-induced toxicity associated with topical application of the drug may be greater than documented.


Assuntos
Antimetabólitos Antineoplásicos/efeitos adversos , Fluoruracila/efeitos adversos , Doenças do Sistema Nervoso/induzido quimicamente , Neutropenia/induzido quimicamente , Administração Cutânea , Idoso , Angioedema/induzido quimicamente , Antimetabólitos Antineoplásicos/administração & dosagem , Queilite/tratamento farmacológico , Fluoruracila/administração & dosagem , Humanos , Ceratose Actínica/tratamento farmacológico , Masculino , Doenças da Unha/induzido quimicamente , Creme para a Pele/efeitos adversos , Distúrbios do Paladar/induzido quimicamente
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