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Merad Y, Derrar H, Tabouri S, Berexi-Reguig F. Candida guilliermondii Onychomycosis Involving Fingernails in a Breast Cancer Patient under Docetaxel Chemotherapy. Case Rep Oncol 2021; 14:1530-1535. [PMID: 34899247 PMCID: PMC8613606 DOI: 10.1159/000519695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 08/11/2020] [Indexed: 11/19/2022] Open
Abstract
Onychomycosis has been shown to have a higher incidence in cancer patients. Nail toxicity is a quite common side effect of anticancer agents. Taxotere© is a chemotherapeutic known to cause great incidence of nail change and has a role in subungual suppuration. We report on a 52-year-old woman with breast cancer admitted in our institution for onycholysis. Because of the stage and histology of breast cancer, neoadjuvant chemotherapy was initiated. The patient received 8 cycles of Taxotere and Adriamycin (AT), and she underwent a modified radical mastectomy. Three months later, the patient developed evidence of onycholysis, involving all the fingernails. We observed the following changes in nails of all the digits in both hands: onycholysis, dystrophy, oedema, and exudate. Nail scraping and purulent discharge were collected and cultured on Sabouraud medium. Physical features of the colonies and biochemical tests (Auxacolor©) revealed Candida guilliermondii as the sole etiologic agent of onychomycosis. This case details an onycholysis in a breast cancer case successfully managed solely with amorolfine lacquer. This clinical and mycological presentation should alert the clinician to the possibility of onychomycosis induced by docetaxel chemotherapy.
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Affiliation(s)
- Yassine Merad
- Department of Parasitology-Mycology, Central Laboratory, Hassani “Abdelkader University Hospital,”, Sidi Bel Abbès, Algeria
- Laboratoire de Synthèse de l'Information Environnementale, Université de Lille, Lille, France
| | - Hichem Derrar
- Department of Pulmonary and Lung Diseases, Sidi Bel Abbès, Algeria
| | - Sarah Tabouri
- Departement of Oncology, Centre Anti Cancer, Sidi Bel Abbès, Algeria
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Alshari O, Aleshawi A, Al Sharie AH, Msameh A, Al-Omari I, Msameh R, Almegdadi A, Albals D. The Effect of Nail Lacquer on Taxane-Induced Nail Changes in Women With Breast Cancer. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2020; 14:1178223420929702. [PMID: 32595274 PMCID: PMC7297473 DOI: 10.1177/1178223420929702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/05/2020] [Indexed: 12/24/2022]
Abstract
Objective Taxane-induced nail changes are considered as an important cosmetic manifestation with an incidence that reaches up to 44% of patients treated with taxane-included therapeutic regimens. In this article, we represent a clinical observational study to evaluate the effect of cosmetic nail lacquer on taxane-induced nail changes in female patients diagnosed with breast cancer. Methods Prospectively, we identified those women who were diagnosed with breast cancer, scheduled to have AC-Taxol protocol. Any female with previous dermatological or systemic disorders that affect nails was excluded from the study. Patients were categorized into 2 groups based on the utilization of nail lacquer. The first group includes women who started to use the nail lacquer after development of nail changes. The second group comprises those women who did not use the nail lacquer at any occasion. Results A total of 59 female patients were included in the study; 46 (78%) of them developed nail changes and the main change was nail discoloration. The first group which has used nail lacquer (17, 28.8%) showed an improvement among 15 (78.9%) patients, whereas 2 (7.4%) of them continued to have worsening symptoms. On the contrary, most of the second group (25, 92.9%) did not show any improvement in nail changes. A statistical significance between the tested groups was observed (P = .000). There is no statistical association between the progression of nail changes and the age of patients. Conclusions Taxane-induced nail changes are considered as an important clinical, cosmetic, and psychological complication, especially for female patients with cancer. This article suggests that nail lacquer may have an effect in the improvement of nail changes, especially nail discoloration. Further investigations are recommended to prove the efficacy of nail lacquer.
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Affiliation(s)
- Osama Alshari
- Department of Internal Medicine, Division of Oncology, Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | | | - Ahmed H Al Sharie
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Ala'a Msameh
- King Abdullah University Hospital, Irbid, Jordan
| | - Isra Al-Omari
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Renad Msameh
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Abdallah Almegdadi
- Faculty of Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Dima Albals
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
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Fonia A, Richert B. Onychalgia Causes and Mechanisms: The “GIFTED KID” and the “FOMITE”. Skin Appendage Disord 2020; 6:77-87. [DOI: 10.1159/000504347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/23/2019] [Indexed: 11/19/2022] Open
Abstract
This article gives an account of the commonest causes of nail pain. The acronyms GIFTED KID and FOMITE will help aid doctors in a busy clinical setting to remember the main causes of onychalgia, respectively, on the fingers and toes. It includes a brief overview of the clinical characteristics and focuses on the type of pain for each condition as well as the mechanisms that cause it.
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Marks DH, Qureshi A, Friedman A. Evaluation of Prevention Interventions for Taxane-Induced Dermatologic Adverse Events. JAMA Dermatol 2018; 154:1465-1472. [DOI: 10.1001/jamadermatol.2018.3465] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Dustin H. Marks
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Azam Qureshi
- Department of Dermatology, The George Washington University Medical Faculty Associates, Washington, DC
| | - Adam Friedman
- The George Washington University School of Medicine and Health Sciences, Washington, DC
- Department of Dermatology, The George Washington University Medical Faculty Associates, Washington, DC
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Thomas R, Williams M, Cauchi M, Berkovitz S, Smith SA. A double-blind, randomised trial of a polyphenolic-rich nail bed balm for chemotherapy-induced onycholysis: the UK polybalm study. Breast Cancer Res Treat 2018; 171:103-110. [DOI: 10.1007/s10549-018-4788-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 04/10/2018] [Indexed: 11/29/2022]
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Baran R, Robert C, Sibaud V. Asymmetric Acral Spared Phenomenon Related to Systemic Anticancer Therapies. Skin Appendage Disord 2018; 4:315-319. [PMID: 30410905 DOI: 10.1159/000486021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 12/05/2017] [Indexed: 11/19/2022] Open
Abstract
We have observed three patients on anticancer therapies presenting with asymmetric acral spared phenomenon and found six identical cases in the literature. All of them had common features, an alteration of the peripheral nerves affecting a limb unilaterally that was spared by a hand-foot syndrome or hand-foot skin reaction. A drug-induced neurotropic effect sounds logical for developing such alterations with specific chemotherapeutic agents (taxanes, cap-ecitabine), while we have not found good explanations concerning the multikinase inhibitor sorafenib nor the topo isomerase inhibitor adriamycin. Nevertheless, we know that clinical manifestations of many inflammatory diseases need intact neural components.
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Affiliation(s)
| | - Caroline Robert
- Department of Oncology and Dermatology, Gustave Roussy Institute, Villejuif, France
| | - Vincent Sibaud
- Department of Oncodermatology, Claudius Regaud Institute, Cancer University Institute, Toulouse Oncopole, Toulouse, France
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Capriotti K, Capriotti J, Pelletier J, Stewart K. Chemotherapy-associated paronychia treated with 2% povidone-iodine: a series of cases. Cancer Manag Res 2017; 9:225-228. [PMID: 28721095 PMCID: PMC5500570 DOI: 10.2147/cmar.s139301] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background Nail changes are known to occur during the use of chemotherapy for a variety of malignancies, particularly those treated with taxanes and EGFR inhibitors. There are currently no actively recruiting prospective clinical trials investigating potential treatments. There are also no US Food and Drug Administration-approved medical treatments for chemotherapy-associated paronychia and no consensus on the best way to treat these common chemotherapy-induced events. Methods A retrospective review of all cases presenting to a single dermatology private practice from June 2016 to January 2017 identified nine patients with chemotherapy-associated paronychia seeking treatment. Each patient was prescribed a topical solution comprised of 2% povidone–iodine in a dimethylsulfoxide vehicle that was prepared by a licensed compounding pharmacy. Patients were seen at 3 week and 6 week follow-up visits. Results All 9/9 patients demonstrated complete or partial resolution. The number of nails involved for each patient ranged from 4–12. There were a total of 58 nails affected in the case series, and 44/58 (76%) resolved overall. The treatment was well tolerated. Conclusion The topical povidone–iodine/dimethylsufoxide solution described is very effective in alleviating the signs and symptoms of paronychia associated with chemotherapy. This novel combination warrants further investigation in randomized, controlled trials to further elucidate its clinical utility.
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Affiliation(s)
- Kara Capriotti
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Bryn Mawr Skin and Cancer Institute, Rosemont, PA
| | - Joseph Capriotti
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Plessen Ophthalmology Consultants, Christiansted, VI, USA
| | - Jesse Pelletier
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Plessen Ophthalmology Consultants, Christiansted, VI, USA
| | - Kevin Stewart
- Veloce BioPharma LLC, Fort Lauderdale, FL.,Plessen Ophthalmology Consultants, Christiansted, VI, USA
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Dow EN, Piccolo J, Segal EM, Charlson JA. Drug induced periarticular thenar erythema with onycholysis related to nano-albumin bound paclitaxel therapy. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.ctrc.2015.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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Kadakia KC, Rozell SA, Butala AA, Loprinzi CL. Supportive cryotherapy: a review from head to toe. J Pain Symptom Manage 2014; 47:1100-15. [PMID: 24210702 PMCID: PMC4013268 DOI: 10.1016/j.jpainsymman.2013.07.014] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 07/17/2013] [Accepted: 07/23/2013] [Indexed: 11/26/2022]
Abstract
CONTEXT Conventional chemotherapy leads to multiple adverse mucocutaneous complications such as oral mucositis, alopecia, ocular toxicity, and onycholysis. Limited pharmacologic interventions are available for preventing these clinical problems. OBJECTIVES This study aimed to critically review the role of cryotherapy (regional hypothermia) for alleviating these adverse symptoms. METHODS A narrative review was performed, with an emphasis on randomized controlled trials. A comprehensive search using PubMed, Ovid, Embase, and MEDLINE(®) was completed. References of all cited articles also were reviewed. Data from the review were composed of articles published between 1970 and May 2013. RESULTS Available evidence suggests that regional hypothermia decreases the burden of chemotherapy-related oral mucositis, alopecia, ocular toxicity, and onycholysis. The major limitations of studies include the absence of blinded control groups and variable clinical end points. CONCLUSION Regional hypothermia decreases the burden of these four chemotherapy-induced complications and is well tolerated. More research is needed to determine what subgroups of cancer patients are most likely to respond to different types of regional hypothermia, the ideal duration of cooling needed, and further improve the ease of use of the cooling devices.
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Affiliation(s)
- Kunal C Kadakia
- Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Shaina A Rozell
- Division of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Anish A Butala
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Kibata K, Tamaki T, Inagaki N, Ogata M, Shimizu T, Nomura S. Nail alterations as a surrogate marker for the efficacy of low-dose metronomic chemotherapy. Oncol Lett 2013; 5:1123-1128. [PMID: 23599750 PMCID: PMC3629050 DOI: 10.3892/ol.2013.1178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Accepted: 01/31/2013] [Indexed: 12/31/2022] Open
Abstract
Docetaxel is a well-known causative agent of nail alterations. The aim of this study was to reveal the impact of nail alterations associated with low-dose metronomic (LDM) docetaxel chemotherapy on the survival of non-small cell lung cancer (NSCLC) patients. Clinical information, survival data and nail alterations in patients treated with LDM docetaxel chemotherapy (docetaxel 15 mg/m2 per week) were retrospectively reviewed. Forty-nine patients were included in this study. Various nail alterations were observed in 17 of the 49 patients (34.7%). Onycholysis and subungual hyperkeratosis were observed in 22.4% and 10.2% of patients, respectively. The number of docetaxel administration cycles was correlated with the incidence and severity of nail alterations. Univariate and multivariate analysis clearly demonstrated that the occurrence of nail alterations was an independent favorable prognostic factor for overall survival. Nail alterations associated with treatment may act as a surrogate marker for the efficacy of low-dose metronomic docetaxel chemotherapy.
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Affiliation(s)
- Kayoko Kibata
- First Department of Internal Medicine, Kansai Medical University, Moriguchi, Osaka 570-8506, Japan
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Swenson KK, Bell EM, Nissen J. Nail toxicity associated with paclitaxel treatment for ovarian cancer. Oncol Nurs Forum 2012; 40:17-9. [PMID: 23269765 DOI: 10.1188/13.onf.17-19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Taxane-induced nail changes: Predictors and efficacy of the use of frozen gloves and socks in the prevention of nail toxicity. Eur J Oncol Nurs 2012; 16:270-5. [DOI: 10.1016/j.ejon.2011.06.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 06/09/2011] [Accepted: 06/20/2011] [Indexed: 11/22/2022]
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Kawaguchi K, Ishiguro H, Morita S, Nakamura S, Ohno S, Masuda N, Iwata H, Aogi K, Kuroi K, Toi M. Correlation between docetaxel-induced skin toxicity and the use of steroids and H₂ blockers: a multi-institution survey. Breast Cancer Res Treat 2011; 130:627-34. [PMID: 21698408 DOI: 10.1007/s10549-011-1641-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 06/13/2011] [Indexed: 11/25/2022]
Abstract
Steroids and H(2) blockers are commonly used as supportive care for taxane-containing chemotherapy, but they also affect docetaxel's primary metabolizer, cytochrome P(450) 3A4. This retrospective observational study was performed to better understand the effects of these compounds on docetaxel-induced skin toxicities, specifically hand-foot syndrome (HFS) and facial erythema (FE), a relationship that is currently poorly understood. Member institutions of the Japan Breast Cancer Research Group were invited to complete a questionnaire on the occurrence of grade 2 or higher HFS and FE among patients treated between April 2007 and March 2008 with docetaxel as an adjuvant or neoadjuvant chemotherapeutic treatment for breast cancer. We obtained data for 993 patients from 20 institutions. Twenty percent received H(2) blockers, and all patients received dexamethasone. Univariate and multivariate analyses revealed that H(2) blockers are associated with a significantly higher incidence of both HFS and FE. The incidence of FE was significantly higher for the docetaxel + cyclophosphamide (TC) regimen than for non-TC regimens combined. Dexamethasone usage did not affect the incidence of either HFS or FE. In conclusion, use of H(2) blockers as premedication in breast cancer patients receiving docetaxel significantly increases the risk of both HFS and FE.
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Affiliation(s)
- K Kawaguchi
- Department of Breast Surgery, Kyoto University Hospital, Kyoto, Japan
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Ferreira O, Baudrier T, Mota A, Duarte AF, Azevedo F. Docetaxel-induced acral erythema and nail changes distributed to photoexposed areas. Cutan Ocul Toxicol 2010; 29:296-9. [DOI: 10.3109/15569527.2010.498397] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Nakamura S, Kajita S, Takagi A, Hashimoto Y, Ishida-Yamamoto A, Takahashi H, Iizuka H. Improvement in docetaxel-induced nail changes associated with cyclooxygenase-2 inhibitor treatment. Clin Exp Dermatol 2009; 34:e320-1. [DOI: 10.1111/j.1365-2230.2009.03275.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Purpose. To provide a comprehensive literature review of chemotherapy-induced nail toxicity, including clinical presentation, implicated drugs and approaches for prevention and management. Data sources. A search of MEDLINE and EMBASE (1966—2008) databases was conducted using the terms (and variations of the terms) antineoplastic agents, nails, nail toxicity, onycholysis, and paronychia. Bibliographies from selected articles were reviewed for appropriate references. Data extraction. The retrieved literature was reviewed to include all articles relevant to the clinical presentation, diagnosis, incidence, prevention, and treatment of chemotherapy-induced nail toxicity. Data synthesis. Nail toxicity is a relatively uncommon adverse effect linked to a number of chemotherapeutic agents. Clinical presentation varies, depending on which nail structure is affected and the severity of the insult. Nail changes may involve all or some nails. Toxicity may be asymptomatic and limited to cosmetic concerns, however, more severe effects, involving pain and discomfort can occur. Taxanes and anthracyclines are the antineoplastic drug groups most commonly implicated. It is suggested that the administration schedule may influence the incidence of nail abnormalities, for example reported cases linked to the weekly administration of paclitaxel. Before instituting chemotherapy, patients should be educated regarding potential nail toxicities and strategies for prevention implemented. Management includes appropriate nail cutting, avoiding potential irritants, topical, or oral antimicrobials, and possibly cessation or dose reduction of the offending agent. Cryotherapy, through the application of frozen gloves or socks, has been beneficial in reducing docetaxel-induced nail toxicity and may be effective for other drugs. J Oncol Pharm Practice (2009) 15: 143—155.
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Affiliation(s)
- Peter Gilbar
- Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia,
| | - Alice Hain
- Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia
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Long-term skin temperature measurements – A practical diagnostic tool in complex regional pain syndrome. Pain 2008; 140:8-22. [DOI: 10.1016/j.pain.2008.07.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2008] [Revised: 06/30/2008] [Accepted: 07/03/2008] [Indexed: 11/22/2022]
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Scotté F, Banu E, Medioni J, Levy E, Ebenezer C, Marsan S, Banu A, Tourani JM, Andrieu JM, Oudard S. Matched case-control phase 2 study to evaluate the use of a frozen sock to prevent docetaxel-induced onycholysis and cutaneous toxicity of the foot. Cancer 2008; 112:1625-31. [PMID: 18286527 DOI: 10.1002/cncr.23333] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Onycholysis occurs in approximately 30% of patients treated with docetaxel. The efficacy and safety of an Elasto-Gel frozen sock (FS) was investigated for the prevention of docetaxel-induced nail and skin toxicity of the feet. METHODS Patients receiving docetaxel at a dose of 70 to 100 mg/m(2) every 3 weeks were eligible for this matched case-control study. Each patient wore an FS for 90 minutes on the right foot. The unprotected left foot acted as control. Nail and skin toxicities were assessed using National Cancer Institute Common Toxicity Criteria (version 3) and compared using a 2-sample Wilcoxon matched-pairs rank test adjusted for tied values. RESULTS Fifty consecutive patients were included between April 2005 and January 2007. Nail toxicity was significantly lower in the FS-protected foot compared with the control foot (grade 0: 100% versus 79%; and grade 1 and 2: 0% versus 21%, respectively) (P= .002). Skin toxicity was grade 0: 98% versus 94%; and grade 1 and 2: 2% versus 6% in the FS-protected and the control feet, respectively. The median times until toxicity occurrence were not found to differ significantly between the groups. One patient experienced discomfort because of cold intolerance. CONCLUSIONS Cold therapy using FS significantly reduced the incidence of docetaxel-induced foot nail toxicity, as previously demonstrated using frozen gloves for the hands.
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Affiliation(s)
- Florian Scotté
- Department of Medical Oncology, Georges Pompidou European Hospital, Paris, France. florian,
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Abstract
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.
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Affiliation(s)
- Mi Ryung Roh
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Yong Cho
- Department of Medical Oncology, Yonsei University College of Medicine, Seoul, Korea
| | - Wook Lew
- Department of Dermatology, Yonsei University College of Medicine, Seoul, Korea
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Winther D, Saunte DM, Knap M, Haahr V, Jensen AB. Nail changes due to docetaxel--a neglected side effect and nuisance for the patient. Support Care Cancer 2007; 15:1191-7. [PMID: 17318589 DOI: 10.1007/s00520-007-0232-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2006] [Accepted: 01/30/2007] [Indexed: 11/28/2022]
Abstract
GOALS OF WORK 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. MATERIALS AND 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. MAIN 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. CONCLUSION 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.
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Affiliation(s)
- Dorte Winther
- Section of Clinical Research, Department of Oncology, Aarhus Sygehus, Nørrebrogade 44, 8000 Aarhus C, Denmark
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Jung HY, Lee CY, Kim HJ, Ahn CM, Chang YS. A Case of Subungal Abscess and Onycholysis Induced by Docetaxel. Tuberc Respir Dis (Seoul) 2007. [DOI: 10.4046/trd.2007.62.2.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Han Young Jung
- Department of Internal Medicine, The Yonsei University College of Medicine, Seoul, Korea
| | - Chang Youl Lee
- Department of Internal Medicine, The Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Jung Kim
- Department of Internal Medicine, The Yonsei University College of Medicine, Seoul, Korea
- Institute of Chest Diseases, The Yonsei University College of Medicine, Seoul, Korea
| | - Chul Min Ahn
- Department of Internal Medicine, The Yonsei University College of Medicine, Seoul, Korea
- Institute of Chest Diseases, The Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Soo Chang
- Department of Internal Medicine, The Yonsei University College of Medicine, Seoul, Korea
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Tejera A, Bosch RJ, López N, Herrera E. Onicolisis con exudado del hiponiquio secundaria a quimioterapia con paclitaxel y capecitabina. ACTAS DERMO-SIFILIOGRAFICAS 2006; 97:536-8. [PMID: 17067535 DOI: 10.1016/s0001-7310(06)73459-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
A 39-year-old female patient who consulted due to onycholysis, subungual hyperkeratosis and presence of exudate in the big toe of the right foot. The lesions appeared during oncology treatment of bilateral breast cancer with lymphatic metastases with paclitaxel every three weeks and capecitabine daily. Clinical manifestations are due to the involvement of the nail bed caused by the chemotherapy. These should be known and taken into account due to the increased use of this type of cytotoxic agents.
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Affiliation(s)
- Antonio Tejera
- Servicio de Dermatología, Hospital Clínico Universitario Virgen de la Victoria, Málaga. España
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Scotté F, Tourani JM, Banu E, Peyromaure M, Levy E, Marsan S, Magherini E, Fabre-Guillevin E, Andrieu JM, Oudard S. Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand. J Clin Oncol 2005; 23:4424-9. [PMID: 15994152 DOI: 10.1200/jco.2005.15.651] [Citation(s) in RCA: 102] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Onycholysis and skin toxicity occur in approximately 30% of patients treated with docetaxel. We investigated the efficacy and safety of an Elasto-Gel (84400 APT Cedex, Akromed, France) frozen glove (FG) for the prevention of docetaxel-induced onycholysis and skin toxicity. PATIENTS AND METHODS Patients receiving docetaxel 75 mg/m2 alone or in combination chemotherapy were eligible for this case-control study. Each patient wore an FG for a total of 90 minutes on the right hand. The left hand was not protected and acted as the control. Onycholysis and skin toxicity were assessed at each cycle by National Cancer Institute Common Toxicity Criteria and documented by photography. Wilcoxon matched-pairs rank test was used. RESULTS Between August 2002 and September 2003, 45 patients were evaluated. Onycholysis and skin toxicity were significantly lower in the FG-protected hand compared with the control hand (P = .0001). Onycholysis was grade (G) 0 in 89% v 49% and G1 to 2 in 11% v 51% for the FG-protected hand and the control hand, respectively. Skin toxicity was G0 in 73% v 41% and G1 to 2 in 27% v 59% for the FG-protected and the control hand, respectively. Median time to nail and skin toxicity occurrence was not significantly different between the FG-protected and the control hand, respectively (106 v 58 days for nail toxicity; 57 v 58 days for skin toxicity). Five patients (11%) experienced discomfort due to cold intolerance. CONCLUSION FG significantly reduces the nail and skin toxicity associated with docetaxel and provides a new tool in supportive care management to improve a patient's quality of life.
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Affiliation(s)
- Florian Scotté
- Department of Medical Oncology, Georges Pompidou European Hospital, 20 rue Leblanc, 75908, Paris Cedex 15, France.
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Woo IS, Shim KH, Kim GY, Lee MA, Kang JH, Hong YS, Lee KS. Nail changes during docetaxel containing combination chemotherapy. Korean J Intern Med 2004; 19:132-3. [PMID: 15366647 PMCID: PMC4531594 DOI: 10.3904/kjim.2004.19.2.132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Nail toxicity following systemic chemotherapy is common. Onychopathy during the period of neutropenia following chemotherapy may cause subungual abscesses and serious infection. Despite taxoid-related toxicity being increasingly reported since 2000, there are still phase II systemic chemotherapy studies using taxoid that have never mentioned nail changes. Recently, new criteria for the evaluation of nail toxicity have been suggested. The present report is the first of its kind, in Korea, to describe a case of docetaxel-associated onychopathy, which improved following a reduction in the docetaxel dose.
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Affiliation(s)
- In Sook Woo
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
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Raff JP, Rajdev L, Malik U, Novik Y, Manalo JM, Negassa A, Hopkins U, Sarta C, Sparano JA. Phase II study of weekly docetaxel alone or in combination with trastuzumab in patients with metastatic breast cancer. Clin Breast Cancer 2004; 4:420-7. [PMID: 15023243 DOI: 10.3816/cbc.2004.n.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study was designed to determine the efficacy and toxicity of weekly docetaxel in metastatic breast cancer when given alone (for HER2/neu negative disease) or with trastuzumab (for HER2/neu overexpressing disease). Patients with metastatic breast carcinoma received docetaxel given on 2 different schedules (group 1A, 33 mg/m2 weekly [n = 21]; group 1B, 40 mg/m2 weekly for 3 weeks with 1 week off [n = 14]). Patients with HER2/neu overexpressing disease also received trastuzumab 4 mg/kg on day 1, then 2 mg/kg on days 8 and 15 of each 28-day cycle (group 2). Fifty-two patients were treated with docetaxel alone (group 1A/B, n = 35) or in combination with trastuzumab (group 2, n = 17). Prior taxane therapy given every 3 weeks had been used for metastatic disease in 19 of 35 patients (54%) in group 1A/B and in 2 of 17 patients (12%) in group 2. The mean delivered dose intensity of docetaxel was 29 mg/m2 per week. Partial response occurred in 7 of 35 patients (21%; 95% exact binomial confidence interval [CI], 9%-38%) treated with docetaxel alone, including 3 of 19 taxane-pretreated patients (16%) and 4 of 16 taxane-naive patients (25%). Partial response occurred in 10 of 17 patients (59%; 95% CI, 34%-82%) treated with docetaxel/trastuzumab. The most common grade 3/4 toxicities, occurring in more than or equal to 10% of patients, included neutropenia (21%), pulmonary toxicity (12%), and hyperglycemia (10%). The median times to disease progression were 4.5 months (95% CI, 2.5-6.5 months) in the docetaxel group and 8.5 months (95% CI, 4.5-12.5 months) in the docetaxel/trastuzumab group. Weekly docetaxel/trastuzumab is an effective regimen for patients with HER2/neu overexpressing metastatic breast cancer. Weekly docetaxel may be effective in as many as 20% of patients who had progressive disease after treatment with taxanes given every 3 weeks.
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Affiliation(s)
- Joshua P Raff
- Albert Einstein Cancer Center, Montefiore Medical Center, Bronx, New York, NY 10461-2373, USA
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Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2003; 12:161-76. [PMID: 12642981 DOI: 10.1002/pds.788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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