This Article Full Text (PDF) All Versions of this Article: 1078155208100450v1 15/3/143    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Gilbar, P. Articles by Peereboom, V.-M. PubMed PubMed Citation Articles by Gilbar, P. Articles by Peereboom, V.-M. Social Bookmarking                         What's this?

Nail Toxicity Induced by Cancer Chemotherapy

Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia, peter_gilbar{at}health.qld.gov.au

Alice Hain, BPharm

Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia

Veta-Marie Peereboom, BPharm

Department of Pharmacy, Toowoomba Health Services, PMB 2, Toowoomba, Australia

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.

Key Words: nail toxicity • chemotherapy-induced • onycholysis • prevention • treatment

This version was published on September 1, 2009

Journal of Oncology Pharmacy Practice, Vol. 15, No. 3, 143-155 (2009)
DOI: 10.1177/1078155208100450


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?