Nail Changes Due to Systemic Anticancer Therapy: A Prospective Observational Study of 129 Patients

Abstract

Background: Nail changes due to systemic drugs are common especially with anticancer treatments. Nail toxicities due to anticancer treatment affects nail plate, nail bed and peiungual area. Objective: To study the pattern of nail changes occurring due to anticancer therapy in patients suffering from neoplasms. Results: prospective, observational study was conducted from May 2005-August 2006. Total 129 diagnosed cases (Male:61, Female:68) of various neoplasms who received chemotherapy were included, of which 101 patients completed the study and they received 1 to 17 (median 4) courses of chemotherapy. The most common malignancy noted was breast cancer i.e. n=42 (32.5%) followed by oral cancer i.e. n=24 (18.6%). Chemotherapy agents included taxanes (n=54), cyclophosphamide (n=42), prednisolone (n=28, doxorubicin (n=25), platins (n=23), anastrazole (n=18), imatinib (n=12) and other agents (n=11). Nail changes were noted in 92 patients (71.3%). Grade-I (mild severity) score of nail changes was observed in 55% of the patients. The most common nail change observed was chromonychia which was seen in 70 patients (54.26%), followed by nail dystrophy in 38 patients (29.45%). Conclusion: Nail changes due to anticancer therapies are common which affect nail plate or bed and also perionychium. It may herald systemic toxicity of the chemotherapy. Knowledge of nail changes during chemotherapy is important to a dermatologist & onco-physician. Funding Statement: The authors declare: A statement of all funding sources that supported the work: None Declaration of Interests: The authors declare: Any conflict of interest disclosures: None. Ethic Approval Statement: The study was conducted in accordance with the Declaration of Helsinki, Good Clinical Practices and was reviewed and approved by ethics committee when required by local regulations. All the patients completed written informed consent prior to enrollment. Patient information was obtained at various health care centers in Nashik, India