Chromonychia Secondary to Chemotherapy

Abstract

Chemotherapy drugs can affect the skin and its appendages. Several clinical presentations can be observed, depending on the affected structure. The most common dermatological side effect is chromonychia. The main causative agents are: (1) cyclophosphamide, which can provoke a diffuse, black pigmentation, longitudinal striae and dark grey pigmentation located proximally on the nails; (2) doxorubicin, which promotes dark brown bands alternating with white striae and dark brown pigmentation in transverse bands, and (3) hydroxyurea, which produces a distal, diffuse, dark brown pigmentation. In the majority of cases, the effects are reversible after the suspension of the causative agent for a few months. We report a patient who developed chromonychia while undergoing treatment with cyclophosphamide, vincristine, doxorubicin, dexamethasone, methotrexate and cytarabine for acute lymphocytic leukemia.

Tell‐tale signs in nails of children with cancer

“…The most common form of chromonychia seen is melanonychia wherein black or dark brown pigmentation is seen. Chromonychia induced by chemotherapeutic agents can be diffuse, or transverse, or longitudinal band patterns, and may even coexist with skin and mucosal pigmentation 4 . Several chemotherapy drugs have been implicated as causative agents, the most common ones being daunorubicin, cyclophosphamide and hydroxyurea 5 .…”

“…Chromonychia induced by chemotherapeutic agents can be diffuse, or transverse, or longitudinal band patterns, and may even coexist with skin and mucosal pigmentation. 4 Several chemotherapy drugs have been implicated as causative agents, the most common ones being daunorubicin, cyclophosphamide and hydroxyurea. 5 Chemotherapeutic drugs act on different phases of cell cycle and hence, the rapidly dividing tissues including nails and skin are most susceptible.…”

Mucocutaneous adverse reactions of cancer chemotherapy and chemoradiation

“…[4] Chromonychia induced by chemotherapeutic agents has different forms, the most common being melanonychia. [5] Although several chemotherapeutic agents have been implicated to cause these nail changes, the most common drugs associated are cyclophosphamide, doxorubicin, and hydroxyurea. [6] In our study, among 151 patients who had nail discoloration, melanonychia was seen in 132 (86.84%) patients who were on FAC regimen, paclitaxel/docetaxel/cisplatin/carboplatin combination therapy, FEC regimen, cisplatin, and docetaxel monotherapy.…”

Orange‐Brown Chromonychia and Kawasaki Disease: A Possible Novel Association?

“…Chromonychia is an aspecific pigmentation phenomenon of the nail plate, described as a side effect of chemotherapy , antimycotic ointment application , use of formaldehyde‐containing nail hardener , Pseudomonas infections , use of angiotensin II receptor blockers , and systemic lupus erythematosus .…”