Longitudinal melanonychia and distal onycholysis associated with 5-fluorouracil/adriamycin/cyclophosphamide chemotherapy for breast cancer

Abstract

Introduction: Longitudinal melanonychia presents with pigmented longitudinal streaks of the nail plate. It results from an increased activity of melanocytes or melanocytic hyperplasia in the nail matrix or nail bed and is associated with increased melanin deposition in the nail plate. Distal onycholysis is characterized by separation of the distal part of the nail plate from the nail bed. Objective: To present a case of longitudinal melanonychia and distal onycholysis associated with 5-fluorouracil/adriamycin/cyclophosphamide chemotherapy. Case report: A 66-year-old woman, who received 5-fluorouracil/adriamycin/cyclophosphamide for breast cancer developed longitudinal melanonychia and distal onycholysis. After discontinuation of chemotherapy, nail changes improved significantly. Conclusions: Drug-induced longitudinal melanonychia and distal onycholysis are common adverse effects of breast cancer chemotherapy. This case shows that lesions may resolve after discontinuation of therapy.