Photoonycholysis

Abstract

The inability to reproduce photoonycholysis experimentally should be emphasized.

Development of Photoonycholysis with Vandetanib Therapy

“…However, photoonycholysis has never been previously reported with anticancer-targeted therapies [22]. Photoonycholysis generally develops several weeks after a phototoxic skin manifestation [18], as in our two patients. Nevertheless, it can also appear independently, without any preexisting cutaneous phototoxic reaction [18].…”

“…It can occur following drug intake but also with different forms of porphyria or pseudoporphyria [18]. Tetracycline derivatives, psoralens, fluoroquinolones, and, less commonly, chloramphenicol, oral contraceptives, chlorpromazine, voriconazole, thiazide diuretics, and griseofulvin are the most frequently incriminated drugs [18,19,20,21]. However, photoonycholysis has never been previously reported with anticancer-targeted therapies [22].…”

“…Photoonycholysis represents an unusual manifestation of acute phototoxicity [14]. It can occur following drug intake but also with different forms of porphyria or pseudoporphyria [18]. Tetracycline derivatives, psoralens, fluoroquinolones, and, less commonly, chloramphenicol, oral contraceptives, chlorpromazine, voriconazole, thiazide diuretics, and griseofulvin are the most frequently incriminated drugs [18,19,20,21].…”

Phototoxic and Photoallergic Reactions

“…It appears late (2-3 weeks after drug intake and sun exposure), may be preceded by pain in the nail apparatus, and occurs mainly with tetracyclines (demethylchlortetracyclie or doxycycline) [45], psoralens, and fluorquinolones [46]. There is no definite explanation for the single involvement of the nail: the nail bed is relatively unprotected from sunlight, contains less melanin, the nail plate may work as a lens, and the inflammatory reaction induces detachment of the nail plate from the nail bed [45][46][47].…”

To Study Nail Changes in Dermatology.

“…There is a bimodal peak of onycholysis in our study which can be explained on the basis of multiple causes of onycholysis which includes trauma, fungal infection, eczema, drug reactions, maceration, photo-onycholysis [23], hypothyroidism [24], hyperthyroidism [25], trauma [26], drugs like 5-FU [27], doxycycline [28][29][30], retinoids [31] and chemotherapy [32]. Our study also did not show any significant difference between the association of onycholysis with only nail changes or in association with skin/hair or systemic disease which can also be explained on basis of the multiple causes of onycholysis.…”