Recognising Nail Changes Induced by Chemotherapy with Taxane-based Regimens and their Dermoscopic Confirmation: A Prospective Observational Study from Northern India
Introduction: Taxanes are chemotherapeutic agents used in a variety of solid tumours. They are known to cause cutaneous as well as nail changes which are temporally associated with intake of drug. Nail involvement is reported in literature from some parts of the world. Aim: To study the pattern of...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2022-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/16870/55977_CE(AD)_F(KR)_PF1(AB_KM)_PFA(AB_KM)_PN(KM).pdf |
| Summary: | Introduction: Taxanes are chemotherapeutic agents used in a variety of solid tumours. They are known to cause cutaneous as well as nail changes which are temporally associated with intake of drug. Nail involvement is reported in literature from some parts of the world.
Aim: To study the pattern of nail changes occurring due to taxane-based chemotherapy regimens in patients suffering from malignancies.
Materials and Methods: This prospective observational study was carried out in a tertiary care hospital in GMC, Patiala, Punjab, India from October 2020 to September 2021. A total of 160 adult patients undergoing cancer chemotherapy with taxanes were included in the study. After taking detailed history, nail changes were examined and confirmed by dermoscopy. The data was analysed using Epi Info 7 by Centers for Disease Control and Prevention (CDC) and Chi-square test was used to calculate the p-value. A p-value<0.05 was considered significant.
Results: A total of 144 patients (87 females and 57 males), with the mean age of 53.8 years, were screened for six chemotherapeutic cycles. Drug-induced Nail Pigmentation (DINP) was the most common nail abnormality seen in 43/144 (29.9%) patients after third cycle and in 105/144 (72.9%) patients after the sixth cycle. The most common pattern was diffuse nail pigmentation 40/105 (38.1%) followed by longitudinal melanonychia 22/105 (21%) after six cycles. Maximum pigmentation 52/60 (86.7%) was observed in patients who received taxane+adriamycin+ cyclophosphamide combination. On onychoscopy, DINP appeared as thin grey regularly arranged parallel longitudinal lines on homogenous grey background.
Conclusion: Taxanes cause varied pattern of nail changes with DINP being the most common. It ranges from longitudinal bands after three cycles to diffuse pigmentation after six cycles.These nail changes show temporal relation with dose, duration, number of drugs, and colour of skin. Dermoscopy is a novel non invasive method with a good diagnostic accuracy. |
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| ISSN: | 2249-782X 0973-709X |