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How to prevent and treat chemotherapy-induced nail abnormalities
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Most frequently changes in chemotherapy affect the nail plate and the nail bed:Changes in pigmentation like melanonychia with cyclophosphamide, doxorubicin and hydroxyurea, true leukonychia with cyclophosphamide, doxorubicin, and vincristine, and also apparent leukonychia.But changes can also affect transitory decrease of matrix activity leading to Beau’s lines (Figure 18.1) or onychomadesis and reducing the nail growth and thickness.Other modifications occurred like onycholysis and hematomas principally, with taxanes and could sometimes complicated with secondary infection, most of the time with Pseudomonas aeruginosa, causing green or yellow coloration and suppuration.
Chemotherapeutic-Induced Nail Reactions
Published in Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti, Dermatologic Reactions to Cancer Therapies, 2019
Eric Wong, Maria Carmela Annunziata, Antonella Tosti
Apparent leukonychia present as parallel, white bands that disappear with pressure. As opposed to true leukonychia, apparent leukonychia does not migrate with growth of the nail plate (1). The exact pathogenesis of leukonychia is unknown, but they are believed to be caused by damage to the nail bed vessels leading to variable blood flow (1,18,11). Muehrcke's nails are a typical example of apparent leukonychia due to chemotherapy (Figure 9.4) (8). Apparent leukonychia is a common side effect of combined chemotherapy. It has also been in reported patients on doxorubicin and tyrosine kinase inhibitors (TKIs), including sorafebnib, sunitinib, and imatinib (8,33). Apparent leukonychia typically resolves with discontinuation of medication (18).
Development of Terry’s nails after a gastrointestinal bleed
Published in Baylor University Medical Center Proceedings, 2021
Christine P. Lin, Mahmud Alkul, Jay M. Truitt, Cloyce L. Stetson
Terry’s nails, a type of apparent leukonychia, is a sign of systemic disease characterized by ground-glass opacity of nearly the entire nail with a narrow band of normal pink or brown nail bed at the distal plate.1 Nail involvement is often bilaterally symmetrical.1,2 Terry’s nails were first described in 1954 by Richard Terry in patients with hepatic cirrhosis.3 Subsequent studies have demonstrated this nail abnormality to be associated with congestive heart failure, chronic kidney disease, diabetes mellitus, and malnutrition.1,2,4 Because Terry’s nails may signify underlying disease, a careful clinical exam is essential in every patient encounter. We report a case of a 77-year-old man who developed Terry’s nails following an acute gastrointestinal bleed and subsequent hemorrhagic shock.