Taxan-associated nail toxicity

Description

A woman aged 69 years treated with adjuvant docetaxel every 3 weeks for luminal-B breast cancer, presented with nail dystrophies.

On clinical examination, nested nail plates (figure 1A, C) divided by deep transverse sulci (figure 1B, D) on all 10 fingers were prominent. We counted three parallel grooves (figure 1B, D) with different distance to each other corresponding to three applied cycles of docetaxel. The second cycle of chemotherapy had to be postponed for 1 week due to febrile neutropenia reflected by a wider distance from the first to second than the second to third groove (figure 1A, C).

Figure 1

Nail plates divided by deep transverse impressions following the interval of docetaxel application (A–D). Orange discolouration at the distal nail plate, mainly due to subungual haemorrhages (A, C). Additionally, paronychial erythema surrounds some of the nails beds (A, B).

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