Docetaxel-Related Onycholysis

A 54-year-old woman with breast cancer metastatic to the lungs had been treated with four courses of docetaxel, to which she partially responded. Following the first cycle of chemotherapy, the patient experienced arrested growth of her fingernails and toenails. Progressively worsening onycholysis then developed. (The edematous appearance of her hand is secondary to removal of axillary lymph glands at the time of her mastectomy.)

Toxic effects on the nails (ridging, pain, hypopigmentation, or hyperpigmentation) is reported in approximately 28.2% of patients treated with docetaxel, reports Dr Giampaolo Talamo of New York. Severe nail changes take place in about 2.8%, and onycholysis occurs in 0.8%.