Abstract
Goals of work
The objective of this study is to estimate the frequency and severity of nail changes due to treatment with the cytotoxic drug docetaxel and, secondly, to estimate how the nail changes effects the patients cosmetically and functionally in their daily activities. Finally, we want to clarify whether fungal infection could contribute in causing the nail changes.
Materials and methods
Fifty-five patients with metastatic breast cancer in treatment with the cytotoxic drug docetaxel participated in the study. They filled out two questionnaires about their experience with possible nail changes. The frequency of fungal infection was examined. At each of the two visits, information about the number of treatment cycles, dose of docetaxel the patient received, frequency of lymph oedema, previous treatment with chemotherapy and the reason of discontinuance of treatment, if relevant, were registered. Finally, photos were taken to document the nail changes in hands and feet.
Main results
Fifty-eight percent had some degree of nail changes and an increase to 88.5% was seen after three additional cycles. A large proportion of the patients experienced the nail changes as a cosmetic nuisance, and more than 32% had functional problems.
Conclusion
Nail changes occur more frequently than previous studies have shown. Furthermore, our study indicates that the nail changes are affecting a large proportion of the patients, both cosmetically and functionally, which may lead to a decrease in their quality of life. No significant association was found according to the possible relation between nail changes and fungal infection.
Similar content being viewed by others
References
National Board of Health (2004) Cancer incidence in Denmark, 2000. National Board of Health, Denmark
Correia O, Azevedo C, Pinto Ferreira E, Braga Cruz F, Polonia J (1999) Nail changes secondary to docetaxel (taxotere). Dermatology 198(3):288–290
Doval DC, Pavithran K (2002) Nail changes due to docetaxel. Br J Dermatol 146(4):709–710
Drake LA, Scher RK, Smith EB, Faich GA, Smith SL, Hong JJ, Stiller MJ (1999) Effect of onychomycosis on quality of life. J Am Acad Dermatol 38(5):702–704
Howard A, Nicolopoulos J (2002) Docetaxel-induced nail dystrophy. Australas J Dermatol 43(4):293–296
Hussain S, Anderson DN, Salvatti ME, Adamson B, McManus M, Braverman AS (2000) Onycholysis as a complication of systemic chemotherapy. Cancer 88(10):2367–2371
Markman M (2003) Managing taxane toxicities. Support Care Cancer 11:144–147
Minisini AM, Tosti A, Sobrero AF, Mansutti M, Piraccini BM, Sacco C, Puglisi F (2003) Taxane-induced nail changes: incidence, clinical presentation and outcome. Ann Oncol 14:333–337
Nilsson J, Svejgaard EL (2004) Onychomycosis in Denmark: prevalence of fungal nail infection in general practice. Mycoses 47:131–135
Obermair A, Binder M, Barrada M, Bancher-Todesca D, Asseryanis E, Kubista E (1998) Onycholysis in patients treated with docetaxel. Ann Oncol 9(2):230–231
Patten SF, Jacob C (1998) Nail bed dyschromia secondary to docetaxel therapy. Arch Dermatol 134:1167–1168
Robinet G, Thomas P, Perol M, Vergnenegre A, Lena H, Taytard A, Paillotin D, Bessa EH, Schuller-Lebeau MP (2000) Phase 2 study of docetaxel in inoperable advanced non-small cell lung cancer. Bull Cancer 87(3):253–258
Saarinen A, Jekunen A, Halme M, Pyrhonen S, Tamminen K, Boyer Roubille N, Mattson K (1996) A phase 2 trial of docetaxel in advanced non-small cell lung cancer. Anticancer Drugs 7(8):890–892
Scotté F, Taurani JM, Banu E, Peyromaure M, Levy E, Marsan S, Magherini E, Fabre-Guillevin E, Andrieu JM, Oudard S (2005) Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand. J Clin Oncol 23(19):4424–4429
Stanton AW, Modi S, Mellor RH, Peters AM, Svensson WE, Levick JR, Mortimer PS (2006) A quantitative lymphoscintigraphic evaluation of lymphatic function in the swollen hands of women with lymphoedema following breast cancer treatment. Clin Sci (Lond) 110(5):553–561
ten Bokkel Huinink WW, Prove AM, Piccart M, Steward W, Tursz T, Wanders J, Franklin H, Clavel M, Verweij J, Alakl M (1994) A phase 2 trial with docetaxel (taxotere) in second line treatment with chemotherapy for advanced breast cancer. Ann Oncol 5(6):527–532
Vanhooteghem O, Richert B, Vindevoghel A, Vandenbossche L, Vandeveire A, De La Brassinne M (2000) Subungual abcess. A new ungual side-effect related to docetaxel therapy. Br J Dermatol 143:462–464
Wasner G, Hilpert F, Schattschneider J, Binder A, Pfisterer J, Baron R (2002) Docetaxel-induced nail changes—a neurogenic mechanism. J Neurooncol 58:167–174
Wiseman LR, Figgitt DP (2000) Docetaxel: an update of its use in advanced breast cancer. Drugs 59(3):621–651
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Winther, D., Saunte, D.M., Knap, M. et al. Nail changes due to docetaxel—a neglected side effect and nuisance for the patient. Support Care Cancer 15, 1191–1197 (2007). https://doi.org/10.1007/s00520-007-0232-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-007-0232-0