Nail manifestations in cancer chemotherapy: A cross-sectional study

Background: Anticancer chemotherapy is associated with multisystem adverse effects. Chemotherapy can affect skin, nails, and hair and may sometimes affect the quality of life to the point of requiring discontinuation of therapy. There are many new chemotherapeutic agents, and with that, a rise in the adverse effects attributed to them. Purpose: To evaluate the frequency of nail changes occurring due to anticancer therapy. Methods: We screened 100 cancer patients admitted in the oncology ward of a tertiary care center in South India from July to September 2017. The nail changes were documented and analyzed with emphasis on developing a relationship if any with a chemotherapeutic agent. Results: Nail changes were observed in 62 (62%) cases. Breast carcinoma (20 cases) was the most common malignancy. Doxorubicin (36 cases) and cyclophosphamide (27 cases) were the most common chemotherapeutic drugs associated with nail changes. Pigmentary changes (32 cases) were the most common nail plate changes. Blue lunula (24 cases) was the most common nail bed change, occurring with cyclophosphamide/doxorubicin. Pyogenic granuloma was the only nail fold change that was noted in a patient of carcinoma of breast treated with gefitinib. Conclusion: Cancer chemotherapy may be associated with a variety of nail changes. Addressing nail changes may have the potential to improve cancer treatment patients' quality of life.