Onycholysis, which is separation of the nail plate from the nail bed at its distal and lateral attachments, can cause pain and impair function and is a well-known side effect of traditional chemotherapeutic agents.
Objectives:
We present two cases of onycholysis associated with capecitabine in women with advanced breast cancer, who were initially referred for evaluation of onychomycosis and review the literature on capecitabine.
Conclusion:
Owing to the increased frequency of use of capecitabine for different cancers, physicians should be aware of this side effect.
JacksonRJ. Morphological diagnosis of skin disease. Grimsby, ON: Manticore; 1998.
3.
ChenGYChenYHHsuMM. Onychomadesis and onycholysis associated with capecitabine. Br J Dermatol2001;145:521–2.
4.
UhlmannCBallabeniPRijkenN. Capecitabine with weekly paclitaxel for advanced breast cancer: a phase 1 dose-finding trial. Oncology2004;67:117–22.
5.
IshikawaTUtohMSawadaN. Tumour selective delivery of 5-fluorouracil by capecitabine, a new oral fluoropyrimidine carbamate, in human cancer xenografts. Biochem Pharmacol1998;55:1091–7.
6.
WalkoCMLindleyC. Capecitabine: a review. Clin Ther2005;27: 23–44.
7.
ScheithauerWBlumJ. Coming to grips with hand-foot syndrome. Insights from clinical trials evaluating capecitabine. Oncology2004;18:1161–8.
8.
FischelJLFormentoPCiccoliniJ. Lack of contribution of dihydrofluorouracil and alpha-fluoro-beta-alanine to the cytotoxicity of 5'-deoxy-5-fluorouridine on human keratinocytes. Anticancer Drugs2004;15:969–74.
9.
HussianSAndersonDNSalvatiME. Onycholysis as a complication of systemic chemotherapy. Cancer2000;88:2367–71.
10.
MainoKLNorwoodCStashowerME. Onycholysis with the appearance of a “sunset” secondary to capecitabine. Cutis2003;72: 234–6.
11.
MunozABarceloRRubioI. Onycholysis associated with capecitabine in combination with irinotecan in two patients with colorectal cancer. J Natl Cancer Inst2003;95:1252–3.
12.
CreamerJDMortimerPSPowlesTJ. Mitozantrone-induced onycholysis, a series of five cases. Clin Exp Dermatol1995;20:459–61.
13.
DanielCRIIIScherRK. Nail changes caused by systemic drugs or ingestants. Dermatol Clin1985;3:491–5.
14.
BaranRJuhlinI. Drug-induced photo-onycholysis. J Am Acad Dermatol1987;17:1012–6.
15.
PicardoMTostiAMarcheseC. Characterization of cultured nail matrix cells. J Am Acad Dermatol1994;30:434–40.
