Surgical Intervention for Paronychia Induced by Targeted Anticancer Therapies.
Adult
Aged
Anti-Bacterial Agents
/ administration & dosage
Antineoplastic Agents
/ adverse effects
Combined Modality Therapy
Drainage
/ methods
Female
Glucocorticoids
/ administration & dosage
Humans
Male
Middle Aged
Molecular Targeted Therapy
/ adverse effects
Nails
/ drug effects
Neoplasms
/ drug therapy
Paronychia
/ chemically induced
Retrospective Studies
Skin
/ drug effects
Treatment Outcome
Journal
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
ISSN: 1524-4725
Titre abrégé: Dermatol Surg
Pays: United States
ID NLM: 9504371
Informations de publication
Date de publication:
01 06 2021
01 06 2021
Historique:
entrez:
24
5
2021
pubmed:
25
5
2021
medline:
30
9
2021
Statut:
ppublish
Résumé
Paronychia is a common toxicity associated with targeted anticancer therapies. Antibiotics and steroids are the standard treatments for severe paronychia, yet they are often inadequate, prolonging the patient's suffering and resulting in changes to effective cancer therapy. This article describes the clinical course of drug-induced paronychia and attempts to identify circumstances under which nail surgery may be beneficial. This is a retrospective case series from a single institution's electronic medical record for patients on paronychia-inducing anticancer therapies with nail disease visit diagnosis codes. The authors identified 36 nail procedures performed on 12 patients, all of whom were managed with conservative steroid and antibiotic therapy with varying degrees of improvement; however, no further improvement was seen after 90 days. Partial matricectomy, nail avulsion, debridement/clipping, and incision and drainage were performed with resolution rates of 100% (11/11), 38.5% (5/13), 12.5% (1/8), and 0% (0/4), respectively. The average time to surgical intervention was 196 days, and the average time to resolution was 268 days. This series highlights the prolonged course of severe drug-induced paronychia and the importance of surgical intervention to reduce pain and impact on cancer treatment. Partial matricectomy should be considered for paronychia unresponsive to conservative therapy by 3 months.
Sections du résumé
BACKGROUND
Paronychia is a common toxicity associated with targeted anticancer therapies. Antibiotics and steroids are the standard treatments for severe paronychia, yet they are often inadequate, prolonging the patient's suffering and resulting in changes to effective cancer therapy.
OBJECTIVE
This article describes the clinical course of drug-induced paronychia and attempts to identify circumstances under which nail surgery may be beneficial.
MATERIALS AND METHODS
This is a retrospective case series from a single institution's electronic medical record for patients on paronychia-inducing anticancer therapies with nail disease visit diagnosis codes.
RESULTS
The authors identified 36 nail procedures performed on 12 patients, all of whom were managed with conservative steroid and antibiotic therapy with varying degrees of improvement; however, no further improvement was seen after 90 days. Partial matricectomy, nail avulsion, debridement/clipping, and incision and drainage were performed with resolution rates of 100% (11/11), 38.5% (5/13), 12.5% (1/8), and 0% (0/4), respectively. The average time to surgical intervention was 196 days, and the average time to resolution was 268 days.
CONCLUSION
This series highlights the prolonged course of severe drug-induced paronychia and the importance of surgical intervention to reduce pain and impact on cancer treatment. Partial matricectomy should be considered for paronychia unresponsive to conservative therapy by 3 months.
Identifiants
pubmed: 34029250
doi: 10.1097/DSS.0000000000003036
pii: 00042728-202106000-00005
doi:
Substances chimiques
Anti-Bacterial Agents
0
Antineoplastic Agents
0
Glucocorticoids
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
775-779Informations de copyright
Copyright © 2021 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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