Adjunctive Pulsed Dye Laser Therapy for Paronychia Induced by Anticancer Agents

Paronychia is a common side effect of anticancer therapies, particularly epidermal growth factor receptor inhibitors (EGFRIs). Standard treatments often provide limited relief. Pulsed dye laser (PDL) therapy at 595 nm, with vascular-targeting and anti-inflammatory effects, may serve as an effective adjunctive treatment.

To evaluate the clinical efficacy and safety of adjunctive 595-nm PDL therapy in the treatment of paronychia induced by anticancer drugs, particularly EGFRIs.

This prospective pre-post study included 70 digits with anticancer drug-induced paronychia, Common Terminology Criteria for Adverse Events [CTCAE] grade 1-2, from ten patients. After a 2-week run-in with standardized treatment, participants received 4 weekly sessions of 595-nm PDL therapy. Outcomes-assessed at baseline, each visit, and 2 weeks posttreatment-included erythema index (EI), modified Severity of Paronychia Assessment Tool (SPOT) score, pain, edema, Physician Global Assessment (PGA), patient satisfaction, and adverse events.

PDL therapy significantly reduced the EI from 1.63 to 1.42 (p < 0.001) and edema from 1.67 to 1.45 (p < 0.001). Modified SPOT scores improved from 3.61 to 1.99 (p < 0.001), with early pain relief observed (4.40-1.25; p < 0.001). PGA improved by Week 3, and patient satisfaction increased from 0 to 100 by Week 5 (p < 0.001).

PDL adjuvant therapy significantly improves both clinical signs and patient-reported outcomes in anticancer drug-induced paronychia.