Adjunctive Pulsed Dye Laser Therapy for Paronychia Induced by Anticancer Agents

Area of Science:

• Dermatology
• Oncology
• Laser Therapy

Background:

• Paronychia is a frequent adverse effect of anticancer therapies, especially epidermal growth factor receptor inhibitors (EGFRIs).
• Conventional treatments for paronychia often yield suboptimal results.
• Pulsed dye laser (PDL) therapy, utilizing its vascular-targeting and anti-inflammatory properties, presents a potential adjunctive treatment modality.

Purpose of the Study:

• To assess the clinical effectiveness and safety of 595-nm PDL therapy as an adjunct treatment for paronychia induced by anticancer drugs.
• To evaluate the impact of PDL therapy on clinical signs and patient-reported outcomes in this patient group.

Main Methods:

• A prospective pre-post study was conducted on 70 digits across ten patients experiencing anticancer drug-induced paronychia (CTCAE grade 1-2).
• Following a 2-week standardized treatment run-in, patients received four weekly sessions of 595-nm PDL therapy.
• Outcomes including erythema index, modified Severity of Paronychia Assessment Tool (SPOT) score, pain, edema, Physician Global Assessment (PGA), and patient satisfaction were evaluated.

Main Results:

• PDL therapy led to significant reductions in erythema index (1.63 to 1.42) and edema (1.67 to 1.45).
• Modified SPOT scores showed marked improvement (3.61 to 1.99), alongside substantial pain relief (4.40 to 1.25).
• Physician Global Assessment improved by Week 3, and patient satisfaction increased to 100% by Week 5.

Conclusions:

• Adjunctive 595-nm PDL therapy demonstrates significant efficacy in improving both clinical manifestations and patient-reported outcomes of anticancer drug-induced paronychia.
• PDL therapy offers a safe and effective treatment option for managing this common side effect of cancer treatment.