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CO2 Laser Matrixectomy for Refractory MEK Inhibitor-Induced Paronychia in Children: A Case Series
Rivka Friedland1,2, Yehonatan Noyman2,3, Assi Levi2,3
1Pediatric Dermatology Unit, Schneider Children's Medical Center of Israel, Petah Tikva, Israel.
Abstract:
Paronychia is a frequent cutaneous adverse event associated with MEK inhibitor therapy and may significantly impair quality of life and compromise treatment adherence. Treatment is usually medical, with poor and unsustained results. We retrospectively evaluated the safety and efficacy of CO2 laser matrixectomy in children at a tertiary center between 2016 and 2026. Five patients with prolonged symptoms despite multiple conservative treatments were identified. Complete resolution was achieved in all patients, with no procedure-related complications. MEK inhibitor therapy was continued without recurrence of paronychia. Outcomes remained favorable during a mean follow-up of 4 years.
Insights
CO2 laser matrixectomy effectively treated paronychia in children undergoing MEK inhibitor therapy. This innovative approach offered a lasting solution, improving quality of life and treatment adherence.
Area of Science:
- Dermatology
- Oncology
- Pediatric Care
Background:
- Paronychia is a common side effect of MEK inhibitor cancer therapy.
- Current medical treatments for paronychia often yield poor and temporary results.
- This condition can negatively impact patients' quality of life and adherence to treatment.
Purpose of the Study:
- To evaluate the safety and efficacy of CO2 laser matrixectomy for treating paronychia in pediatric patients.
- To assess the long-term outcomes of this surgical intervention in children receiving MEK inhibitor therapy.
Main Methods:
- A retrospective study was conducted at a tertiary center from 2016 to 2026.
- Five pediatric patients with persistent paronychia, unresponsive to conservative treatments, underwent CO2 laser matrixectomy.
- Patient data, including treatment response and complications, were analyzed.
Main Results:
- Complete resolution of paronychia was achieved in all five patients treated with CO2 laser matrixectomy.
- No procedure-related complications were reported.
- Patients successfully continued MEK inhibitor therapy without paronychia recurrence, with favorable outcomes over a mean 4-year follow-up.
Conclusions:
- CO2 laser matrixectomy is a safe and effective treatment for paronychia in children undergoing MEK inhibitor therapy.
- This procedure provides a durable solution, potentially improving treatment adherence and quality of life.
- Further research may support wider adoption of this surgical technique for managing this adverse event.
