Multidisciplinary Management of Severe Taxane-Induced Nail Toxicity in a Breast Cancer Patient

Taxane-induced nail toxicity (TINT) is a relatively common but often underreported adverse effect of docetaxel-based chemotherapy that may significantly impair quality of life and functional status. Severe cases can require structured supportive care involving multiple clinical disciplines. We present a case of high-grade TINT in a patient with breast cancer successfully managed with a multidisciplinary supportive approach.

A 70-year-old woman with HER2-positive breast cancer received neoadjuvant TCH chemotherapy (docetaxel, cyclophosphamide, trastuzumab), followed by surgery and adjuvant trastuzumab emtansine. Nail toxicity developed after the second cycle of docetaxel and progressed to subungual hemorrhages, onycholysis, and marked onychodystrophy associated with pain and functional limitation. The patient underwent podiatric treatment including mechanical nail debridement and topical collagen-based serum therapy. Supportive pharmacologic management, including selective COX-2 inhibitors, was also introduced.

Gradual epithelial healing and nail regrowth were observed over a six-month follow-up period. Pain and functional impairment improved, and systemic oncologic therapy was continued without interruption. No recurrence of severe nail complications was noted during subsequent treatment.

This case illustrates that severe taxane-induced nail toxicity may be effectively controlled with coordinated multidisciplinary supportive care. Early podiatric intervention combined with pharmacologic symptom management may help maintain treatment continuity and improve patient comfort during taxane-based chemotherapy.