Nail hyperpigmentation secondary to therapy with doxorubicin

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Doxorubicin (Adriamycin) is a widely used anthracycline chemotherapy agent.
• Chemotherapy-induced side effects can impact patient quality of life and treatment adherence.
• Nail changes are a recognized, though less common, adverse effect of certain chemotherapeutic agents.

Observation:

• Patients undergoing doxorubicin therapy may develop hyperpigmentation of the fingernails.
• Two distinct patterns of hyperpigmentation have been observed: diffuse and transversely banded.
• The observed pigmentation is hypothesized to be melanin-based.

Findings:

• Fingernail hyperpigmentation associated with doxorubicin treatment presents in diffuse or transversely banded patterns.
• The pigment responsible for the nail discoloration is presumed to be melanin.
• Cessation of doxorubicin therapy leads to the resolution of hyperpigmentation as the nail grows out.

Implications:

• Awareness of these nail changes can aid clinicians in managing patient expectations and side effects.
• Understanding the mechanism (melanin) may inform future research into managing chemotherapy-induced nail toxicity.
• Monitoring for and recognizing these benign nail changes is important for patient care during doxorubicin treatment.