Chemotherapy is a treatment that uses drugs to destroy, stop the spread or retard the growth of cancer cells. Two groups of chemotherapy drugs cause changes to the nails. These two groups include the taxanes and the anthracyclines. Direct toxicity of the chemotherapy drugs on the fingernails or toenails proves responsible for this side effect. The changes to the nails are reversible once the chemotherapy treatment is discontinued.
Nail discoloration
According to an article featured in the "Annals of Oncology", five case reports by A. M. Minisini and colleagues document changes in nail pigmentation in patients who received taxanes. Melanonychia or the darkening of the fingernails is a side effect of the taxanes. Hyperpigmentation appears scattered on the fingernail or in transverse bands. Transverse bands form in a crosswise pattern. Melanonychia occurs more commonly in patients with dark skinned than fair skinned patients. Cited on the website, Chemocare.com, darkened nail beds is a less common side effect of the anthracyclines. This side effect occurs within two weeks after treatment has begun.
According to HCP live, Muehrcke's lines are a side effect of the anthracyclines. The lines appear as narrow white transverse bands on the fingernails.
In an article featured in the "Southern Medical Journal", report S. Chapman and P.R. Cohen report the occcurrence of leukonychia in three cases of patients who received chemotherapy. Leukonychia is a disorder characterized by a white discoloration of the nails. Toxic chemotherapy drugs temporarily interfere with nail growth. A review of the case studies and published reports isolated vincristine, cyclophosphamide, and doxorubicin as the drugs most likely to cause this side effect.
Nail detachment
The medical experts writing for DermNet NZ lists onycholysis and onchomadesis as possible side effects of chemotherapy. Onycholysis is the detachment of the nail from the nail bed, or the skin below the nail. The nail begins to detach at the top of the nail and progresses back to the cuticle.This side effect occurs specifically with the group of chemotherapy drugs containing taxane. Onchomadesis is the loss of the entire fingernail.
Grooves in the fingernails
DermNet NZ includes the development of Beau's lines in the list of chemotherapy side effects. Beau's lines resemble horizontal grooves, which appear on the fingernails. They result because of an interruption in the production of keratin. Fingernails and toenails consist of keratin, which is a fibrous protein.
