Nail Changes with Targeted Antineoplastic Drugs

Effects of cisplatin treatment on the rat neurohypophysis

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100142256 ◽

1986 ◽

Vol 44 ◽

pp. 122-123

Author(s):

J.M. Fadool ◽

P.J. Boyer ◽

S.K. Aggarwal

Keyword(s):

Side Effects ◽

Urine Output ◽

Morphological Changes ◽

Limiting Factor ◽

Antineoplastic Drugs

Cisplatin (CDDP) is currently one of the most valuable antineoplastic drugs available. However, it has severe toxic side effects of which nephrotoxicity is the major dose limiting factor in its use. It induces morphological changes in the kidney with hampered urine output. The present study is an effort to determine the influence of the drug on the neurohypophysis for any antidiuretic effects on the kidney.

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Distinctive Nail Changes in Advanced Hepatic Cirrhosis

Gastroenterology ◽

10.1016/s0016-5085(19)36030-5 ◽

1955 ◽

Vol 29 (2) ◽

pp. 258-261 ◽

Cited By ~ 6

Author(s):

Dennis A.J. Morey ◽

James O. Burke

Keyword(s):

Hepatic Cirrhosis ◽

Nail Changes

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Chemotherapy and other antineoplastic drugs

AccessScience ◽

10.1036/1097-8542.128900 ◽

2015 ◽

Keyword(s):

Antineoplastic Drugs

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A Review of Nail Changes in Acrokeratosis Paraneoplastica (Bazex Syndrome)

Skin Appendage Disorders ◽

10.1159/000513828 ◽

2021 ◽

pp. 1-10

Author(s):

Bipasha Roy ◽

Shari R. Lipner

Keyword(s):

Head And Neck ◽

Squamous Cell ◽

Clinical Presentation ◽

Nail Plate ◽

Squamous Cell Carcinomas ◽

Morbidity And Mortality ◽

Cutaneous Manifestations ◽

Nail Changes ◽

Paraneoplastic Dermatosis ◽

Acrokeratosis Paraneoplastica Bazex

Acrokeratosis paraneoplastica (Bazex syndrome) is a rare paraneoplastic dermatosis associated with internal malignancies. Clinical presentation is characterized by erythematous or violaceous scaly plaques involving the digits, nose, ears, palms, and soles. Nail changes commonly present concurrently with cutaneous manifestations. In this review, we characterize nail changes associated with acrokeratosis paraneoplastica. A total of 48 cases were analyzed. Nail findings were nonspecific, with the most common being nail plate thickening, onycholysis, subungual hyperkeratosis, longitudinal ridging, discoloration, and nail plate loss. In most patients, nail changes involved the majority of fingernails and toenails and most often appeared prior to the diagnosis of malignancy. The most common associated underlying malignancies were squamous cell carcinomas of the head and neck. A diagnosis of acrokeratosis paraneoplastica should be considered in patients with onychodystrophy involving multiple nails with accompanying atypical psoriasiform dermatoses. Screening for internal malignancies may significantly decrease morbidity and mortality for these patients.

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Characteristics of wipe sampling methods for antineoplastic drugs in North America: comparison of six providers

Pharmaceutical Technology in Hospital Pharmacy ◽

10.1515/pthp-2020-0016 ◽

2020 ◽

Vol 5 (1) ◽

Author(s):

Claire Chabut ◽

Jean-François Bussières

Keyword(s):

Environmental Monitoring ◽

Service Provider ◽

Sampling Methods ◽

Service Providers ◽

Limit Of Detection ◽

The United States ◽

Antineoplastic Drugs ◽

Wipe Sampling ◽

Pubmed Database ◽

Google Search

Abstract Objectives Several societies have published guidelines to limit the occupational exposure of workers. Several of these guidelines recommend periodic (once or twice a year) environmental monitoring of specific sites where antineoplastic drugs are prepared and administered. However, most of the guidelines provide no guidance concerning which antineoplastic drugs should be monitored, the preferred sampling sites, appropriate test methods or limits of detection. The aim of this study was to characterize providers that quantify antineoplastic drug measured on surfaces. Methods This was a cross-sectional descriptive study. To identify service providers offering environmental monitoring tests, we searched the PubMed database and used the Google search engine. We contacted each service provider by email between June 3rd and June 15th, 2020. We specified the objective of our study and described the information needed and the variables of interest with standardized questions. Additional questions were sent by emails or via teleconferences. No statistical analyses were performed. Results We identified six providers offering services to Canadian hospitals, either based in Canada or in the United States. Five of these providers were private companies and one was a public organization. Each service provider was able to measure trace contamination of 3–17 antineoplastic drugs. Five of the providers quantified drugs using ultra performance liquid chromatography coupled with tandem mass spectrometry (UPLC-MSMS), which allowed for lower LODs. The sixth provider offered quantification by immunoassay, which has higher LODs, but offers near real-time results; the surface area to be sampled with this method was also smaller than with UPLC-MSMS. The services offered varied among the service providers. The information about LODs supplied by each provider was often insufficient and the units were not standardized. A cost per drug quantified could not be obtained, because of variability in the scenarios involved (e.g. drug selection to be quantified, number of samples, nondisclosure of ancillary costs). Four of the six service providers were unable to report LOQ values. Conclusions Few data are available from Canadian service providers concerning the characteristics of wipe sampling methods for antineoplastics. This study identified six north-American providers. Their characteristics were very heterogeneous. Criteria to consider when choosing a provider include the validation of their analytical method, a low limit of detection, the choice of drugs to be quantified and the sites to be sampled, obtaining details about the method and understanding its limits, and price. This should be part of a structured multidisciplinary approach in each center.

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Incidence of Adverse Cutaneous Reactions to Epidermal Growth Factor Receptor Inhibitors in Patients with Non-Small-Cell Lung Cancer

Dermatology ◽

10.1159/000513233 ◽

2021 ◽

pp. 1-5

Author(s):

Paolo Gisondi ◽

Davide Geat ◽

Alessandra Mattiucci ◽

Fiorella Lombardo ◽

Antonio Santo ◽

...

Keyword(s):

Lung Cancer ◽

Epidermal Growth Factor Receptor ◽

Growth Factor Receptor ◽

Small Cell ◽

Egfr Inhibitor ◽

Small Cell Lung ◽

Nail Changes ◽

Cutaneous Reactions ◽

Epidermal Growth ◽

Oncologic Treatment

Background: Epidermal growth factor receptor (EGFR) inhibitors are routinely used in advanced non-small-cell lung cancer (NSCLC) harboring EGFR mutations. However, their use is associated with gastrointestinal and cutaneous toxicities, including acneiform eruptions, pruritus, xerosis, nail and hair changes. Aside from reducing patients’ quality of life, such cutaneous reactions have a considerable impact on the oncologic treatment given that dose reduction or even drug discontinuation may be necessary, especially for the severe forms. Objectives: To assess the incidence, impact on treatment and management of EGFR inhibitor-related cutaneous reactions in patients with NSCLC. Methods: We conducted a prospective observational study on 87 consecutive patients with advanced NSCLC treated with EGFR-tyrosine kinase inhibitors from January to December 2019. Patients who developed mucocutaneous reactions were evaluated and treated by both oncologists and dermatologists, and underwent dermatologic follow-up until resolution of the cutaneous reaction. Demographic and clinical data were collected for each patient, and the severity of the cutaneous reaction was graded using the Common Terminology Criteria for Adverse Events. Results: Seventy-one patients (81.6%) developed cutaneous reactions. The number of cutaneous reactions per patient was 1 in 37%, 2 in 41% and 3 or more in 22%. The most common cutaneous reactions included acneiform eruptions (56.3%), xerosis ± asteatotic eczema (48.3%), nail changes (39.1%), mucositis (29.9%), pruritus (24.1%) and hair changes (12.6%). Afatinib was associated with a higher rate of nail changes and mucositis (p < 0.01 and p < 0.005, respectively) compared to other agents, while no patient-related predictive factors were identified. Dose reduction was performed in 18% of patients. Multidisciplinary management involving dermatologists allowed to resume the drug in all patients who had discontinued it due to the cutaneous reactions. Conclusions: A multidisciplinary approach to EGFR inhibitor-related cutaneous reactions is advantageous and can reduce the need to discontinue oncologic treatment.

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