Nail Toxicities Associated with EGFR Inhibitors: An Overview
Introduction
Epidermal growth factor receptor (EGFR) inhibitors are a class of targeted therapies used in the treatment of various types of cancer, including lung, breast, and colorectal cancer. These medications work by blocking the activity of the EGFR, a protein that promotes cell growth and proliferation. While EGFR inhibitors have shown promising efficacy in treating cancer, they can also cause a range of side effects, including nail toxicities.
Incidence of Nail Toxicities
The overall incidence of nail toxicities with EGFR inhibitors is approximately 17%. The majority of these toxicities are low-grade, such as nail discoloration, brittleness, and splitting. However, high-grade nail toxicities, such as nail loss, can occur in some patients.
Types of Nail Toxicities
The most common nail toxicities associated with EGFR inhibitors include:
- Paronychia (inflammation and infection of the nail fold)
- Nail discoloration (yellowing, darkening, or whitening of the nails)
- Nail brittleness and splitting
- Onycholysis (separation of the nail from the nail bed)
- Nail loss
Management of Nail Toxicities
The management of nail toxicities associated with EGFR inhibitors depends on the severity of the toxicity. Mild toxicities, such as nail discoloration and brittleness, can often be managed with conservative measures, such as using moisturizing lotions and avoiding harsh chemicals.
For more severe toxicities, such as onycholysis and nail loss, treatment may include:
- Antibiotics to treat any underlying infections
- Topical antifungal creams
- Protective nail dressings
- Dose reduction or discontinuation of EGFR inhibitor therapy
Conclusion
Nail toxicities are a common side effect of EGFR inhibitor therapy. While most toxicities are low-grade and can be managed with conservative measures, high-grade toxicities can significantly impact a patient's quality of life. It is important for patients to be aware of the potential for nail toxicities and to discuss any concerns with their healthcare provider.
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