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癌症患者化疗引起的指甲变化：拉贾斯坦邦西北部的一项横断面研究

Nail Changes Caused by Chemotherapy among Cancer Patients: A Cross-Sectional Study of Northwest Rajasthan.

作者信息

Trivedi Madhvi, Mehta R D, Kumar H S, Ghiya B C, Soni Prasoon, Meena Manish Kumar, Kumar Vineet, Rekha S

机构信息

Department of Dermatology, Venereology and Leprosy, Sardar Patel Medical College, Bikaner, Rajasthan, India.

出版信息

Indian Dermatol Online J. 2020 Sep 19;11(6):953-958. doi: 10.4103/idoj.IDOJ_84_20. eCollection 2020 Nov-Dec.

DOI:10.4103/idoj.IDOJ_84_20
PMID:33344346
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7734979/
Abstract

BACKGROUND

The nail changes caused by chemotherapy in cancer patients are difficult to assess and often overlooked by clinician. The present study was undertaken to study nail changes caused by various chemotherapeutic agents and various drug protocols most commonly associated with them.

MATERIALS AND METHOD

Five hundred patients with malignancies receiving chemotherapy in the oncology ward and skin outpatient department were screened in this cross-sectional observational study from November 2018 to October 2019.

RESULTS

Nail changes due to chemotherapy were observed in 37.6% patients. The most common condition observed was melanonychia (84.04%), followed by half and half nails (6.91%), erythronychia (5.31%), longitudinal grooves (2.12%), leukonychia (2.12%), Mees' lines (1.59%), Beau's lines (0.53%), pitting (0.53%), and subungual hyperkeratosis (0.53%). The usual protocol to cause melanonychia was platinum analogues + taxanes based combinations, half and half nails by platinum analogues + taxanes + 5 fluorouracil (5FU) based polypharmacy, and erythronychia by cisplatin-based adjuvants.

CONCLUSION

The knowledge of the nail changes caused by chemotherapy will help in counseling of already worried patients with malignancy. It will also improve patient compliance and enrich the clinicians' knowledge pertaining to chemotherapy-induced nail changes.

摘要

背景

癌症患者化疗引起的指甲变化难以评估，临床医生常常忽视。本研究旨在探讨各种化疗药物及与之最常相关的各种用药方案所引起的指甲变化。

材料与方法

在这项横断面观察性研究中，于2018年11月至2019年10月对肿瘤病房和皮肤科门诊接受化疗的500例恶性肿瘤患者进行了筛查。

结果

37.6%的患者观察到化疗引起的指甲变化。观察到的最常见情况是甲下黑素沉着（84.04%），其次是对半甲（6.91%）、红甲（5.31%）、纵嵴（2.12%）、白甲（2.12%）、Mees线（1.59%）、Beau线（0.53%）、点状凹陷（0.53%）和甲下过度角化（0.53%）。引起甲下黑素沉着的常用方案是铂类类似物+紫杉烷类联合用药，对半甲是铂类类似物+紫杉烷类+5-氟尿嘧啶（5FU）联合用药，红甲是顺铂辅助用药。

结论

了解化疗引起的指甲变化将有助于为已忧心忡忡的恶性肿瘤患者提供咨询。这也将提高患者的依从性，并丰富临床医生关于化疗引起指甲变化的知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/11ea3686f10b/IDOJ-11-953-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/904295ecdbde/IDOJ-11-953-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/a4d3802caeae/IDOJ-11-953-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/332829e014b4/IDOJ-11-953-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/2a9648426429/IDOJ-11-953-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/e751f192f1e1/IDOJ-11-953-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/11ea3686f10b/IDOJ-11-953-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/904295ecdbde/IDOJ-11-953-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/a4d3802caeae/IDOJ-11-953-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/332829e014b4/IDOJ-11-953-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/2a9648426429/IDOJ-11-953-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/e751f192f1e1/IDOJ-11-953-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5917/7734979/11ea3686f10b/IDOJ-11-953-g006.jpg

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本文引用的文献

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Polydactylous Transverse Erythronychia: Report of a Patient with Multiple Horizontal Red Bands Affecting the Fingernails.多指（趾）性横向红甲症：一例累及指甲的多条水平红色带患者的报告。
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The risk of nail changes with taxane chemotherapy: a systematic review of the literature and meta-analysis.
紫杉烷类化疗导致指甲改变的风险：文献系统综述与荟萃分析
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Distinct patterns of chromonychia, Beau's lines, and melanoderma seen with vincristine, adriamycin, dexamethasone therapy for multiple myeloma.在使用长春新碱、阿霉素、地塞米松治疗多发性骨髓瘤时观察到的甲变色、博氏线和黑皮病的不同模式。
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