Drug-Induced Nail Disorders: Prevention Is Best

In This Article

How Do Nail Abnormalities Occur?

Drug-induced nail changes include those that are well known and are considered common sequelae of treatment, such as those induced by cancer chemotherapeutic agents, and less common changes that have been reported in only a few cases.[1] A summary of drug-induced nail changes is provided in table 1.

The nail is composed of 4 epithelia: nail folds, nail matrix, nail bed/hyponychium and nail plate. Although the pathogenesis of drug-induced nail disorders is not always understood, these abnormalities usually result from one of the following:

  • toxic effect on the nail epithelia

  • excretion and storage of the drug within the nail plate

  • dermal deposition of the drug (usually also affecting the skin and/or mucosae)

  • indirect effects resulting in impaired distal digital perfusion.


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