Chemotherapy-induced asymmetrical melanonychia

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Ivan Petković

Ivan Petković

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Abstract

Introduction: Chemotherapy may cause various nail damages, including chromonychia, melanonychia, onycholisis, and onychomadesis. Melanonychia is characterized by melanin-derived brown-to-black nail pigmentation. It may occur as a result of nail matrix melanocytic activation or melanocytic hyperplasia, and nail invasion by melanin-producing pathogens. Case report: We present a case of a patient who developed an extremely rare event of asymmetric melanonychia during systemic treatment of non-Hodgkin lymphoma. The melanonychia developed in dose-dependent manner after 500 mg of doxorubicin. One of the most incriminating agents for melanonychia development are doxorubicin and to a less extent cyclophosphamide. Our patient received both drugs as combined chemotherapy. After treatment completion, the phenomenon disappeared. An extremely unexpected event was skin melanoma occurrence. Conclusion: It has not been clarified yet whether this event was causally related to previous nail-related melanocyte activation or it was just a coincidence.

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