Gefitinib-induced paronychia: response to autologous platelet-rich plasma.

Abstract

BACKGROUND:

Paronychia has been reported in as many as 10% of patients treated with gefitinib. Although conservative management and treatment with topical or systemic antibiotics are beneficial, no effective method exists for intractable cases. Platelet-rich plasma (PRP)consists of a high concentration of platelets that promote wound healing through chemotaxis, cell proliferation,angiogenesis, and tissue remodeling.

OBSERVATIONS:

We herein report a refractory case of gefitinib-induced paronychia successfully treated with autologous PRP. A 68-year-old woman who had been diagnosed as having lung adenocarcinoma with multiple bone and brain metastases initiated gefitinib therapy at an oral dose of 250 mg/d. After 1 month, multiple paronychia with periungual granulation appeared on the nailfold of the first, second, and third toenails of both feet.Because the paronychia recurred repeatedly despite use of a topical antibiotic, topical corticosteroid, and short term systemic antibiotic, she started PRP treatment. After 3 months, the lesion showed marked improvement with minimal pain or discharge.

CONCLUSION:

This case highlights the therapeutic challenges of using PRP to promote tissue repair in intractable gefitinib-induced paronychia and merits further investigation.

• Authors: Soon-Hyo Kwon, Jae-Woo Choi, Jong-Soo Hong, Sang-Young Byun, Kyoung-Chan Park, Sang-Woong Youn, Chang-Hun Huh, Jung-Im Na
• Journal: Archives of dermatology (Arch Dermatol) Vol. 148 Issue 12 Pg. 1399-402 (Dec 2012) ISSN: 1538-3652 [Electronic] United States
• PMID: 22986691 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antineoplastic Agents
• Quinazolines
• Gefitinib

Topics

• Aged
• Antineoplastic Agents (adverse effects)
• Female
• Gefitinib
• Humans
• Lung Neoplasms (drug therapy)
• Paronychia (chemically induced, therapy)
• Platelet-Rich Plasma
• Quinazolines (adverse effects)