Tuberc Respir Dis TRD Tuberculosis and Respiratory Diseases 1738-3536 2005-6184 The Korean Academy of Tuberculosis and Respiratory Diseases 10.4046/trd.2007.62.2.125 Case Report A Case of Subungal Abscess and Onycholysis Induced by Docetaxel Jung Han Young M.D. 1 Lee Chang Youl M.D. 1 Kim Hyung Jung M.D. 1 2 Ahn Chul Min M.D. 1 2 Chang Yoon Soo M.D. 1 Department of Internal Medicine, The Yonsei University College of Medicine, Seoul, Korea. Institute of Chest Diseases, The Yonsei University College of Medicine, Seoul, Korea. Address for correspondence: Yoon Soo Chang, M.D. Department of Internal Medicine, 8th Floor Annex Building Yongdong Severance Hospital, 146-92 Dogok-dong, Kangnam-gu, Seoul 135-270, Korea. Tel: 02-2019-3309, Fax: 02-3463-3882, yschang@yumc.yonsei.ac.kr 02 2007 28 02 2007 62 2 125 128 11 12 2006 08 02 2007 Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases 2007

Docetaxel is a taxoid antineoplastic drug, which is widely used to treat locally advanced or metastatic non-small cell lung cancer (NSCLC). Among the adverse dermatological reactions, nail disorders such as bending, onycholysis, hypo- or hyperpigmentation are rare. We report a case of a 62-year-old male with advanced NSCLC (cT4N3M1, stage IV), who developed purulent discharge and onycholysis in the nail of all his fingers and the left great toe after five courses of anti-neoplastic chemotherapy, which included docetaxel (cumulative dose: 370 mg/m2, 590 mg). Seven days after the final session of chemotherapy, the patient had become aware of discoloration and swelling of the nail beds with out pain. Three days later, greenish-yellow purulent discharge oozed out from the involved nails. Microbiologic studies revealed Pseudomonas aeruginosa. Intravenous and topical antibiotics (mupirocin) were applied. After 2 weeks, regrown nails were observed and the onycholysis had improved.

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Computed tomography shows mass lesion in the lower lobe of left lung

After 5th chemotherapy, computed tomography shows marked resolution of primary tumor in the ekf

At initial admission, all finger nails showed subungal abscess and onycholysis induced by docetaxel.

All finger nails showed improvement after 14-days antibiotic treatment.