A rare case of Lindsay’s nails in a patient treated with paclitaxel
for breast cancer

Andrzej K. Jaworek; Radosław Dziedzic; Magdalena Mazgaj; Anna Michałowska-Kaczmarczyk; Anna Wojas-Pelc

doi:10.5114/dr.2021.107285

eISSN: 2084-9893
ISSN: 0033-2526

Dermatology Review/Przegląd Dermatologiczny

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2/2021
vol. 108

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abstract:

Case report

A rare case of Lindsay’s nails in a patient treated with paclitaxel for breast cancer

Andrzej K. Jaworek

¹

,

Radosław Dziedzic

²

,

Magdalena Mazgaj

³

,

Anna Michałowska-Kaczmarczyk

⁴

,

Anna Wojas-Pelc

¹

Department of Dermatology, Jagiellonian University Medical College, Krakow, Poland
Students’ Dermatology Research Association, Jagiellonian University Medical College, Krakow, Poland
Clinical Department of Dermatology, University Hospital, Krakow, Poland
Department of Oncology, Jagiellonian University Medical College, Krakow, Poland

Dermatol Rev/Przegl Dermatol 2021, 108, 137-144

DOI: https://doi.org/10.5114/dr.2021.107285

Online publish date: 2021/06/28

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Introduction
The nail apparatus is a skin appendage which, among other functions, stabilises the fingertips and protects the distal parts of fingers or toes from injuries. It may become dystrophic following chemotherapy. Diverse nail symptoms require a complex differential diagnosis.

Objective
Presentation of a case of Lindsay’s nails in a patient treated with paclitaxel for breast cancer.

Case report
A 65-year-old woman reported to a dermatology outpatient clinic with changes to her fingernails and toenails. Six months earlier, she had undergone left-sided mastectomy for breast cancer and then commenced chemotherapy with paclitaxel in combination with trastuzumab. A few weeks after starting this chemotherapy regimen, the patient noticed pronounced haemorrhages in the region of the toes, followed by matt whitening of the proximal part of the fingernail apparatus, sharply demarcated from the brown-coloured distal part. In addition, the patient experienced neuropathic symptoms in the fingers. The clinical picture of the lesions and the patient’s disease history suggested a variant of leukonychia, i.e. Lindsay’s nails, induced by chemotherapy.

Conclusions
The presented case of Lindsay’s nails (“half-and-half” nails) is unique, as it was never before reported in the literature in association with paclitaxel therapy.

keywords:

A rare case of Lindsay’s nails in a patient treated with paclitaxel for breast cancer

Andrzej K. Jaworek 1 , Radosław Dziedzic 2 , Magdalena Mazgaj 3 , Anna Michałowska-Kaczmarczyk 4 , Anna Wojas-Pelc 1

nail apparatus, drug-induced changes, paclitaxel, Lindsay’s nails

Andrzej K. Jaworek

¹

,

Radosław Dziedzic

²

,

Magdalena Mazgaj

³

,

Anna Michałowska-Kaczmarczyk

⁴

,

Anna Wojas-Pelc

¹