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Case Reports
. 2023 Oct 14:42:91-94.
doi: 10.1016/j.jdcr.2023.09.027. eCollection 2023 Dec.

Hydroxyurea-induced melanonychia

Michael G Buontempo  1   2 , Zaima S Chaudhry  3 , Ruchi S Raval  2 , Kelly Mourtzanakis  2 , Vignesh Ramachandran  1 , Jerry Shapiro  1 , Kristen Lo Sicco  1
Affiliations
Case Reports

Hydroxyurea-induced melanonychia

Michael G Buontempo et al. JAAD Case Rep. .
No abstract available

Keywords: drug-induced side effects; hydroxyurea; hyperpigmentation; management of hydroxyurea-induced melanonychia; melanoma; melanonychia; nail biopsy; nail changes; thrombocytosis; transverse melanonychia.

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Conflict of interest statement

Dr Lo Sicco is a consultant for Pfizer and Aquis. Dr Shapiro is a consultant for Aclaris Therapeutics, Incyte, and Replicel Life Sciences. Drs Shapiro and Lo Sicco have been investigators for Regen Lab and are investigators for Pfizer. Authors Buontempo, Raval, and Mourtzanakis and Drs Chaudhry and Ramachandran have no conflicts to disclose.

Figures

Fig 1
Fig 1
Hands. A, A detailed view of the patient’s thumb’s ungueal unit, highlighting the presence of linear melanonychia. The hyperpigmented bands are observed as well-defined, longitudinal streaks coursing from the proximal nailfold to the distal free edge of the nail plate. Their width measures less than 3 mm, aligning with the clinical presentation of melanonychia induced by hydroxyurea therapy. B, A panoramic view of the patient’s digital ungueal units in both hands. It is evident from the presentation that multiple fingernails manifest hyperpigmentation starting at the proximal nailfold and extending longitudinally across the nail plate. These linear bands are present uniformly across all digits, accentuating the distinctiveness of this manifestation. The ubiquity and consistency of the hyperpigmentation in all the nails underscore a potential systemic etiology, corroborated by the patient’s hydroxyurea therapy.
Fig 2
Fig 2
Feet. A, The patient’s right pedal ungueal unit revealing transverse bands of melanonychia. Notably, the degree of hyperpigmentation is striking and not restricted to the nail plate but extending to encompass the periungueal tissues, thereby highlighting the systemic origin of the pigmentation. B, The patient’s left pedal ungueal unit depicting a consistent pattern of transverse melanonychia as evidenced in the preceding images. The bilaterally symmetrical manifestation across both feet emphasizes the systemic implications of hydroxyurea therapy and differentiates it from localized etiologies of ungueal hyperpigmentation. Such consistent patterns observed bilaterally on both the manus and pes emphasize the widespread influence of hydroxyurea therapy on ungueal pigmentation.
See this image and copyright information in PMC

References

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