Gefitinib-Induced Paronychia Response to Autologous Platelet-Rich Plasma

作者：Kwon Soon Hyo; Choi Jae Woo; Hong Jong Soo; Byun Sang Young; Park Kyoung Chan; Youn Sang Woong; Huh Chang Hun; Na Jung Im^*

来源：Archives of Dermatology, 2012, 148(12): 1399-1402.

DOI：10.1001/archdermatol.2012.3022

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 nail fold 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. Arch Dermatol. 2012;148(12):1399-1402. Published online September 17, 2012. doi:10.1001/archdermatol.2012.3022

• 出版日期2012-12