Drug-induced Nail Changes

Many side-effects of drugs on the nails are now well known. Some are classic while others have been recently described. Since the last edition of this book, antineoplastic drugs have been recognized as affecting the nails. Many nail signs have been described with these treatments, including onycholysis, hematomas, perionyxis and pyogenic granuloma. The severity of the discomfort can sometime necessitate cessation of therapy. Besides these new drugs, side-effects observed during treatment with retinoids, cyclines, antiretroviral drugs, cardiovascular drugs and antimalarial drugs are well known. Some side-effects described with new drugs are more confidential [AQ: not sure what you mean by 'confidential'] such as those seen with anti-TFN, cyclosporine, selenium, antifungals, reverse transcriptase inhibitor therapy, salsalate and interferon. Toxic drugs such as arsenic, silver, mercury, thallium and polychlorinated biphenyls are also responsible for nail changes.