sirolimus and Nail-Diseases

Temsirolimus belongs to the mammalian target of rapamycin (mTOR) inhibitors, targeted therapies for which indications are booming in oncology. While their tolerance is usually good, mucocutaneous toxicity is the most common, including stomatitis, rashes, edemas, pruritus, dry skin and nail disorders. The latter are common in clinical practice but have not yet been well characterized. We report 2 cases of patients who developed, after 6-7 months with temsirolimus, a dystrophy of the 20 nails with fragility, distal onycholysis, yellow discoloration, associated in 1 case with painful paronychia. Topical steroids improved the paronychia, without changing the nail dystrophy. To our knowledge, the occurrence of yellow nail discoloration with temsirolimus has never been reported before. We review the cutaneous and mucosal toxicities induced by temsirolimus and everolimus, two mTOR inhibitors used as anticancer agents and by their parent molecule sirolimus.

Topics: Aged, 80 and over; Antineoplastic Agents; Carcinoma, Renal Cell; Everolimus; Female; Humans; Kidney Neoplasms; Middle Aged; Nail Diseases; Sirolimus; Steroids; TOR Serine-Threonine Kinases; Treatment Outcome

Topics: Administration, Topical; Antibiotics, Antineoplastic; Female; Fibroma; Humans; Infant; Nail Diseases; Remission Induction; Sirolimus; Skin Neoplasms; Tuberous Sclerosis

Topics: Adolescent; Chronic Disease; Gram-Positive Bacterial Infections; Humans; Immunosuppressive Agents; Kidney Transplantation; Male; Nail Diseases; Peptostreptococcus; Sirolimus; Staphylococcal Infections; Staphylococcus aureus; Streptococcal Infections; Streptococcus milleri Group; Suppuration; Thumb