Síndrome mão-pé e alterações ungueais secundárias ao tratamento com paclitaxel: existe relação com presença de fungos?

Abstract

Introduction: Cancer is a worldwide public health problem that causes thousands of deaths each year. Instead of different types of cancer, the breast cancer is the most frequent among women. Paclitaxel chemotherapy induces several adverse reactions including hand-foot syndrome. This syndrome is a toxic skin reaction that mainly affects hands, feet and nails. Nail changes can lead to predisposition to infections, such as onychomycosis. Aims: Toinvestigate the frequency of nail changes and the presence of fungi on the on fingernails and toenailsof the patients with hand-foot syndrome due to of treatment with paclitaxel. Materials and Methods: Prospective study, carried out from October 2018 to December 2019, which included 81 patients undergoing treatment for breast cancer, using paclitaxel and who presented signs and / or symptoms of hand-foot syndrome with or without nail changes. Data were collectedthrough interviews guided by a structured questionnaire and information was taken from medical records and results of mycological tests. Results: The average age of women was 54.7± 7.4 years. Nail changes occurred in 69 patients (85.2%), and of these, 43 (62.3%) presented positive test for fungi. Dermatophyte fungi (n = 15; 27.2%), non-dermatophyte filamentous fungi (n = 8; 14.5%) and yeasts (n = 38; 69.0%) were identified. Conclusion: Nail changes were the most frequent manifestations in patients with hand-foot syndrome treated with paclitaxel. It was evidenced that fungi are present in the nails of the most of the patients, and the most frequent are Candida and Trichophyton species. The results pointed to the need to select safe management alternatives for patients, so that they can prevent nail lesions, prevent fungi proliferation and reducenegative impacts on quality of life.