Abstract

CALVO SALVADOR, M; SANABRIAS FERNANDEZ DE SEVILLA, R; SANTIAGO PRIETO, ME  and  SANCHEZ GUERRERO, A. Nail toxicity associated with urea treatment. Rev. OFIL·ILAPHAR [online]. 2021, vol.31, n.2, pp.208-209.  Epub Aug 16, 2021. ISSN 1699-714X.  https://dx.doi.org/10.4321/s1699-714x2021000200018.

Melanonychia is the pigmentation of the nail, this alteration is induced by diverse causes: inflammatory processes, traumatisms, autoimmune diseases or medications. There are numerous drugs that can produce alterations in the nails (anti-infectious, chemotherapy agents, retinoid), the alterations are reversible in most cases after drug discontinuation.

Chemotherapeutic agent hydroxyurea is identified as a cause of nail toxicity rarely. It is a hydroxylated derivative of urea, which acts by inhibiting DNA synthesis.

In this article, we present the case of a 61-year-old lung transplant patient diagnosed with diabetes insipidus who, however, developed SIADH (inadequate secretion of antidiuretic hormone) during his hospitalization, the patient received treatment with water restriction and urea. After the start of treatment, the patient began to present lesions on the nails of the hands and feet, which remitted with time after drug discontinuation. No other medication prescribed during admission has been linked to nail toxicity, so urea was considered a possible cause of nail lesions in this patient. This reaction was notified to the Spanish Pharmacovigilance System.

Keywords : Melanonychia; nail-toxicity; urea; inadequate secretion of antidiuretic hormone; insipid diabetes.

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