2018年10月18日木曜日

化学療法と爪の年輪様変化:NEJMのイメージ


October 18, 2018
N Engl J Med 2018; 379:1561

Nail Changes during Chemotherapy

  • Musa F. Alzahrani, M.B., B.S., M.H.Sc., 
  • and Mohammed I. AlJasser, M.B., B.S.

化学療法を行う間に年輪のように変化する爪模様。これには懐かしい投稿がある↓。















Musa F. Alzahrani, M.B., B.S., M.H.Sc.
King Saud University, Riyadh, Saudi Arabia
Mohammed I. AlJasser, M.B., B.S.
King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

今回のものはサウジアラビアからのもので、ベースの変化が褐色様の変化だから禍々しい。

A 42-year-old man who was undergoing treatment for non-Hodgkin’s lymphoma presented to the oncology clinic with changes in his fingernails. Five months earlier, he had presented with gastric-outlet obstruction and had received a diagnosis of high-grade B-cell non-Hodgkin’s lymphoma. He then completed four cycles of chemotherapy, which had included rituximab, etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin. Physical examination showed diffuse, dark brown discoloration of his fingernails (melanonychia) and two types of transverse white lines that were not palpable. The serum albumin level was 2.5 g per deciliter (reference range, 3.5 to 5.0). The opaque-appearing transverse lines (long arrow) on the fingernails are called Mees’ lines (true leukonychia), and the more translucent-appearing lines (short arrow) are called Muehrcke’s lines (apparent leukonychia). Mees’ lines develop as a result of injury to the nail matrix, whereas Muehrcke’s lines are related to abnormal nail-bed vasculature. Therefore, Mees’ lines do not diminish with compression of the nail plate, and Muehrcke’s lines do. Multiple chemotherapy agents are associated with these nail changes. Muehrcke’s lines can also occur in patients with hypoalbuminemia. After six cycles of chemotherapy, the patient had remission of the non-Hodgkin’s lymphoma. Approximately 6 months after the completion of chemotherapy, the fingernail changes resolved completely.

さて懐かしい投稿は今から8年前のものである。ボー線と紹介された。

2010年5月20日木曜日


ボー線:化学療法の強さと間隔が爪に現れる












矢印の時だけシスプラチンが投薬されていないという説明がついていた。


Multiple Beau's Lines

Number 20Volume 362:e63

Images in Clinical Medicine

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