Onycholysis after chemotherapy in a patient with lymphoma.

A 38-year-old man, without previous history of disease, was diagnosed with stage IIIB high-grade T-cell non-Hodgkin's lymphoma. He initially received eight cycles of cyclophosphamide (1350 mg), doxorubicin (90 mg), vincristine (2 mg) and prednisone (100 mg/day for 5 days) ^ CHOP regimen ^ with good response. The patient was disease-free for 3 years, after which the disease relapsed and he was scheduled to be treated with a total of six cycles of cyclophosphamide (1350 mg), mitoxantrone (36 mg), vincristine (2 mg), prednisone (100 mg/day for 5 days) and bleomycin (15 mg) ^ CNOP ^ Bleo regimen. Two weeks after the fourth CNOP ^ Bleo treatment cycle, painless onycholysis of all ¢ngernails and toenails became evident (Fig. 1). Onycholysis was accompanied by subungual haemorrhage, though no bleeding disorder was disclosed by the consequent laboratory investigation. No nail discoloration or other skin abnormality (including haemorrhagic lesions) on physical examination were noted.