Acute Paronychia After High-Dose Methotrexate Therapy

The dermatologic changes that may occur after cancer chemotherapy include cytotoxic effects, pigment alterations, and various eruptions.1 The determination of the causative agent for a dermatosis due to a cytostatic drug is often difficult because of the increased use of combination chemotherapy. We describe herein a patient with acute paronychia following chemotherapy, which was probably caused by methotrexate sodium; a dermatologic complication that, to our knowledge, has not been described previously. Report of a Case A 73-year-old man had had a four-year history of atypical eczema initially diagnosed as early mycosis fungoides, but the eczema had disappeared after treatment with 20 mg/day of oral prednisone. Enlargement of the lymph nodes of the neck and the axillae had been present for six months. A lymph node biopsy specimen had disclosed the microscopic changes of malignant lymphoma. The patient had then been referred to the hematology department, where he received three