Co-occurrence of five chemotherapy induced nail findings.

A 58-year-old man with acute myeloid leukemia developed five distinct new fingernail changes after chemotherapy. These include onycholysis, palpable transverse depressions across his fingernails, diffuse melanonychia, transverse, nonblanching white bands, and thin white transverse lines all caused by his chemotherapy regimen. It is uncommon to find all five of these physical exam findings simultaneously. We describe the underlying pathophysiology for hospital-based clinicians and highlight their transient course.