BACKGROUND: Epidermal growth factor receptor (EGFR) and cellular-mesenchymal to epithelial transition factor (c-Met) are widely expressed on cancer cells. There is a synergistic effect of EGFR and HGF/c-Met pathways on proliferation, downstream activation of signal transduction and an additive effect. Studies show that combination of both signaling pathways could potentially be targeted in a synergistic fashion. Amivantamab, a bispecific monoclonal antibody targeting EGFR and c-Met, yielded robust and durable responses in a variety of clinicals trials. However, few researches have reported its efficacy in Chinese non-small cell lung cancer (NSCLC) patients. This study was conducted to evaluate the effectiveness and tolerance of Amivantamab in NSCLC patients with EGFR/MET gene abnormalities at Peking University Cancer Hospital. METHODS: The study enrolled NSCLC patients who received Amivantamab in our hospital between August 2020 and December 2021, and analyzed the response, survival, and treatment-related adverse events. RESULTS: Fifteen patients were enrolled in this research, and six of them received Amivantamab treatment and the other nine patients received Amivantamab plus Lazertinib treatment. The rates of partial response (PR), stable disease (SD), and progressive disease (PD) were 46.7% (7/15), 46.7% (7/15) and 6.7% (1/15), respectively. The overall response rate (ORR) and disease control rate (DCR) were 28.6% (2/7) and 100.0% (7/7) in seven patients with EGFR exon 20 insertion, respectively. The ORR and DCR were 40.0% (2/5) and 100.0% (5/5) in five post-osimertinib EGFR-mutant patients, respectively. After a median follow-up of 8.7 months, the median progression-free survival and overall survival were not reached. The most common treatment-related adverse events were rash (86.7%), paronychia (80.0%), and infusion-related reactions (60.0%), and most of them were graded as 1 to 2. Grade 3 to 4 adverse events included rash (33.3%), alanine aminotransferase elevation (13.3%), gamma-glutamyl transpeptidase elevation (13.3%), peripheral edema (6.7%), thromboembolism (6.7%), interstitial lung disease (6.7%), and thrombocytopenia (6.7%). CONCLUSIONS Amivantamab was effective in Chinese NSCLC patients with EGFR exon 20 insertion and post-Osimertinib EGFR-mutant patients, similar to the results of clinical trials conducted in western countries. Amivantamab was well tolerated and emphases should be put on adverse events such as rash, paronychia, and infusion-related reactions.
Antibodies, Bispecific ; Carcinoma, Non-Small-Cell Lung/genetics* ; ErbB Receptors/genetics* ; Exanthema/drug therapy* ; Humans ; Lung Neoplasms/genetics* ; Mutation ; Paronychia/drug therapy* ; Protein Kinase Inhibitors/therapeutic use*

No abstract available.
Paronychia

PURPOSE: We tried to evaluate whether there are any specific features in treatment outcomes of firstline afatinib in patients with epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC), compared with gefitinib or erlotinib. MATERIALS AND METHODS: We analyzed patients treated with first-line afatinib, gefitinib, or erlotinib for advanced EGFR-mutant NSCLC at Samsung Medical Center between 2014 and 2016. RESULTS: In total, 467 patients received first-line afatinib (n=165), gefitinib (n=230), or erlotinib (n=72). Afatinib was used more often in patients with tumors harboring deletion in exon 19 (Del19), whereas the gefitinib group had more elderly, females, and never smokers. The median progression-free survival (PFS) time for afatinib, gefitinib, and erlotinib was 19.1 months, 13.7 months, and 14.0 months, respectively (p=0.001). The superior PFS of afatinib was more remarkable in subgroups of Del19 or uncommon EGFR mutations. Overall toxicity profiles of the three drugs were comparable, though more grade 3 or 4 toxicities were detected in afatinib (7.3%) compared with gefitinib (2.6%) or erlotinib (1.8%). The common grade 3 or 4 toxicities of afatinib included diarrhea (3.0%), paronychia (2.4%), and skin rash (1.8%). Dose modification was more frequently required in patients treated with afatinib (112/165, 68%), compared with gefitinib (5/230, 2%) and erlotinib (4/72, 6%). Interestingly, however, dose reduction in the afatinib group did not impair its efficacy in terms of PFS (dose reduction vs. no reduction group, 23.5 months vs. 12.4 months). CONCLUSION: First-line afatinib showed satisfactory efficacy data and manageable toxicity profiles.
Aged ; Carcinoma, Non-Small-Cell Lung ; Diarrhea ; Disease-Free Survival ; Erlotinib Hydrochloride ; Exanthema ; Exons ; Female ; Humans ; Paronychia ; Receptor, Epidermal Growth Factor

No abstract available.
Abscess* ; Citrobacter* ; Humans ; Paronychia*

Cutaneous bone formation may be primary or secondary. If it is primary, there are no preceding cutaneous lesions. If it is secondary, bone forms through metaplasia within a preexisting lesion caused by inflammation, traumatic injury, and a neoplastic tumor. Paronychia is inflammation of the proximal nail fold and presents as painful periungual erythema, sometimes with associated purulence. Chronic paronychia is most commonly related to mechanical or chemical factors. Here, we report a case of chronic paronychia accompanied by cutaneous ossification in a 33-year-old woman who presented with a 2-year history of recurrent paronychia on the left first finger.
Adult ; Erythema ; Female ; Fingers ; Humans ; Inflammation ; Metaplasia ; Osteogenesis ; Paronychia*

Green nail syndrome (chromonychia) is a nail disorder characterized by onycholysis and green-black discoloration of the nail bed. This condition is often associated with chronic paronychia. Pseudomonas aeruginosa is the most commonly identified organism in cultures from the affected area. Despite the various treatment options available, removal of the nail is still necessary in many cases. A 35-year-old man presented with dark-greenish discoloration of the nail plate and onycholysis on the left thumbnail. He had been treated with oral antifungal and antibiotic agents for several months; however, the lesion showed no improvement. The diagnosis of green nail syndrome was established after a positive bacterial culture, and on the basis of the antibiotic sensitivity test result, tobramycin eye drop (Tobrex(R)) was then prescribed. Three weeks later, the nail discoloration almost vanished but the onycholysis remained. Herein, we recommend the application of tobramycin eye drop as an easy and safe treatment option for green nail syndrome.
Adult ; Diagnosis ; Humans ; Onycholysis ; Paronychia ; Pseudomonas aeruginosa ; Tobramycin*

Acrodermatitis continua of Hallopeau (ACH) is a rare form of acropustular eruption characterized by a presence of aseptic pustules on inflammatory periungual or subungual regions. Frequently accompanied by paronychia, atrophic skin changes, onychodystrophy, and osteolysis of distal phalanges of the digits, it is considered to be a variant of pustular psoriasis with a chronic relapsing course and refractoriness to many therapeutic modalities. Here, we present a case of a 45-year-old female who presented with multiple pustules pathologically diagnosed as pustular psoriasis on her left thumb. She suffered from ACH for over a decade, and in the process experienced frequent relapses and showed poor response to numerous treatment modalities such as narrow band UVB, topical steroid, steroid intralesional injection, oral retinoids, 308 nm excimer laser, and oral immune suppressants. However, the patient showed dramatic clinical improvements to administration of etanercept (TNF-alpha antagonist, twice a week) for a period of one month. The cessation of etanercept led to recurrence of symptoms and marked deterioration of the skin lesion within a month again, but the re-initiation of treatment soon relieved the problem. After completion of a three months trial of etanercept, the cutaneous lesion subsided, and the patient is now successfully controlled with topical steroid maintenance therapy. Hereby, we report a patient with ACH successfully treated with etanercept.
Acrodermatitis ; Female ; Humans ; Immunoglobulin G ; Injections, Intralesional ; Lasers, Excimer ; Middle Aged ; Osteolysis ; Paronychia ; Psoriasis ; Receptors, Tumor Necrosis Factor ; Recurrence ; Retinoids ; Skin ; Thumb ; Etanercept

Onychatrophy is the processes in which the nail has initially formed satisfactorily and then shows total or partial regression. The causes of onychatrophy with pterygium include lichen planus, acrosclerosis, Stevens-Johnson syndrome, and cicatrical pemphigoid, and those without pterygium include severe paronychia, Stevens-Johnson syndrome, epidermolysis bullosa, and drugs. Bleomycin is an antitumor, antibacterial, and antiviral agent used in many dermatologic diseases such as warts, vascular anomalies, hemangioma, and cutaneous malignancies. Cutaneous adverse effects of bleomycin strongly depend on the route of administration and dosage. Bleomycin intralesional injection for periungual warts could result in permanent Raynaud phenomenon, nail dystrophy, and nail loss. We report five cases of onychatrophy following bleomycin intralesional injections for periungual warts. We remind that if bleomycin intralesional injection near the nail matrix is inevitable in recalcitrant periungual warts, the performer must manipulate precisely to avoid adverse effects.
Bleomycin ; Epidermolysis Bullosa ; Hemangioma ; Injections, Intralesional ; Lichen Planus ; Nails ; Paronychia ; Pemphigoid, Bullous ; Pterygium ; Raynaud Disease ; Stevens-Johnson Syndrome ; Warts

BACKGROUND: Paronychia is a common infectious disease affecting fingernails and toenails. Although bacterial and fungal infections as well as mechanical trauma may play roles in the pathogenesis of this disease, there are few bacteriological studies about paronychia in military personnel. OBJECTIVE: To identify the causative bacteria of paronychia in military personnel. METHODS: We retrospectively analyzed the microbiological results of 145 patients who visited a tertiary referral hospital for Korean soldiers from August 2004 to October 2006. RESULTS: Twenty-eight different types of aerobic bacteria were identified, with the most common being Staphylococcus aureus (38.0%), Streptococcus pyogenes (7.2%), and Pseudomonas aeruginosa (5.4%). Staphylococcus aureus was identified mostly in finger and toe paronychial lesions and Pseudomonas aeruginosa was recovered commonly from toe paronychial lesions. All cases of paronychia were controlled by the combination of antiseptic dressing, topical antibacterial ointment, oral antibiotics, and antimycotic agents. CONCLUSION: The types of bacteria that most commonly caused paronychia in military personnel were Staphylococcus aureus, Staphylococcus pyogenes, and Pseudomonas aeruginosa. Thus, the commonly used oral antibiotics for paronychia, such as amoxicillin-clavulanate, clindamycin, and trimethoprim-sulfamethoxazole, are good choices in the treatment of paronychia in military personnel.
Anti-Bacterial Agents ; Bacteria ; Bacteria, Aerobic ; Bandages ; Clindamycin ; Communicable Diseases ; Fingers ; Humans ; Military Personnel ; Nails ; Paronychia ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus ; Streptococcus pyogenes ; Tertiary Care Centers ; Toes ; Trimethoprim, Sulfamethoxazole Drug Combination

Staphylococcus lugdunensis is part of the normal human skin flora and has the ability to establish primary infection in deep skin and vascular infections. A 41-year-old male presented with brittle, thick, crusted right thumb nail with yellow to brown discoloration and erythematous edema around the nail fold. We identified S. lugdunensis by bacterial culture for the pus. The lesion was improved after 2 months treatment of oral cefditoren and clarithromycin. We report a case of onychia and paronychia caused by S. lugdunensis.
Adult ; Cephalosporins ; Clarithromycin ; Edema ; Humans ; Male ; Nails ; Paronychia ; Skin ; Staphylococcus ; Staphylococcus lugdunensis ; Suppuration ; Thumb