Need Advice - Paronychia not healing because of Tarceva - 1252437

ssflxl
Posts:204

Dear Friends.

I am seeking your collective wisdom as I have this paronychia of my big toe that is not healing since I am on Tarceva. It is not draining any pus for days and I've had this since end of November!! Toe is red, swollen and skin won't heal. Yes, I've had the usual topical and oral antibiotics. Any other advice that anyone of you know about. I would appreciate it.

thanks

ssflxl

Forums

catdander
Posts:

That's such a dreadful complication. I came up with this link. There are several references to it and possible solutions on this page.
http://cancergrace.org/topic/afatinib-cetuximab-trial-user-group/page/3/
another such discussion,
http://cancergrace.org/lung/topic/lets-share-the-experience-of-bibw-299…

I was looking for where certain spring talked about breaking down and having the dreaded surgery that I believe ended up helping tremendously. Although I'm may not be remembering that correctly and she isn't likely to be back online her as she goes through the recent loss of her dad.

I hope you get some relief from it soon,
Janine

Jazz
Posts: 279

ssflxl,

See a podiatrist ASAP! When I was on Tarceva, I had a badly infected toe that finally had to have the nail removed and the area lanced. It was the only thing that worked. Certain spring had her toes cauterized, I believe. I don't know if that's the same thing, but a podiatrist is the only answer when it's that bad.

Good luck,
Jazz

Dr West
Posts: 4735

I agree that this is probably outside of the range of what an oncologist would manage, though I will often have my patients take a break from treatment for 1-2 weeks if they're having severe problems with infections, and I'll often add an antibiotic like cephalexin (Keflex). These measures can help, but I think a podiatrist is likely to be most helpful.

Good luck.

-Dr. West

ssflxl
Posts: 204

thanks all for your advice. I will try Bactroban but I really think I may need nail removed/trimmed. There is a growth next to my nail that prevents the healing. It doesn't look like pus, and like I said, I haven't had any pus from the toe for a couple week.

thanks

ssflxl

double trouble
Posts: 573

I agree about the podiatrist, but wanted to mention that the last time I was in the drug store I noticed a whole array of foot care products aimed at diabetics. I had never noticed them before. They were in the same area as the diabetic supplies. I would think with all of the trouble diabetics have with their feet that at least some of these products would be good.

Just a thought. I'm sorry you're having to deal with this. Sounds painful.

Debra

poppyjo
Posts: 33

I am suffering with 3 very sore toenails. I showed my oncologist and he said the nails didn't look infected. So, he put me on Clindamycin oral drug, 300 mg every 6 hours for 7 days. I must say I had a difficult time taking this drug because of the horrible after taste, which has caused a very bad upset stomach. Today, is my last dosage. I'm not seeing any improvement in my toenails. So, I will see a podiatrist, too. I also have issues with cracked finger tips. I'm using white gloves at bedtime with lots of lotion. This seems to help. Also, polysporin on the cracks and a bandaid, helps. I tried the polysporin on the toenails and it helped some but not enough. You are not alone in this toenail problem.

certain spring
Posts: 762

ssflxl, I agree with everyone who says go to a podiatrist. I would add - "and soon!" I had the same problem, in both big toes, for nearly a year and I sympathise massively as it was painful, time-consuming and unpleasant. It sounds as if you've got a "granuloma" (I think it's called) - an overgrowth of scar tissue which grows fast and furiously at the site of the problem. Unfortunately that just makes things worse, because if nail spikes have become embedded in the skin, it becomes harder to get them out.
This is also the reason why antibiotics sometimes aren't sufficient - they can clear up the infection for a while, but if there is a structural problem such as an ingrowing toenail, the whole cycle just starts up all over again.
I was very resistant to surgery but thus far (touch wood) it has worked. I had it in August and have had not problems since. They burned away the nail on both sides, and the most painful part was not the procedure but the anaesthetic beforehand. My big regret is that I was not sent to a podiatrist straight away: he said he might have been able to manage it more conservatively had he seen me sooner. All best.

ssflxl
Posts: 204

Hello friends,

Certain Spring - thanks for your advice. I did make appt for the procedure this Friday. I saw the "podiatrist" and he said I have pyoderma (as in pyoderma granulosum and this condition occurs in those who has altered immune function and those with chronic inflammation as in Crohn's or Rheumatoid Arthritis). Tarceva puts us into both of these categories. Anyway, he said he has to trim the nail and then cauterize it. The pyoderma is not really an infection - it's an open sore and it's due to inflammation. Like I said, I didn't have pus for several weeks already, but this did start out with a paronychia infection. I finally put some steroid cream over my toe and it has helped the redness and swelling and pain - doesn't completely go away, but at least helps 50%. So I learned something and hope that it can benefit others too. Little things like this can make our daily lives challenging indeed. Nobody can really appreciate these things unless you live through it yourself. It takes me an hour to get out of the house everyday.

thanks all

ssflxl