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Chemotherapeutic agents are known to cause a myriad of cutaneous side effects that the dermatologist is often called upon to identify and treat. The taxoid drug paclitaxel is commonly used in oncology. To date, there have been few adverse dermatologic effects reported secondary to paclitaxel use. This is in contrast to the related drug docetaxel. We report a case in which paclitaxel caused onycholysis and nail loss in a patient being treated for lung cancer. To our knowledge, this finding has not previously been reported in the American dermatologic literature, though it has been reported in association with docetaxel use. It is important for clinicians to recognize that onycholysis can be associated with paclitaxel. Prompt recognition may prevent the unnecessary use of antibiotics or antifungal medications. Discontinuation of paclitaxel chemotherapy generally is not required, and regrowth of nails can be expected following completion of therapy.

Pyruvic acid (PA) is an alpha-hydroxy acid with potent keratolytic properties. Fifty-six patients with common warts treated with two PA formulations were surveyed 2 to 29 months after beginning treatment (mean, 18 months). Thirty-eight patients used a 70 percent PA formulation with added 0.5 percent 5-fluorouracil (PA-5FU). Eighteen patients used a plain 70 percent PA formulation without added 5FU. Three-quarters of the patients reported using the formulation for 4 weeks or less. Overall, 64 percent of the patients treated with either of the two formulations experienced complete clearing of their lesions. There was no increased efficacy noted with the PA-5FU formulation. Eighty-two percent of eighteen children, aged 16 years or younger, experienced clearing of lesions.

A student in a veterinary program noted an inflammatory tinea corporis on the right forearm after working with cows. Culture grew Trichophyton verrucosum. A nine-day course of treatment with oral fluconazole, 100 mg daily, resulted in prompt resolution. Awareness of the clinical presentations of barn itch, and familiarity with wet mount and histopathologic features, and special growth requirements of T. verrucosum will facilitate prompt diagnosis and treatment. Therapy with newer antifungal agents such as fluconazole may offer advantages over grisefulvin.

Two cases of photosensitivity to the nonsteroidal anti-inflammatory agent piroxicam are described. The action spectrum appears to be in the ultraviolet A (UVA) range (320 to 400 nm). Hallmarks of the photosensitivity reaction include an acute eczematous dermatitis with frank vesicle formation clinically and spongiosis and a perivascular mononuclear cell infiltrate histologically. Piroxicam and other nonsteroidal anti-inflammatory drugs are capable of inducing cutaneous photosensitivity.