Cyclophosphamide induced nail pigmentation

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Abstract
Cyclophosphamide therapy may occasionally cause black pigmentation of the nails. This side effect is reported in 5 [human] cases, and data on 11 cases in the literature is reviewed. These changes start in proximal nail beds and progress distally; on withdrawal of cyclophosphamide, clearing of nail pigmentation proceeds in a similar fashion. Development of nail pigmentation does not bear any relation to the primary condition for which cyclophosphamide was prescribed. Dose of the drug before onset of pigmentation ranged from 1.2 to 12.3 g; duration of treatment ranged from 10 days-26 wk. The mechanism of the nail pigmentation is unknown.