Follow-up of Favipiravir-Induced Nail Fluorescence: Implications for Nail and Drugs
Keywords:
Favipiravir, Nail, Fluorescence, DrugAbstract
Introduction: Favipiravir creates fluorescence on nails, which can be seen with Wood's light.
Objectives: The objectives of this study are to examine the properties of fluorescence in the nail due to favipiravir and to observe whether other drugs also produce fluorescence in the nail.
Methods: The research is descriptive, prospective, and quantitative. This study recruited 30 healthcare workers who received favipiravir treatment and 30 volunteers who took or did not take any medication except favipiravir from March 2021 to December 2021. Fingernails of the patients and control groups were examined under Wood's light in the darkroom. If fluorescence was observed in the fingernails, we followed up once a month until the fluorescence disappeared. We calculated the nail growth rate by dividing the distance of nail fluorescence from the proximal nail fold by the number of days since favipiravir was started.
Results: We found nail fluorescence in all patients receiving a loading dose of favipiravir. The fluorescence in the nail decreased and disappeared in the 3rd month. The average nail growth rate at the first visit was 0.14 mm/day. The nail growth rate at the second visit was 0.10 mm/day. A statistically significant difference was found between the first and second visit nail growth rates (z: -2.576; p=0.010<0.05). We found that other drugs did not produce any fluorescence in the nail.
Conclusions: Nail fluorescence induced by favipiravir is dose-dependent and decreases in intensity over time. Nail fluorescence due to favipiravir is likely due to the active ingredient of the drug.
References
Mojeski JA, Almashali M, Jowdy P, et al. Ultraviolet imaging in dermatology. Photodiagnosis and photodynamic therapy. 2020;30:101743.
Du YX, Chen XP. Favipiravir: Pharmacokinetics and Concerns About Clinical Trials for 2019-nCoV Infection. Clinical pharmacology and therapeutics. 2020;108(2):242-247.
Klatte J, van der Beek N, Kemperman PJJotEAoD, Venereology. 100 years of Wood's lamp revised. 2015;29(5):842-847.
Hendricks AAJAod. Yellow lunulae with fluorescence after tetracycline therapy. 1980;116(4):438-440.
KIERLAND RR, SHEARD C, MASON HL, LOBITZ WCJJotAMA. Fluorescence of nails from quinacrine hydrochloride. 1946;131(10):809-810.
Aslan Kayıran M, Cebeci F, Erdemir VA, Aksoy H, Akdeniz N, Gürel MS. Fluorescence of nails and hair on Wood's lamp examination in Covid pandemic; undefined effect of Favipiravir in humans. Dermatologic therapy. 2021;34(1):e14740.
Guder H, Ozunal ZJJD, Cosmetics. Nail Fluorescence in COVID-19 Patients. 2021;3(4):79-82.
Gülseren D, Yalıcı‐Armagan BJJoCD. Yellow‐white fluorescence on the nails: A novel finding of Favipiravir used for the treatment of COVID‐19. 2021.
Turan Ç, Metin N, Utlu Z, Yıldız TT, Caferoğlu Sakat SJJoCD. Evaluation of the frequency and intensity of favipiravir‐associated yellow‐green fluorescence in lunulae, hair, and face. 2021.
Baswan S, Kasting GB, Li SK, et al. Understanding the formidable nail barrier: A review of the nail microstructure, composition and diseases. Mycoses. 2017;60(5):284-295.
Geyer AS, Onumah N, Uyttendaele H, Scher RKJJotAAoD. Modulation of linear nail growth to treat diseases of the nail. 2004;50(2):229-234.
Yanatma I, Cenk HJSAD. Evaluation of Nail Findings in Patients with COVID-19 History and Wood’s Lamp Examination. 2021:1-6.
Preda-Naumescu A, Penney K, Pearlman RL, Brodell RT, Daniel CR, Nahar VKJSad. Nail Manifestations in COVID-19: Insight into a Systemic Viral Disease. 2021;7(6):433-438.
Gupta AK, Stec N, Bamimore MA, Foley KA, Shear NH, Piguet V. The efficacy and safety of pulse vs. continuous therapy for dermatophyte toenail onychomycosis. Journal of the European Academy of Dermatology and Venereology : JEADV. 2020;34(3):580-588.
Lipner SR, Scher RKJJotAAoD. Onychomycosis: clinical overview and diagnosis. 2019;80(4):835-851.
Debruyne D, Coquerel A. Pharmacokinetics of antifungal agents in onychomycoses. Clinical pharmacokinetics. 2001;40(6):441-472.
Demir B, Cicek D, Turkoglu S, Yuksel Bozdemir N, Sarikurt F, E BJDT. Wood's Lamp Examination of Hair and Nails Related to COVID‐19 Treatment. 2021:e15174.
Kutlu Ö, Yılmaz Ş. Fingernail lunula luminescence in COVID-19 patients: Is it a favipiravir-related reaction or a novel manifestation of coronavirus infection. Photodermatology, photoimmunology & photomedicine. 2021;37(4):343-344.
Zhang T, Wang X, Zhou H, He YJMC, Crystals L. Screening and fluorescence investigation on favipiravir cocrystal. 2021:1-16.
Palmeri A, Pichini S, Pacifici R, Zuccaro P, Lopez AJCp. Drugs in nails. 2000;38(2):95-110.
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