Bevacizumab-induced subungual hemorrhage

Dermatol Online J. 2024 Oct 15;30(5). doi: 10.5070/D330564427.

Abstract

Exudative (wet) age-related macular degeneration can be treated with the vascular endothelial growth factor (VEGF)-inhibiting monoclonal antibody bevacizumab. Currently, bevacizumab therapy is associated with known skin-related side effects, such as rash, mucosal hemorrhage, and hemorrhagic ulcers. While subungual "splinter" hemorrhage is a documented side effect of VEGF receptor antagonists and Raf protein inhibitors, there are no prior reports of bevacizumab-induced subungual hemorrhage to the best of our knowledge. Thus, we present the case of a 71-year-old female diagnosed with bilateral age-related macular degeneration, who, during six months of intravitreal bevacizumab treatment, began noticing fingernail discoloration, described as similar to that of a bruise. Given our patient's history of bevacizumab therapy and the documented reports of bevacizumab-associated mucosal and ulcerative hemorrhage, we hypothesize that the discoloration and hemorrhage are likely unreported adverse effects associated with bevacizumab therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angiogenesis Inhibitors* / adverse effects
  • Bevacizumab* / adverse effects
  • Bevacizumab* / therapeutic use
  • Female
  • Hemorrhage* / chemically induced
  • Humans
  • Intravitreal Injections
  • Nail Diseases* / chemically induced
  • Wet Macular Degeneration / drug therapy

Substances

  • Bevacizumab
  • Angiogenesis Inhibitors