Objective: Onychomycosis has been shown to have a higher incidence in cancer patient. Nail toxicity is quite common side effect of anticancer agents, Taxotere© is a chemotherapeutic known to cause great incidence of nail change and has a role of subungual suppuration. We present a case of onychomycosis induced by Taxotere chemotherapy and proved by mycological tests.

Case report: We report on a 52 year-old female, with breast cancer admitted in our institution for onycholysis. Because of stage and histology of breast cancer neoadjuvant chemotherapy was initiated, patient received 8 cycles of taxotere and Adriamycin (AT), and she underwent a modified radical mastectomy. Three-month later, patient evidence of onycholysis developed, involving all the fingernails. We observed the following changes in nails of all the digits in both hands: onycholysis, dystrophy, oedema, and exudate.

Methodology: Nail scraping and purulent discharge were collected for culture and direct examination by KOH and chloral lactophenol for mycological examination, fungal identification was based on physical features of the colonies and biochemical tests (Auxacolor©).

Results: Physical features of the colonies and biochemical tests (Auxacolor©)revealed Candida guillermondii as sole etiologic agent of onychomycosis. This case details an onycholysis in cancer breast case successfully managed solely with amorolfine lacquer 5% for a minimal duration of 3 month.

Conclusion: Candidiasis is one of the commonest complications seen in immunosuppressed cancer patients, and Candida guillermondii is frequently isolated in onychomycosis. Early recognition and treatment of yeast onychomycosis with purulent discharge is important especially in immunocompressed patients.