Fluorescence Reflection on Nails after the Treatment of COVID-19 with Favipiravir

Abstract

Objective: Favipiravir is recommended for treatment of COVID-19 by the Turkey National Treatment Guideline for COVID-19. It has been widely used for COVID-19 infected patients in Turkey. Fluorescence of the nails with certain topical and systemic drugs with Wood’s lamp was and reported in the English literature. This study is designed to determine the fluorescence effect of favipiravir in the nails of COVID-19 patients.

Materials and Methods: Eighty five patients with COVİD-19 infection who were treated with favipiravir and/or hydroxychloroquine and 50 healthy volunteers’ nails were examined by Wood’s lamp. Fluorescence and therapeutic interest were recorded. Data were compared.

Results: Seventy one of the patients (83.5%) had fluorescent nails under UV radiation in the patient group, where no fluorescence was observed in the healthy control group.

Conclusion: Fluorescence of the nails in the patients with confirmed COVID-19 infection who were treated with favipiravir is a common finding. 

Keywords

• COVID-19
• favipiravir
• fluorescence

COVİD-19’un Favipiravir ile Tedavisi Sonrası Tırnaklarda Floresan Yansıma

Öz

Amaç: Favipiravir, COVID-19 Türkiye Ulusal Tedavi Klavuzunda, COVİD-19 tedavisi için önerilmektedir. Türkiye’de COVID-19 ile enfekte hastalarda yaygın olarak kullanılmaktadır. Belli topikal ve sistemik ilaçlar ilaçlarla tırnaklarda Wood lambası ile floresan yansıma bildirilmiştir. Bu çalışma, COVID-19 hastalarının tırnaklarında favipiravirin floresan etkisini belirlemek için tasarlanmıştır.

Materyal ve Metot: Favipiravir ve/veya hidroksiklorokin ile tedavi edilen COVİD-19 enfeksiyonlu 85 hasta ve 50 sağlıklı gönüllünün tırnakları Wood lambası ile incelendi. Floresan yansıma ve ilaç öyküleri kaydedildi. Veriler karşılaştırıldı.

Bulgular: Hasta grubunda, 71 hastada (%83,5) UV radyasyon altında tırnaklarda floresan yansıma mevcuttu. Sağlıklı kontrol grubunda floresans gözlenmedi.

Sonuç: Favipiravir ile tedavi edilen COVİD-19 tespit edilmiş hastaların tırnaklarında floresan yansıma yaygın bir bulgudur. 

Anahtar Kelimeler

• COVID-19
• favipiravir
• floresan

Kaynakça

1. Aslan KM, 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. Dermatol Ther. 2021;6:e14740.
2. Ilchyshyn A, Vickers CF. Yellow nail syndrome associated with penicillamine therapy. Acta Derm Venereol. 1983;63(6):554-555.
3. Lehuédé G, Toussirot E, Despaux J, Michel F, Wendling D. Yellow nail syndrome associated with thiol compound therapy for rheumatoid arthritis. Two case reports. Joint Bone Spine. 2002;69(4):406-408.
4. Kierland RR, Sheard C. Fluorescence of nails from quinacrine hydrochloride. J Am Med Assoc. 1946;6(131):809-810.
5. Piraccini BM, Iorizzo M. Drug Reactions Affecting the Nail Unit: Diagnosis and Management. Dermatologic Clinics.  2007;25(2):215-221.
6. Hendricks AA. Yellow lunulae with fluorescence after tetracycline therapy. Arch Dermatol. 1980;116(4):438-440.
7. Fam AG, Paton TW. Nail pigmentation after parenteral gold therapy for rheumatoid arthritis: “gold nails”. Arthritis Rheum. 1984;27: 119-120.
8. Patel S, Tosti A. An overview of management of drug-induced hair and nail disorders. Clinical Practice. 2014;11:327-339.

9. Giménez García RM, Carrasco Molina S. Drug-Induced Hyperpigmentation: Review and Case Series. J Am Board Fam Med. 2019;32(4):628-638.
10. Asawanonda P, Taylor CR. Wood’s light in dermatology. Int J Dermatol. 1999;38(11):801-807.
11. Safa MM, Ahmed AH, Sherin FH, Amira HK. Experimental design approach for development of spectrofluorimetric method for determination of favipiravir; a potential therapeutic agent against COVID-19 virus:
12. Application to spiked human plasma, Spectrochimica Acta Part A: Molecular and Biomolecular Spectroscopy. Spectrochim Acta A Mol Biomol Spectrosc. 2021;249:119241. doi: 10.1016/j.saa.2020.119241
13. T.C. Sağlik Bakanlığı. COVID-19 Rehberi 2020. https://covid19.saglik.gov.tr/TR-66301/covid-19-rehberi.html. Erişim tarihi 03 Eylül 2020.