Practical Tips for Managing Nail and Skin Changes While Receiving Talquetamab

EP: 1.Alan's Multiple Myeloma Journey: Facing a New Diagnosis

EP: 2.Connecting With Multiple Myeloma Support Groups and Online Resources

EP: 3.Alan's Treatment Course and Quality-of-Life Goals

EP: 4.Coordinated Health Care Teams and Caregiver Support

EP: 5.Extending Talquetamab Education Beyond the Hospital

EP: 6.Addressing Early Talquetamab Toxicity Concerns

EP: 7.Developing a System-Wide Protocol for Talquetamab Toxicity Management

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EP: 8.Practical Tips for Managing Nail and Skin Changes While Receiving Talquetamab

EP: 9.Managing Taste Changes and Weight Loss During Talquetamab Treatment

EP: 10.Advice for the Patient Starting Treatment With Talquetamab

EP: 11.Advice for the Caregiver: Be a Patient Advocate

EP: 12.Addressing Common Talquetamab Misunderstandings

Talquetamab-related skin toxicities result from GPRC5D expression in heavily keratinized tissues, particularly affecting palms and soles with characteristic peeling and sloughing. Management strategies focus on aggressive moisturization using emollients such as CeraVe, ammonium lactate 12% cream (AmLactin), and occlusive agents such as Aquaphor applied under cotton gloves overnight. Additional recommendations include topical steroids for inflammation and avoiding hot water exposure that can worsen skin toxicities.

Nail toxicities reflect GPRC5D expression in nail beds, leading to nail fragility, separation, and potential nail loss. Prevention strategies include nail hardeners, vitamin E cuticle oil, and newer products such as Polybalm (comprised of polyphenolic-rich herbal oils with organic waxes). Protective measures involve avoiding trauma through proper footwear, activity modifications, and using finger cots or bandages when nails begin separating to prevent catching them on clothing or hair.

Hygiene maintenance becomes critical during nail and skin toxicities to prevent secondary infections in immunocompromised patients. Recommendations include keeping nails short and clean, wearing gloves during household tasks such as dishwashing, and maintaining good handwashing practices. The comprehensive approach addresses both the active management of existing toxicities and the prevention of complications, recognizing that these effects are generally temporary and resolve over time with continued treatment.