Practical Tips for Managing Nail and Skin Changes While Receiving Talquetamab

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 like CeraVe, ammonium lactate 12% cream (MLactin), and occlusive agents like 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 like PolyBomb (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 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 like dishwashing, and maintaining good hand washing practices. The comprehensive approach addresses both active management of existing toxicities and prevention of complications, recognizing that these effects are generally temporary and resolve over time with continued treatment.