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Chemotherapy with hydroxyurea was reported to cause brown discoloration of the nail and multiple pigmented nail bands. A case is described of a 76-year-old woman with chronic myelogenous leukemia, a blood cancer characterized by excessive proliferation of granulocytes, a granular white blood cell, in the bone marrow. After 12 months of treatment with hydroxyurea, she developed light brown bands along the length of the nails of the thumb and middle finger of both hands and a single band on her right ring finger. Other anticancer agents, such as cyclophosphamide and doxorubicin, can also cause the development of pigmented nail bands. The origin and subsequent development of this pigmentation is not known, but may result from direct toxic effects of the drug on the nail. The drug may stimulate melanocytes, the cells that produce the pigment melanin, and thereby cause the formation of nail bands. The stimulation of melanocytes may be influenced by the amount of drug, blood vessel supply, amount of granules (cell storage compartments) containing melanin, and characteristics of melanocytes. Hydroxyurea treatment was reported to cause other skin-related disorders, including scaling and redness; wasting; hair loss; increased discoloration; brittle and decaying nails; and changes in nail pigment. These findings are consistent with previous studies showing that hydroxyurea causes the formation of pigmented nail bands. (Consumer Summary produced by Reliance Medical Information, Inc.)