Wednesday, July 22, 2009

Green fingernails

The New England Journal of Medicine (NEJM) has a section called "Image Challenge." It's a bit of fun trivia that ranges across many different disease states. This image shows a person who has green finger nails. No nail polish used here. The cause for this green discoloration? Pseudomonas aeruginosa infection. Here's the summary from the NEJM:
Green nails, a form of chromonychia, may be caused by bacterial infection with P. aeruginosa. This syndrome is typically seen in patients with nail disease such as onycholysis, onychotillomania, or paronychia, particularly in those whose abnormal nails have been exposed to moist environments. The green color is caused by the fluorescent siderophore pyoverdin, produced by P. aeruginosa.
You don't see this every day. You may see yellow fingernails, pitting, Mees' lines, and other nail abnormalities, but green fingernails? Image source: NEJM

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