Green nail syndrome: Analysis of the association with onychomycosis

Ohn, Jungyoon; Yu, Duk Jun; Park, Hyun Sun; Cho, Soyun; Mun, Je‐Ho

doi:10.1016/j.jaad.2020.01.040

Cited by 22 publications

(27 citation statements)

References 5 publications

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“…Polymicrobial infections of the nail have also been observed in individuals with green nail syndrome (Table 3) [8,[10][11][12]. In one report of 23 patients with green nail syndrome, fungal and bacterial co-infection was found in 65% of the patients [13]. Although co-infection was identified, we suspect the green nail discoloration was secondary to the virulent pigments (pyocyanin and pyoverdine) produced by Pseudomonas aeruginosa.…”

Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 88%

Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Forouzan¹,

Cohen²

2021

Cureus

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Green nail syndrome is a form of chromonychia, discoloration of the nail plate, that describes fingernails or toenails that are green in appearance. Bacterial-associated green nail syndrome, referred to as chloronychia, is most common; however, fungal and polymicrobial etiologies have been reported. Two 70-year-old women presented with green discoloration of their nails for over five months; both women had prior unsuccessful treatments and were referred for further evaluation and treatment. The affected nails were biopsied and cultured. Bacterial cultures did not yield any organisms; however, fungal cultures grew Candida parapsilosis after four weeks. Both women were treated with a topical alcohol-based solution and ketoconazole cream with improvement in their nail discoloration after two months. We introduce a term that specifically describes fungal etiology-associated green nail syndrome: viridionychia.

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Section: Table 1: Single Bacterial Etiologies Of Green Nail Discolorationmentioning

confidence: 88%

Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Forouzan¹,

Cohen²

2021

Cureus

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“…Onychomycosis can present alongside green nail syndrome. A retrospective analysis of green nail syndrome patients at referral centers revealed fungal coinfection in 65.2% of patients (21). Onychomycosis can present with a dermatophytoma, a compact ball of fungal filaments and large spores which appears as a white/yellow or orange/brown longitudinal streak in the nail plate (22,23).…”

Section: Clinical Features and Differential Diagnosesmentioning

confidence: 99%

Diagnosis of Onychomycosis: From Conventional Techniques and Dermoscopy to Artificial Intelligence

2021

Self Cite

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Onychomycosis is a common fungal nail infection. Accurate diagnosis is critical as onychomycosis is transmissible between humans and impacts patients' quality of life. Combining clinical examination with mycological testing ensures accurate diagnosis. Conventional diagnostic techniques, including potassium hydroxide testing, fungal culture and histopathology of nail clippings, detect fungal species within nails. New diagnostic tools have been developed recently which either improve detection of onychomycosis clinically, including dermoscopy, reflectance confocal microscopy and artificial intelligence, or mycologically, such as molecular assays. Dermoscopy is cost-effective and non-invasive, allowing clinicians to discern microscopic features of onychomycosis and fungal melanonychia. Reflectance confocal microscopy enables clinicians to observe bright filamentous septate hyphae at near histologic resolution by the bedside. Artificial intelligence may prompt patients to seek further assessment for nails that are suspicious for onychomycosis. This review evaluates the current landscape of diagnostic techniques for onychomycosis.

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“…El compromiso de la lámina ungueal puede ser parcial o total y usualmente es indoloro. 4,23,24,25 El diagnóstico diferencial a considerar en el SUV incluye el hematoma subungueal, melanoma maligno, infecciones por otros patógenos (Aspergillus, Candida, Proteus) y pigmentación exógena por sustancias químicas. 4, 15 Imagen 2.…”

Section: Clínicaunclassified

Síndrome de la uña verde: revisión actualizada de una patología emergente en la era COVID-19

Hasbún¹,

Cruz

2021

Bol. Micol.

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El síndrome de la uña verde o cloroniquia corresponde a la infección por Pseudomonas aeruginosa de una lámina ungueal dañada en pacientes con algún factor de riesgo identificable, siendo los más frecuentes la inmunosupresión, el ambiente húmedo constante y la patología ungueal preexistente. Su diagnóstico es relativamente sencillo si se logra observar la tríada característica de coloración verdosa de la lámina ungueal, paroniquia proximal crónica y onicolisis distal; en casos de duda diagnóstica se puede enviar una muestra de la uña afectada para cultivos o estudio histopatológico. El pilar de su tratamiento corresponde al uso de antibióticos tópicos o sistémicos en conjunto con medidas generales que protejan de la humedad. Es muy importante enfatizar la prevención de esta patología en el personal de salud, especialmente en el contexto del lavado de manos frecuente y riguroso implementado durante la pandemia COVID-19, ya que existen reportes de transmisión nosocomial de P.aeruginosa por profesionales de la salud con infección ungueal.

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Green nail syndrome: Analysis of the association with onychomycosis

Cited by 22 publications

References 5 publications

Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Fungal Viridionychia: Onychomycosis-Induced Chloronychia Caused by Candida parapsilosis-Associated Green Nail Discoloration

Diagnosis of Onychomycosis: From Conventional Techniques and Dermoscopy to Artificial Intelligence

Síndrome de la uña verde: revisión actualizada de una patología emergente en la era COVID-19

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