Green Nail Syndrome Research Articles

The Green Nail Syndrome (“Chloronychia”) in Healthcare Workers: Challenges and Strategies

The Green Nail Syndrome (“Chloronychia”) in Healthcare Workers: Challenges and Strategies

Green nail syndrome caused by Pseudomonas aeruginosa (literature review)

Green nail syndrome is a bacterial nail disease caused by Pseudomonas aeruginosa, which is characterized by discoloration of the nail plate, onycholysis and proximal paronychia. Despite the prevalence of the pathology and the increase in incidence, today there are no clinical recommendations for the management of patients with chloronychia. This article discusses the etiology, pathogenesis, risk factors, and therapeutic options for managing these patients.

绿甲综合征1例

绿甲综合征1例

Green nail syndrome: Contribution of dermoscopy in two cases

Green nail syndrome (GNS) is a nail disorder that may be caused by several etiologies, among which Pseudomonas aeruginosa is the main factor that produces pyocyanin and pyoverdine, causing green discoloration. This infection may be confused with etiologies, such as co-infection with onychomycosis. Herein, we report the dermoscopic models of GNS observed in two cases.

33824 Skin of color representation in Google image searches of common nail conditions

Introduction: Online resources in dermatology lack sufficient diversity in skin tones, which has been documented for common skin conditions. Representation of skin of color in online images of nail conditions is not well characterized. Methods: Common nail conditions were searched on Google images. The first 50 photographs for each condition were visually analyzed, rated on the Fitzpatrick scale, and categorized as Fitzpatrick I-II, Fitzpatrick III-IV, Fitzpatrick V-VI, or indeterminate, when categorization was not possible. Results: 34 nail conditions were searched on Google images. A total of 1826 photographs were evaluated, with 55% displaying Fitzpatrick skin types I-II, 31% displaying Fitzpatrick skin types III-IV, 7% displaying Fitzpatrick skin types V-VI, and 7% categorized as indeterminate. 5.9% (2/34) of searches displayed no photographs with Fitzpatrick skin types V-VI (nail pitting and onychomycosis, specifically). The conditions with the highest proportion of images displaying Fitzpatrick skin types V-VI are as follows: anonychia (32.7%), Darier disease (19.6%), longitudinal melanonychia (18.3%), and onychomadesis (15.7%). The conditions with the lowest proportion of images displaying Fitzpatrick skin types V-VI are as follows: brittle nails (1.9%), green nail syndrome (1.9%), ingrown nail (1.9%), nail psoriasis (1.9%), and pincer nail (1.9%). Conclusion: Skin of color is underrepresented in online searches of common nail conditions. With the increased reliance on the internet, especially Google, by patients and physicians to acquire medical information, there is an urgent need to include images representative of all skin tones in online medical content.

Green nail syndrome complicated by pseudomonal keratitis in a teenager with artificial nails.

Green nail syndrome (GNS) is a pseudomonal nail infection that presents with characteristic green nail discoloration. It typically affects patients with preexisting nail conditions or chronic exposure to wet environments but can also be seen with local trauma. Our patient presented with a pseudomonal corneal ulcer of the left eye and was incidentally found to have GNS, which developed after home artificial nail application. This unusual case of extensive pediatric GNS illustrates a rare and serious infectious complication of prolonged artificial nails.

Pseudomonas infection of nail: Green nail syndrome secondary to onychomycosis

Pseudomonas infection of nail: Green nail syndrome secondary to onychomycosis

Green nail syndrome on the nail plate and bed related with Enterococcus and Fusarium coinfection.

Abstract.

Enhancement of photodynamic bactericidal activity of curcumin against Pseudomonas Aeruginosa using polymyxin B

BackgroundPseudomonas aeruginosa (P. aeruginosa) is an emerging opportunistic pathogen, which can cause bacterial skin diseases such as green nail syndrome, interdigital infections and folliculitis. Curcumin-mediated antimicrobial photodynamic therapy (aPDT) has been demonstrated as a promising therapeutic option for the treatment of skin infection though its inactivation of gram-negative bacteria such as P. aeruginosa. Materials and methodsIn the present study, we examined the adjuvant effect of polymyxin B on the antibacterial activity of curcumin-mediated aPDT against P. aeruginosa. P. aeruginosa was treated with curcumin in the presence of 0.1–0.5 mg/L polymyxin B and irradiated by blue LED light (10 J/cm2). Bacterial cultures treated with curcumin alone served as controls. Colony forming units (CFU) were counted and the viability of P. aeruginosa was calculated after aPDT treatment. The possible underlying mechanisms for the enhanced killing effects were also explored. ResultsThe killing effects of curcumin-mediated aPDT against P. aeruginosa was significantly enhanced by polymyxin B (over 2-log reductions). Moreover, it was also observed that addition of polymyxin B in the curcumin-mediated aPDT led to the apparent bacterial membrane damage with increased leakage of cytoplasmic contents and extensive DNA and protein degradation. DiscussionThe photodynamic action of curcumin against P. aeruginosa could be significantly enhanced by the FDA-approved drug polymyxin B. Our results highlight the potential of introducing polymyxin B to enhance the effects of aPDT treatment against gram-negative skin infections, in particular, P. aeruginosa.

Dermoscopy of Green Nail Syndrome: The "Green Aurora Sign".

Dermoscopy of Green Nail Syndrome: The "Green Aurora Sign".

Complications of gel manicures

Green nail syndrome is a nail disorder mostly seen in the elderly and those frequently exposed to water. Gel nail polish has become a very popular alternative to regular nail polish received during manicures. This popularity has allowed potential adverse effects to surface. We present a unique case of green nail syndrome in a healthy 50 year old healthy female after the removal of gel nail polish after a few weeks. The case raises awareness to potential complications and further consequences of gel manicures.

Green nail syndrome caused by Citrobacter braakii.

A 34‐year‐old woman presented due to progressive painful swelling around the nail of the right index finger. Onychectomy and drainage of the abscess of the affected finger were performed as the inflammation was progressive despite the previous antibiotic therapy. The microbiological culture revealed a ciprofloxacin‐susceptible Citrobacter braakii.

Clinical analysis of Pseudomonas aeruginosa-positive and -negative green nail syndrome cases: A single center retrospective analysis.

Green nail syndrome (GNS) is a paronychial infection mainly due to Pseudomonas aeruginosa, characterized by green discoloration of the nail plate. Although the diagnosis of GNS may be straightforward with its distinctive color change, the clinical management of the disease can be sometimes confusing, especially when the bacterial culture result is inconsistent. There is, however, a paucity of comprehensive reviews regarding the treatment of GNS in the actual clinical setting. In this retrospective review of 34 patients, we found that GNS mostly occurs on a single digit (79.4%) on the big toe or thumb (85.3%) with frequent concurrent fungal infection (67.6%). The prevalence of inconsistent bacterial culture result with no evidence of P.aeruginosa was unexpectedly high (n=22, 64.7%), in which case coagulase-negative staphylococci were most frequently detected. The P.aeruginosa-negative group did not demonstrate any statistically significant differences compared with the P.aeruginosa-positive group, and it still responded well to the typical topical and/or oral fluoroquinolone treatment. GNS without the evidence of P.aeruginosa may be a more common occurrence than reported in the literature, and it can be managed successfully with the same strategy employed to treat P.aeruginosa-positive cases. It may result from the low detection rate of P.aeruginosa due to the limited sensitivity of the test, or inadequate amount and/or contamination of the sample, warranting close scrutiny by clinicians.

Skin manifestations of Pseudomonas aeruginosa infections.

Pseudomonas aeruginosa is an opportunistic pathogen with considerable morbidity and mortality, particularly in vulnerable hosts. Skin manifestations are common, either representing local inoculation or secondary skin seeding following bloodstream infections. As patients with various predisposing conditions are expanding, we sought to review the most recent published evidence regarding epidemiology, risk factors and diagnosis of skin manifestations of P. aeruginosa. New data exist on epidemiology and diagnosis of skin infections; systemic infections are impacted by multidrug-resistance issues and host immune status. Green nail syndrome, toe web infection, hot tub folliculitis, hot hand-foot infection and external otitis are the most common infections originating from the skin per se. Local treatments are the cornerstone and prognosis is favorable in immunocompetent hosts. Ecthyma gangrenosum and P. aeruginosa subcutaneous nodules are usually associated with bloodstream infections and occur primarily in immunocompromised hosts. Necrotizing skin and soft tissue infections occur in diabetic, alcoholic and immunocompromised patients; management requires a multidisciplinary team with surgical approach. Burn wound infections may also be challenging, requiring a specialized team. In all the four latter types of P. aeruginosa skin infections portending significant morbidity and mortality, systemic antibiotics are an integral part of the treatment.

Green Nail Syndrome, A Rare Infection of Pseudomonas aeruginosa in The Nail

ObjectiveA nail infection is a common case caused by fungal infection, thus can make any bacterial correlated infection in the nail can be under-diagnosed. However, Pseudomonas aeruginosa can cause nail infection known as green nail syndrome (chromonychia). Method A 3 years old girl presented with greenish discoloration on the nail plate of the right toenail since previous a month. She came from well-educated family, but the water resource at their home was not good enough. The specimen of nail scraping was sent to the microbiology laboratory. The Gram from nail scraping didn’t show any significant result. After 24 hours, a greenish colony, non-lactose fermenter on the Mac Conkey and a dominant blue-green color colony on the blood sheep agar had grown. The colonies are beta hemolytic, flat and spreading. They were also positive to oxidase and catalase. Result The Gram result from the colony was showed as basil negative Gram. Identification from Vitex 2® concluded as Pseudomonas aeruginosa that resistant to all penicillin derivate and 2nd generation of cephalosporin. However the isolate was still sensitive to ceftazidime, carbapenems, quinolones and amino-glycosides. The treatment was decided using topical fluoroquinolone nadifloxacin, and gave a significant result in a month Conclusion Green nail syndrome that is caused by P. aeruginosa infection could be treated by topical fluoroquinolone for 1-2 months

Green nail syndrome: Analysis of the association with onychomycosis

To the Editor: Green nail syndrome (GNS) is an infectious disorder caused by Pseudomonas aeruginosa that presents as greenish pigmented nails. Although an anecdotal association between GNS and onychomycosis has been reported,1-4 data in the literature are limited. Therefore, we conducted this study to investigate the association of fungal coinfection with GNS.

Dermoscopic Features of Green Nail Syndrome Associated with Dermatophytosis and, Traumatic Onycholysis

Dermoscopic Features of Green Nail Syndrome Associated with Dermatophytosis and, Traumatic Onycholysis

Onychomycosis Coinfected with Pseudomonas aeruginosa: Report of Four Cases

Patients presenting with green nail syndrome often show coinfection with fungus. A delay in the accurate diagnosis of coinfection may warrant longer treatment duration. Four patients with green nail syndrome coinfected with fungus were reviewed retrospectively. Fungal culture, cultivating Candida parapsilosis and Candida albicans, was performed in two patients' samples. The mean time of the initiation of treatment for onychomycosis after the first visit was 5.75 weeks. If green nail syndrome is suspected, screening for fungal coinfections and precise management are necessary.

Gross Image of Green Nail Syndrome Co-infected with Trichophyton rubrum

Gross Image of Green Nail Syndrome Co-infected with Trichophyton rubrum

Green nail syndrome.

Green nail syndrome.