Nail Shedding: A Case Report.
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Date
2013-10
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Abstract
Aims: The etiology of nail shedding in an 85-year-old man as well as predisposing and
precipitating factors were evaluated, focusing on whether nail loss was secondary to
infection or not.
Presentation of Case: An 85-year-old man was examined for complete detachment and
loss of the nail plates of the index and middle fingers of his right hand. There were no
previous nail disorders or a recent traumatic injury. He was non-smoker and was not
receiving any drug therapy before nail loss. Clinical symptoms and signs persisted after
10 days empirical use of antibiotics and local treatment. Culture samples by that time
indicated an Enterobacter cloacae local infection. He was treated with topical application
of the gentamycin injection solution on the nail beds. There was normal regrowth of the
nails. No abnormality of the nail unit of both fingers was evident 2 years later.
Discussion: The pathogenesis of nail shedding in our patient was assessed. Although a
causal relation of nail loss and a primary Enterobacter cloacae infection was highly
suggestive, other causes such as missed minor trauma, ischemia or idiopathic could not
be excluded.
Conclusion: A primary Enterobacter cloacae infection was the most likely cause of an
acute nail shedding of the index and middle fingers of the right hand in an 85-year-old
man. Treatment with local use of the gentamycin injection solution was proved a welltolerated,
safe and efficacious mode of treatment.
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Keywords
Nail shedding, loss, onycholysis
Citation
Sferopoulos Nikolaos K. Nail Shedding: A Case Report. British Journal of Medicine and Medical Research. 2013 Oct-Dec; 3(4): 1325-1330.