A case of green nail syndrome

13 April 2016
green nail syndrome
Photo: BMJ 2015.

13 April 2016

Alice Klein

A 57-year-old man developed green fingernails after spending several months working in an electronics company in Canada.

The man's job involved mixing buckets of chemicals and occasionally dipping circuit boards into chemical baths containing isocyanate-based resins.

Although he said he always wore latex gloves while working directly with chemicals, he admitted to his GP that they often became moist after he left them on for too long, and that he tended to use his bare hands to wash up utensils in the area.

A series of investigations revealed that chemical contact had caused his nails to lift from the nail beds and that the moist environment had allowed bacteria to flourish in the space between.

The bacterial type — Pseudomonas aeruginosa — was the cause of the green discolouration, his doctor wrote in BMJ Case Reports.

The man was started on polymyxin B antibiotic cream to treat the infection and his nails regained normal appearance after 6 months.

The case report authors warned that latex gloves were not recommended for handling isocyanates and said butyl rubber, nitrile rubber, PVC or PVA gloves should be used instead.

green nail syndrome
The man's nails after 2 months of treatment with topical antibiotics. Photo: BMJ 2015.
Last Reviewed: 13 April 2016
Reproduced with kind permission from Australian Doctor

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