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Related Experiment Videos

Critical illness onychomadesis.

J P Wester1, R S van Eps, A Stouthamer

  • 1Department of Surgical Intensive Care, Academic Hospital Free University, Amsterdam, The Netherlands. J.Wester@azvu.nl

Intensive Care Medicine
|February 24, 2001
PubMed
Summary
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This case report details a rare nail deformity, onychomadesis (nail shedding), observed in a critically ill patient with a pulmonary abscess. This severe systemic illness manifestation offers new insights into nail changes during critical care.

Area of Science:

  • Critical Care Medicine
  • Dermatology
  • Pulmonology

Background:

  • Severe systemic illness, such as pulmonary abscess, can precipitate various dermatological manifestations.
  • Nail changes, including Beau's lines, are recognized indicators of significant physiological stress.
  • Onychomadesis, or complete nail shedding, is a rare but dramatic nail response to severe insults.

Observation:

  • A 48-year-old male with pneumococcal meningitis, pneumonia, and a large pulmonary abscess developed onycholysis of all fingernails and toenails.
  • The patient required prolonged mechanical ventilation and extensive surgical intervention for the pulmonary abscess.
  • Complete shedding of all nails (onychomadesis) was observed during the prolonged critical illness course.

Findings:

  • The development of onychomadesis in this patient represents an extreme manifestation of Beau's lines.

Related Experiment Videos

  • This specific association between pulmonary abscess and subsequent onychomadesis has not been previously documented in medical literature.
  • The case highlights a potential link between severe pulmonary infections and significant nail abnormalities.

    • Implications:

    • This observation expands the understanding of nail deformities in critically ill patients.
    • Clinicians should be aware of the possibility of onychomadesis in patients with severe systemic infections and prolonged critical illness.
    • Further research may elucidate the precise mechanisms linking pulmonary abscesses to onychomadesis.