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Orange-brown chromonychia and Kawasaki disease: a possible novel association?
Lucia Tessarotto1, Giulia Rubin2, Luca Bonadies2
1Department of Pediatrics, Ospedale Dell'Angelo, Mestre, Italy.
Insights
Kawasaki disease (KD) can cause orange-brown nail pigmentation, a finding not previously well-documented. This nail change may represent a late sign of KD, potentially aiding in future diagnoses.
Area of Science:
- Pediatrics
- Rheumatology
- Dermatology
Background:
- Kawasaki disease (KD) is an acute febrile vasculitis affecting medium-sized arteries, primarily in children.
- While characteristic clinical features of KD are well-established, less common or late-onset manifestations require further investigation.
- Nail changes, such as Beau's lines, have been reported in KD, but specific pigmentation patterns are not widely recognized.
Abstract:
A 4-year-old girl with clinical and laboratory signs of Kawasaki disease (KD) was hospitalized and given intravenous immunoglobulin plus aspirin therapy, with rapid defervescence and clinical improvement, and was discharged 48 hours after admission. At the time of her follow-up echocardiography on day 14, orange-brown pigmentation of the nail beds was noticed and confirmed with dermoscopy. No clear association between KD and orange-brown chromonychia has been demonstrated, although reports and case series suggest a possible link between these two entities. We suggest that this particular finding might be encompassed in late (subacute) changes of extremities as part of KD diagnostic criteria.
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