Previously published Photo Quizzes are now featured in a mobile app. Get more information at http:// www.aafp.org/afp/apps. A 52-year-old male smoker presented with a mildly pruritic rash that began three months earlier on his back and spread to his scalp, trunk, and extremities, including the palms and soles. He had a history of alcoholic cirrhosis. He had no recent new exposures, including me...

A 23-year-old female patient presented with spontaneous appearance of nail haemorrhages on both hands after a tracking holiday in Peru and Bolivia. At altitudes above 3000 meters, she initially developed painful splinter haemorrhages (figure 1), followed by subungual haematoma (figure 2) and eventually distal onycholysis at all fingernails on both hands (figure 3). Remarkably, her toenails were...

Yellow nail syndrome was defined in 1964 as a combination of slow growing, discoloured nails and edema (Samman & White, 1964). The rate of growth of finger nails was less than 0.2 mm per week compared with the normal 0.5-1.2 mm per week. The nails were thickened and the cuticles were deficient. The color varied from pale yellow to slightly greenish. Onycholysis (separation of the nail from its ...

Targeting epidermal growth factor receptor (EGFR)-mediated signalling pathways has become routine practice in the treatment of lung cancer. Erlotinib is an oral EGFR tyrosine kinase inhibitor, licensed for maintenance monotherapy treatment in patients with locally advanced or metastatic non-small cell lung cancer after first-line chemotherapy. The authors present the case of a 51-year-old patie...

Acrylic nails, including sculptured nails and the new ultraviolet-curable gel polish lacquers, have been associated with allergic contact dermatitis (ACD). We report 2 cases of ACD to acrylic nails with severe onychodystrophy and psoriasiform changes including onycholysis and subungual hyperkeratosis. In both cases, the patients did not realize the association between the use of acrylate-based ...

A 39-year-old Caucasian male presented with a 5-year history of thickened toenail. The patient admitted that he used topical isoconazole nitrate twice daily for two months, without any improvement. The past medical history was unremarkable. The physical examination revealed subungual hyperkeratosis and onycholysis on the lateral side of the first toenail, onychoschizia of the second and fourth ...

Docetaxel (Taxotere), an anticancer agent, is known to cause various reactions, including hypersensitivity, oedema, skin toxicity with erythrodysesthesia syndrome, infusion site reactions, alopecia, nail onycholysis, nail pigmentation, photosensitivity, scleroderma and stomatitis. However, of all the reported effects, photosensitivity has only rarely been described in the literature. We experie...

Green nails, also known as chloronychia or green nail syndrome, are characterized by green discoloration of the nail plate (greenish-yellow, greenish-brown, greenish-black), proximal chronic non-tender paronychia, and distolateral onycholysis. The cause is Pseudomonas aeruginosa infection of the nail plate in persons whose hands are constantly exposed to water, soaps, and detergents or are subj...