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A 53-year-old intensive care nurse receiving monotherapy with efalizumab for psoriasis involving her arms, legs, and nails presented with a several-week history of slowly progressive green discoloration of both thumbnails, which were affected by psoriasis-induced onycholysis (Panel A). Bacteriologic examination of nail scrapings revealed the presence of fluoroquinolone-sensitive Pseudomonas aeruginosa and Klebsiella pneumoniae. After 2 weeks of treatment with topical nadifloxacin, the nail color returned to normal (Panel B). Green nails, a form of chromonychia, may be caused by bacterial infection with P. aeruginosa. This syndrome is typically seen in patients with nail disease such as onycholysis, onychotillomania, . . . [Full Text of this Article] |
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