Overview
Chloronychia, also known as green nail syndrome, is a condition characterized by the discoloration of the nail plate to a greenish hue due to the overgrowth of the bacterium Pseudomonas species under the nail plate. 1Diagnosis
Clinical Presentation: Green discoloration of the nail plate 1.
Microbiological Confirmation: Nail plate culture identifying Pseudomonas species 1.
Histopathology: Not typically required but may show bacterial colonies under the nail 1.Management
Antibiotic Therapy: Oral or topical antibiotics targeting Pseudomonas; examples include fluoroquinolones or cephalosporins 1.
Nail Debridement: Removal of the infected nail plate to allow topical treatments to penetrate 1.
Topical Antimicrobials: Application of topical agents such as nail lacquers containing agents like ciclopirox or silver 1.Special Populations
Occupational Factors: Mechanical stimulation from repetitive tasks (e.g., keypunching) may predispose individuals 1.Key Recommendations
Confirm diagnosis through nail culture identifying Pseudomonas species (Evidence: Moderate) 1
Initiate treatment with appropriate systemic antibiotics targeting Pseudomonas (Evidence: Moderate) 1
Consider nail debridement to facilitate effective topical treatment application (Evidence: Expert opinion) 1References
1 Honda M, Hattori S, Koyama L, Iwasaki T, Takagi O. Leukonychia striae. Archives of dermatology 1976. link