Skip to main content
SpringerLink
Log in

Nail Reactions to Poisons and Intoxicants

  • Chapter
Scher and Daniel’s Nails

  • 1974 Accesses

Abstract

There are a number of chemicals and elements that, when ingested may lead to clinical changes in the nails. Poisons that have been reported to cause nail findings when individuals are exposed include carbon monoxide, vinyl chloride, toxic oil, potassium cyanide, polychlorinated biphenyls (PCBs), tetrodotoxin (TTX), selenium. Heavy metals exposure may also cause nail changes. Metal exposures that have been reported to cause nail findings include gold, lead, silver, aniline, mercury, copper, arsenic, thallium, and titanium. These changes include discoloration of the nail plate or nail bed, vascular disruption, growth disturbance that may lead to grooves or complete shedding of the nail plate, among other findings. In some cases, these findings can be characteristic and aid in detection of the causative agent.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 74.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 84.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Hatami M, Naftolin F, Khatamee MA. Abnormal fingernail beds following carbon monoxide poisoning: a case report and review of the literature. J Med Case Rep. 2014;8:263.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Johnson R, Ruelle A, Shermer D. Bullae formation secondary to carbon monoxide poisoning. J Am Podiatr Med Assoc. 1999;89(3):152–4.

    Article  CAS  PubMed  Google Scholar 

  3. Wilkerson MG, Wilkin JK. Red lunulae revisited: a clinical and histopathologic examination. J Am Acad Dermatol. 1989;20(3):453–7.

    Article  CAS  PubMed  Google Scholar 

  4. Langlois NE. Digital image analysis of fingernail colour in cadavers comparing carbon monoxide poisoning to controls. Forensic Sci Med Pathol. 2010;6(1):9–12.

    Article  PubMed  Google Scholar 

  5. Czirják L, Csiki Z, Nagy Z, Tóth E. Exposure to chemicals and systemic sclerosis. Ann Rheum Dis. 1995;54(6):529.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Ostlere LS, Harris D, Buckley C, Black C, Rustin MH. Atypical systemic sclerosis following exposure to vinyl chloride monomer. A case report and review of the cutaneous aspects of vinyl chloride disease. Clin Exp Dermatol. 1992;17(3):208–10.

    Article  CAS  PubMed  Google Scholar 

  7. Datta PK, Ghosh S, De A. Idiopathic non-familial acro-osteolysis: a rare case report. Indian J Dermatol. 2012;57(6):486–8.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Posada de la Paz M, Philen RM, Borda AI. Toxic oil syndrome: the perspective after 20 years. Epidemiol Rev. 2001;23(2):231–47.

    Article  CAS  PubMed  Google Scholar 

  9. Alonso-Ruiz A, Zea-Mendoza AC, Salazar-Vallinas JM, Rocamora-Ripoll A, Beltrán-Gutiérrez J. Toxic oil syndrome: a syndrome with features overlapping those of various forms of scleroderma. Semin Arthritis Rheum. 1986;15(3):200–12.

    Article  CAS  PubMed  Google Scholar 

  10. Coentrão L, Moura D. Acute cyanide poisoning among jewelry and textile industry workers. Am J Emerg Med. 2011;29(1):78–81.

    Article  PubMed  Google Scholar 

  11. Coentrão L, Neves A, Moura D. Hydroxocobalamin treatment of acute cyanide poisoning with a jewellery-cleaning solution. BMJ Case Rep. 2010;2010:1–3.

    Google Scholar 

  12. Budden MG, Wilkinson DS. Skin and nail lesions from gold potassium cyanide. Contact Dermatitis. 1978;4(3):172–3.

    Article  CAS  PubMed  Google Scholar 

  13. Hsu MM, Mak CP, Hsu CC. Follow-up of skin manifestations in Yu-Cheng children. Br J Dermatol. 1995;132(3):427–32.

    Article  CAS  PubMed  Google Scholar 

  14. Gladen BC, Taylor JS, Wu YC, Ragan NB, Rogan WJ, Hsu CC. Dermatological findings in children exposed transplacentally to heat-degraded polychlorinated biphenyls in Taiwan. Br J Dermatol. 1990;122(6):799–808.

    Article  CAS  PubMed  Google Scholar 

  15. Rogan WJ, Gladen BC, Hung KL, Koong SL, Shih LY, Taylor JS, Wu YC, Yang D, Ragan NB, Hsu CC. Congenital poisoning by polychlorinated biphenyls and their contaminants in Taiwan. Science. 1988;241(4863):334–6.

    Article  CAS  PubMed  Google Scholar 

  16. Gladen BC, Rogan WJ, Hardy P, Thullen J, Tingelstad J, Tully M. Development after exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene transplacentally and through human milk. J Pediatr. 1988;113(6):991–5.

    Article  CAS  PubMed  Google Scholar 

  17. Masuda Y. Health status of Japanese and Taiwanese after exposure to contaminated rice oil. Environ Health Perspect. 1985;60:321–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Wong CK, Chen CJ, Cheng PC, Chen PH. Mucocutaneous manifestations of polychlorinated biphenyls (PCB) poisoning: a study of 122 cases in Taiwan. Br J Dermatol. 1982;107(3):317–23.

    Article  CAS  PubMed  Google Scholar 

  19. Chen L, Li Z, Zhao ZQ. Forensic medical identification of death due to poisoning of tetrodotoxin in puffer fish. Fa Yi Xue Za Zhi. 1999;15(3):131–2. 189.

    CAS  PubMed  Google Scholar 

  20. Fernández-Ortega JF, Morales-de los Santos JM, Herrera-Gutiérrez ME, Fernández-Sánchez V, Rodríguez Loureo P, Rancaño AA, Téllez-Andrade A. Seafood intoxication by tetrodotoxin: first case in Europe. J Emerg Med. 2010;39(5):612–7.

    Article  PubMed  Google Scholar 

  21. MacFarquhar JK, Broussard DL, Melstrom P, Hutchinson R, Wolkin A, Martin C, Burk RF, Dunn JR, Green AL, Hammond R, Schaffner W, Jones TF. Acute selenium toxicity associated with a dietary supplement. Arch Intern Med. 2010;170(3):256–61.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Müller D, Desel H. Acute selenium poisoning by paradise nuts (Lecythisollaria). Hum Exp Toxicol. 2010;29(5):431–4.

    Article  PubMed  CAS  Google Scholar 

  23. Leads from the MMWR. Selenium intoxication–New York. JAMA. 1984;251(15):1938.

    Article  Google Scholar 

  24. Lopez RE, Knable AL Jr, Burruss JB. Ingestion of a dietary supplement resulting in selenium toxicity. J Am Acad Dermatol. 2010;63(1):168–9.

    Article  PubMed  Google Scholar 

  25. Schuh B, Jappe U. Selenium intoxication: undesirable effect of a fasting cure. Br J Dermatol. 2007;156(1):177–8.

    Article  CAS  PubMed  Google Scholar 

  26. Webb A, Kerns W 2nd. What is the origin of these nail changes in an otherwise healthy young patient? J Med Toxicol. 2009;5(1):31. 39.

    Article  PubMed  Google Scholar 

  27. Schrauzer GN. Selenomethionine: a review of its nutritional significance, metabolism and toxicity. J Nutr. 2000;130(7):1653–6.

    Article  CAS  PubMed  Google Scholar 

  28. Bendix G, Bjelle A. A 10 year follow up of parenteral gold therapy in patients with rheumatoid arthritis. Ann Rheum Dis. 1996;55(3):169–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Gottlieb NL, Smith PM, Penneys NS, Smith EM. Gold concentrations in hair, nail, and skin during chrysotherapy. Arthritis Rheum. 1974;17(1):56–62.

    Article  CAS  PubMed  Google Scholar 

  30. Roest MA, Ratnavel R. Yellow nails associated with gold therapy for rheumatoid arthritis. Br J Dermatol. 2001;145(5):855–6.

    Article  CAS  PubMed  Google Scholar 

  31. Fam AG, Paton TW. Nail pigmentation after parenteral gold therapy for rheumatoid arthritis: “gold nails”. Arthritis Rheum. 1984;27(1):119–20.

    Article  CAS  PubMed  Google Scholar 

  32. Aste N, Pau M, Carcassi M, et al. Nail pigmentation during chrysotherapy: ‘gold nails’. Chron Dermatol. 1994;4:647–51.

    Google Scholar 

  33. Voigt K, Holzegel K. Permanent nail changes following gold therapy. Hautarzt. 1977;28(8):421–3.

    CAS  PubMed  Google Scholar 

  34. ter Borg EJ, Ramselaar CG, Wiltink EH. Nail shedding (Beau’s lines) after severe gold dermatitis. Arthritis Rheum. 2000;43(6):1420.

    PubMed  Google Scholar 

  35. Al-Sabbak M, Sadik Ali S, Savabi O, Savabi G, Dastgiri S, Savabieasfahani M. Metal contamination and the epidemic of congenital birth defects in Iraqi cities. Bull Environ Contam Toxicol. 2012;89(5):937–44.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Sensirivatana R, Supachadhiwong O, Phancharoen S, Mitrakul C. Neonatal lead poisoning. An unusual clinical manifestation. Clin Pediatr (Phila). 1983;22(8):582–4.

    Article  CAS  Google Scholar 

  37. Zhu WY, Xia MY, Huang SD, Du D. Hyperpigmentation of the nail from lead deposition. Int J Dermatol. 1989;28(4):273–5.

    Article  CAS  PubMed  Google Scholar 

  38. Baran R. Modifications of colour: chromonychias or dyschromias. In: Pierre M, editor. The nail. Edinburgh: Churchill Livingstone; 1981. p. 30–8.

    Google Scholar 

  39. Thurtle N, Greig J, Cooney L, Amitai Y, Ariti C, Brown MJ, Kosnett MJ, Moussally K, Sani-Gwarzo N, Akpan H, Shanks L, Dargan PI. Description of 3,180 courses of chelation with dimercaptosuccinic acid in children ≤ 5 y with severe lead poisoning in Zamfara, Northern Nigeria: a retrospective analysis of programme data. PLoS Med. 2014;11(10):e1001739.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Dietrich KN, Ware JH, Salganik M, Radcliffe J, Rogan WJ, Rhoads GG, Fay ME, Davoli CT, Denckla MB, Bornschein RL, Schwarz D, Dockery DW, Adubato S, Jones RL, Treatment of Lead-Exposed Children Clinical Trial Group. Effect of chelation therapy on the neuropsychological and behavioral development of lead-exposed children after school entry. Pediatrics. 2004;114(1):19–26.

    Article  PubMed  Google Scholar 

  41. Kim Y, Suh HS, Cha HJ, Kim SH, Jeong KS, Kim DH. A case of generalized argyria after ingestion of colloidal silver solution. Am J Ind Med. 2009;52(3):246–50.

    Article  CAS  PubMed  Google Scholar 

  42. Plewig G, Lincke H, Wolff HH. Silver-blue nails. Acta Derm Venereol. 1977;57(5):413–9.

    CAS  PubMed  Google Scholar 

  43. Tanner LS, Gross DJ. Generalized argyria. Cutis. 1990;45(4):237–9.

    CAS  PubMed  Google Scholar 

  44. Shelley WB, Shelley ED, Burmeister V. Argyria: the intradermal “photograph,” a manifestation of passive photosensitivity. J Am Acad Dermatol. 1987;16(1 Pt 2):211–7.

    Article  CAS  PubMed  Google Scholar 

  45. White JM, Powell AM, Brady K, Russell-Jones R. Severe generalized argyria secondary to ingestion of colloidal silver protein. Clin Exp Dermatol. 2003;28(3):254–6.

    Article  CAS  PubMed  Google Scholar 

  46. Kubba A, Kubba R, Batrani M, Pal T. Argyria an unrecognized cause of cutaneous pigmentation in Indian patients: a case series and review of the literature. Indian J Dermatol Venereol Leprol. 2013;79(6):805–11.

    Article  PubMed  Google Scholar 

  47. Saluja SS, Bowen AR, Hull CM. Resident rounds: part III – case report: argyria – a case of blue-gray skin. J Drugs Dermatol. 2015;14(7):760–1.

    PubMed  Google Scholar 

  48. Griffith RD, Simmons BJ, Bray FN, Falto-Aizpurua LA, Yazdani Abyaneh MA, Nouri K. 1064 nm Q-switched Nd:YAG laser for the treatment of argyria: a systematic review. J Eur Acad Dermatol Venereol. 2015;29(11):2100–3.

    Article  CAS  PubMed  Google Scholar 

  49. Cohen SR. Yellow staining caused by 4,4′-methylenedianiline exposure. Occurrence among molded plastics workers. Arch Dermatol. 1985;121(8):10227.

    Article  Google Scholar 

  50. Fuller ME, Kruczek J, Schuster RL, Sheehan PL, Arienti PM. Bioslurry treatment for soils contaminated with very high concentrations of 2,4,6-trinitrophenylmethylnitramine (tetryl). J Hazard Mater. 2003;100(1–3):245–57.

    Article  CAS  PubMed  Google Scholar 

  51. Khodashenas E, Aelami M, Balali-Mood M. Mercury poisoning in two 13-year-old twin sisters. J Res Med Sci. 2015;20(3):308–11.

    PubMed  PubMed Central  Google Scholar 

  52. Dinehart SM, Dillard R, Raimer SS, Diven S, Cobos R, Pupo R. Cutaneous manifestations of acrodynia (pink disease). Arch Dermatol. 1988;124(1):107–9.

    Article  CAS  PubMed  Google Scholar 

  53. Kern AB. Mercurial pigmentation. Arch Dermatol. 1969;99(1):129–30.

    Article  CAS  PubMed  Google Scholar 

  54. Butterworth T, Strean LP. Mercurial pigmentation of nails. Arch Dermatol. 1963;88:55–7.

    Article  CAS  PubMed  Google Scholar 

  55. Fakour H, Esmaili-Sari A. Occupational and environmental exposure to mercury among Iranian hairdressers. J Occup Health. 2014;56(1):56–61.

    Article  CAS  PubMed  Google Scholar 

  56. McParland H, Warnakulasuriya S. Oral lichenoid contact lesions to mercury and dental amalgam–a review. J Biomed Biotechnol. 2012;2012:589569.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  57. Pigatto PD, Guzzi G, Severi G. Oral lichen planus: mercury and its kin. Arch Dermatol. 2005;141(11):1472–3. author reply 1473.

    Article  PubMed  Google Scholar 

  58. Kato Y, Hayakawa R, Shiraki R, Ozeki K. A case of lichen planus caused by mercury allergy. Br J Dermatol. 2003;148(6):1268–9.

    Article  CAS  PubMed  Google Scholar 

  59. Kalouche H, Watson A, Routley D. Blue lunulae: argyria and hypercopprecaemia. Australas J Dermatol. 2007;48(3):182–4.

    Article  PubMed  Google Scholar 

  60. Schilsky ML. Diagnosis and treatment of Wilson’s disease. Pediatr Transplant. 2002;6(1):15–9.

    Article  CAS  PubMed  Google Scholar 

  61. Huang L, Wu H, van der Kuijp TJ. The health effects of exposure to arsenic-contaminated drinking water: a review by global geographical distribution. Int J Environ Health Res. 2015;25(4):432–52.

    Article  CAS  PubMed  Google Scholar 

  62. Pratt M, Wadden P, Gulliver W. Arsenic keratosis in a patient from Newfoundland and Labrador, Canada: case report and review. J Cutan Med Surg. 2016;20(1):67–71.

    Article  CAS  PubMed  Google Scholar 

  63. Ahsan T, Zehra K, Munshi A, Ahsan S. Chronic arsenic poisoning. J Pak Med Assoc. 2009;59(2):105–7.

    PubMed  Google Scholar 

  64. Karagas MR, Gossai A, Pierce B, Ahsan H. Drinking water arsenic contamination, skin lesions, and malignancies: a systematic review of the global evidence. Curr Environ Health Rep. 2015;2(1):52–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Hashim JH, Radzi RS, Aljunid SM, Nur AM, Ismail A, Baguma D, Sthiannopkao S, Phan K, Wong MH, Sao V, Yasin MS. Hair arsenic levels and prevalence of arsenicosis in three Cambodian provinces. Sci Total Environ. 2013;463–464:1210–6.

    Article  PubMed  CAS  Google Scholar 

  66. Hutton JT, Christians BL. Sources, symptoms, and signs of arsenic poisoning. J Fam Pract. 1983;17(3):423–6.

    CAS  PubMed  Google Scholar 

  67. Hall AH. Chronic arsenic poisoning. Toxicol Lett. 2002;128(1–3):69–72.

    Article  CAS  PubMed  Google Scholar 

  68. Shafiquzzaman M, Jahan MK, Rahman MM, Islam MT, Miah MA, Kamal M, Islam MM, Choudhury AM, Chowdhury SA, Mohammad N. Association between morphological changes of nail and nail arsenic level in patients with arsenicosis. Mymensingh Med J. 2009;18(1):27–30.

    CAS  PubMed  Google Scholar 

  69. Pinto B, Goyal P, Flora SJ, Gill KD, Singh S. Chronic arsenic poisoning following ayurvedic medication. J Med Toxicol. 2014;10(4):395–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Uede K, Furukawa F. Skin manifestations in acute arsenic poisoning from the Wakayama curry-poisoning incident. Br J Dermatol. 2003;149(4):757–62.

    Article  CAS  PubMed  Google Scholar 

  71. Wang S, Shi N, Geng Z, Li X, Hu X, Wang Z. Inhibitory mechanism of dimercaptopropanesulfonic acid (DMPS) in the cellular biomethylation of arsenic. Biochimie. 2014;106:167–74.

    Article  CAS  PubMed  Google Scholar 

  72. Saha A, Sadhu HG, Karnik AB, Patel TS, Sinha SN, Saiyed HN. Erosion of nails following thallium poisoning: a case report. Occup Environ Med. 2004;61(7):640–2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Alarcón-Segovia D, Amigo MC, Reyes PA. Connective tissue disease features after thallium poisoning. J Rheumatol. 1989;16(2):171–4.

    PubMed  Google Scholar 

  74. Montoya-Cabrera MA, Sauceda-García JM, Escalante-Galindo P, López-Morales E. Thallium poisoning which stimulated systemic lupus erythematosus in a child. Gac Med Mex. 1991;127(4):333–6.

    CAS  PubMed  Google Scholar 

  75. Herrero F, Fernandez E, Gomez J, Pretel L, Canizares F, Frias J, Escribano JB. Thallium poisoning presenting with abdominal colic, paresthesia, and irritability. J Toxicol Clin Toxicol. 1995;33(3):261–4.

    Article  CAS  PubMed  Google Scholar 

  76. Atsmon J, Taliansky E, Landau M, Neufeld MY. Thallium poisoning in Israel. Am J Med Sci. 2000;320(5):327–30.

    Article  CAS  PubMed  Google Scholar 

  77. Heyl T, Barlow RJ. Thallium poisoning: a dermatological perspective. Br J Dermatol. 1989;121(6):787–91.

    Article  CAS  PubMed  Google Scholar 

  78. Saddique A, Peterson CD. Thallium poisoning: a review. Vet Hum Toxicol. 1983;25(1):16–22.

    CAS  PubMed  Google Scholar 

  79. Decker A, Daly D, Scher RK. Role of titanium in the development of yellow nail syndrome. Skin Appendage Disord. 2015;1(1):28–30.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Valdes L, Huggins J, Gade F, et al. Characteristics of patients with yellow nail syndrome and pleural effusion. Respirology. 2014;19:985–92.

    Article  PubMed  Google Scholar 

  81. Berglund F. Titanium and yellow nail syndrome, novel strategies in lymphedema. 2012. http://www.intechopen.com/books/novelstrategies-in-lymphedema/titanium-and-the-yellow-nail-syndrome.

  82. Ben-Yehuda A, Ben-Chetrit E, Eliakim M. Yellow nail syndrome: case report and review of the literature. Isr J Med Sci. 1986;22:117–9.

    CAS  PubMed  Google Scholar 

  83. Ishizaki C, Sueki H, Kohsokabe S, Nishida H. Yellow nail induced by bucillamine. Int J Dermatol. 1995;34:493–4.

    Article  CAS  PubMed  Google Scholar 

  84. David-Vaudey E, Jamard B, Hermant C, et al. Yellow nail syndrome in rheumatoid arthritis: a drug-induced disease? Clin Rheumatol. 2004;23:376–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dermatology & Laser Center of Chapel Hill, Chapel Hill, NC, USA

    Chris G. Adigun

Authors
  1. Chris G. Adigun
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. University of Pennsylvania, Philadelphia, PA, USA

    Adam I. Rubin

  2. Brown University, Providence, RI, USA

    Nathaniel J. Jellinek

  3. Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, USA

    C. Ralph Daniel III

  4. Department of Dermatology, Weill Cornell Medical College, New York, NY, USA

    Richard K. Scher

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Adigun, C.G. (2018). Nail Reactions to Poisons and Intoxicants. In: Rubin, A.I., Jellinek, N.J., Daniel, C.R., Scher, R.K. (eds) Scher and Daniel’s Nails. Springer, Cham. https://doi.org/10.1007/978-3-319-65649-6_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-65649-6_29

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-65647-2

  • Online ISBN: 978-3-319-65649-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation