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Nail Reactions to Poisons and Intoxicants

  • Chris G. Adigun
Chapter

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.

Keywords

Beau’s lines Mee’s lines Leukonychia Onychomadesis Onycholysis Onychalgia Blue lunulae 

References

  1. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Johnson R, Ruelle A, Shermer D. Bullae formation secondary to carbon monoxide poisoning. J Am Podiatr Med Assoc. 1999;89(3):152–4.CrossRefPubMedGoogle Scholar
  3. 3.
    Wilkerson MG, Wilkin JK. Red lunulae revisited: a clinical and histopathologic examination. J Am Acad Dermatol. 1989;20(3):453–7.CrossRefPubMedGoogle Scholar
  4. 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.CrossRefPubMedGoogle Scholar
  5. 5.
    Czirják L, Csiki Z, Nagy Z, Tóth E. Exposure to chemicals and systemic sclerosis. Ann Rheum Dis. 1995;54(6):529.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 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.CrossRefPubMedGoogle Scholar
  7. 7.
    Datta PK, Ghosh S, De A. Idiopathic non-familial acro-osteolysis: a rare case report. Indian J Dermatol. 2012;57(6):486–8.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 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.CrossRefPubMedGoogle Scholar
  9. 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.CrossRefPubMedGoogle Scholar
  10. 10.
    Coentrão L, Moura D. Acute cyanide poisoning among jewelry and textile industry workers. Am J Emerg Med. 2011;29(1):78–81.CrossRefPubMedGoogle Scholar
  11. 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. 12.
    Budden MG, Wilkinson DS. Skin and nail lesions from gold potassium cyanide. Contact Dermatitis. 1978;4(3):172–3.CrossRefPubMedGoogle Scholar
  13. 13.
    Hsu MM, Mak CP, Hsu CC. Follow-up of skin manifestations in Yu-Cheng children. Br J Dermatol. 1995;132(3):427–32.CrossRefPubMedGoogle Scholar
  14. 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.CrossRefPubMedGoogle Scholar
  15. 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.CrossRefPubMedGoogle Scholar
  16. 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.CrossRefPubMedGoogle Scholar
  17. 17.
    Masuda Y. Health status of Japanese and Taiwanese after exposure to contaminated rice oil. Environ Health Perspect. 1985;60:321–5.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 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.CrossRefPubMedGoogle Scholar
  19. 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.PubMedGoogle Scholar
  20. 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.CrossRefPubMedGoogle Scholar
  21. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Müller D, Desel H. Acute selenium poisoning by paradise nuts (Lecythisollaria). Hum Exp Toxicol. 2010;29(5):431–4.CrossRefPubMedGoogle Scholar
  23. 23.
    Leads from the MMWR. Selenium intoxication–New York. JAMA. 1984;251(15):1938.CrossRefGoogle Scholar
  24. 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.CrossRefPubMedGoogle Scholar
  25. 25.
    Schuh B, Jappe U. Selenium intoxication: undesirable effect of a fasting cure. Br J Dermatol. 2007;156(1):177–8.CrossRefPubMedGoogle Scholar
  26. 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.CrossRefPubMedGoogle Scholar
  27. 27.
    Schrauzer GN. Selenomethionine: a review of its nutritional significance, metabolism and toxicity. J Nutr. 2000;130(7):1653–6.CrossRefPubMedGoogle Scholar
  28. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 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.CrossRefPubMedGoogle Scholar
  30. 30.
    Roest MA, Ratnavel R. Yellow nails associated with gold therapy for rheumatoid arthritis. Br J Dermatol. 2001;145(5):855–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Fam AG, Paton TW. Nail pigmentation after parenteral gold therapy for rheumatoid arthritis: “gold nails”. Arthritis Rheum. 1984;27(1):119–20.CrossRefPubMedGoogle Scholar
  32. 32.
    Aste N, Pau M, Carcassi M, et al. Nail pigmentation during chrysotherapy: ‘gold nails’. Chron Dermatol. 1994;4:647–51.Google Scholar
  33. 33.
    Voigt K, Holzegel K. Permanent nail changes following gold therapy. Hautarzt. 1977;28(8):421–3.PubMedGoogle Scholar
  34. 34.
    ter Borg EJ, Ramselaar CG, Wiltink EH. Nail shedding (Beau’s lines) after severe gold dermatitis. Arthritis Rheum. 2000;43(6):1420.PubMedGoogle Scholar
  35. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  36. 36.
    Sensirivatana R, Supachadhiwong O, Phancharoen S, Mitrakul C. Neonatal lead poisoning. An unusual clinical manifestation. Clin Pediatr (Phila). 1983;22(8):582–4.CrossRefGoogle Scholar
  37. 37.
    Zhu WY, Xia MY, Huang SD, Du D. Hyperpigmentation of the nail from lead deposition. Int J Dermatol. 1989;28(4):273–5.CrossRefPubMedGoogle Scholar
  38. 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. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  40. 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.CrossRefPubMedGoogle Scholar
  41. 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.CrossRefPubMedGoogle Scholar
  42. 42.
    Plewig G, Lincke H, Wolff HH. Silver-blue nails. Acta Derm Venereol. 1977;57(5):413–9.PubMedGoogle Scholar
  43. 43.
    Tanner LS, Gross DJ. Generalized argyria. Cutis. 1990;45(4):237–9.PubMedGoogle Scholar
  44. 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.CrossRefPubMedGoogle Scholar
  45. 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.CrossRefPubMedGoogle Scholar
  46. 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.CrossRefPubMedGoogle Scholar
  47. 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.PubMedGoogle Scholar
  48. 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.CrossRefPubMedGoogle Scholar
  49. 49.
    Cohen SR. Yellow staining caused by 4,4′-methylenedianiline exposure. Occurrence among molded plastics workers. Arch Dermatol. 1985;121(8):10227.CrossRefGoogle Scholar
  50. 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.CrossRefPubMedGoogle Scholar
  51. 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.PubMedPubMedCentralGoogle Scholar
  52. 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.CrossRefPubMedGoogle Scholar
  53. 53.
    Kern AB. Mercurial pigmentation. Arch Dermatol. 1969;99(1):129–30.CrossRefPubMedGoogle Scholar
  54. 54.
    Butterworth T, Strean LP. Mercurial pigmentation of nails. Arch Dermatol. 1963;88:55–7.CrossRefPubMedGoogle Scholar
  55. 55.
    Fakour H, Esmaili-Sari A. Occupational and environmental exposure to mercury among Iranian hairdressers. J Occup Health. 2014;56(1):56–61.CrossRefPubMedGoogle Scholar
  56. 56.
    McParland H, Warnakulasuriya S. Oral lichenoid contact lesions to mercury and dental amalgam–a review. J Biomed Biotechnol. 2012;2012:589569.CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Pigatto PD, Guzzi G, Severi G. Oral lichen planus: mercury and its kin. Arch Dermatol. 2005;141(11):1472–3. author reply 1473.CrossRefPubMedGoogle Scholar
  58. 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.CrossRefPubMedGoogle Scholar
  59. 59.
    Kalouche H, Watson A, Routley D. Blue lunulae: argyria and hypercopprecaemia. Australas J Dermatol. 2007;48(3):182–4.CrossRefPubMedGoogle Scholar
  60. 60.
    Schilsky ML. Diagnosis and treatment of Wilson’s disease. Pediatr Transplant. 2002;6(1):15–9.CrossRefPubMedGoogle Scholar
  61. 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.CrossRefPubMedGoogle Scholar
  62. 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.CrossRefPubMedGoogle Scholar
  63. 63.
    Ahsan T, Zehra K, Munshi A, Ahsan S. Chronic arsenic poisoning. J Pak Med Assoc. 2009;59(2):105–7.PubMedGoogle Scholar
  64. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 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.CrossRefPubMedGoogle Scholar
  66. 66.
    Hutton JT, Christians BL. Sources, symptoms, and signs of arsenic poisoning. J Fam Pract. 1983;17(3):423–6.PubMedGoogle Scholar
  67. 67.
    Hall AH. Chronic arsenic poisoning. Toxicol Lett. 2002;128(1–3):69–72.CrossRefPubMedGoogle Scholar
  68. 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.PubMedGoogle Scholar
  69. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  70. 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.CrossRefPubMedGoogle Scholar
  71. 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.CrossRefPubMedGoogle Scholar
  72. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Alarcón-Segovia D, Amigo MC, Reyes PA. Connective tissue disease features after thallium poisoning. J Rheumatol. 1989;16(2):171–4.PubMedGoogle Scholar
  74. 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.PubMedGoogle Scholar
  75. 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.CrossRefPubMedGoogle Scholar
  76. 76.
    Atsmon J, Taliansky E, Landau M, Neufeld MY. Thallium poisoning in Israel. Am J Med Sci. 2000;320(5):327–30.CrossRefPubMedGoogle Scholar
  77. 77.
    Heyl T, Barlow RJ. Thallium poisoning: a dermatological perspective. Br J Dermatol. 1989;121(6):787–91.CrossRefPubMedGoogle Scholar
  78. 78.
    Saddique A, Peterson CD. Thallium poisoning: a review. Vet Hum Toxicol. 1983;25(1):16–22.PubMedGoogle Scholar
  79. 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.CrossRefPubMedPubMedCentralGoogle Scholar
  80. 80.
    Valdes L, Huggins J, Gade F, et al. Characteristics of patients with yellow nail syndrome and pleural effusion. Respirology. 2014;19:985–92.CrossRefPubMedGoogle Scholar
  81. 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. 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.PubMedGoogle Scholar
  83. 83.
    Ishizaki C, Sueki H, Kohsokabe S, Nishida H. Yellow nail induced by bucillamine. Int J Dermatol. 1995;34:493–4.CrossRefPubMedGoogle Scholar
  84. 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.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Chris G. Adigun
    • 1
  1. 1.Dermatology & Laser Center of Chapel HillChapel HillUSA

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