I was teaching at the residency program this week and had an interesting nail finding in a child. The girl had a rash 2 months before on her hands and feet and then all of her fingernails started peeling. She otherwise was in good health and felt fine.
What was it? It is called onychomadesis. It can happen 1-2 months after hand-foot-mouth viral illness caused by the Coxsackie virus. The nail plate separates from the nail bed. This makes it look like the nails are peeling. Normal nail growth occurs within 1-4 months and will resolve without any assistance.
I’m glad we could put the patient and the parent’s mind to rest. Reassuring them that this was a normal process was all that was needed.