Ann Dermatol.  2014 Aug;26(4):514-516. 10.5021/ad.2014.26.4.514.

Green Nail Syndrome Treated with the Application of Tobramycin Eye Drop

• Bae Y
• Lee GM
• Sim JH
• Lee S
• Lee SY
• Park YL

• KMID: 2265596
• DOI: http://doi.org/10.5021/ad.2014.26.4.514

Abstract

Green nail syndrome (chromonychia) is a nail disorder characterized by onycholysis and green-black discoloration of the nail bed. This condition is often associated with chronic paronychia. Pseudomonas aeruginosa is the most commonly identified organism in cultures from the affected area. Despite the various treatment options available, removal of the nail is still necessary in many cases. A 35-year-old man presented with dark-greenish discoloration of the nail plate and onycholysis on the left thumbnail. He had been treated with oral antifungal and antibiotic agents for several months; however, the lesion showed no improvement. The diagnosis of green nail syndrome was established after a positive bacterial culture, and on the basis of the antibiotic sensitivity test result, tobramycin eye drop (Tobrex(R)) was then prescribed. Three weeks later, the nail discoloration almost vanished but the onycholysis remained. Herein, we recommend the application of tobramycin eye drop as an easy and safe treatment option for green nail syndrome.

Keyword

Eye drop; Green nail syndrome; Pseudomonas aeruginosa; Tobramycin

MeSH Terms

Adult
Diagnosis
Humans
Onycholysis
Paronychia
Pseudomonas aeruginosa
Tobramycin*
Tobramycin

Figure

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  Fig. 1 The distal two-thirds of the left thumbnail showing dark-greenish pigmentation and onycholysis.

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  Fig. 2 At 8 weeks after medication, the dark-green discoloration vanished and only a small part of the onycholysis remained.

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