Abstract

Green Nail Syndrome (GNS), also known as chloronychia, is an infection of the nail that leads to a green-black discoloration and onycholysis of the nail. The condition is usually confined to one or two nails, and can occur on both finger and toenails. GNS is caused by growth of the bacterium Pseudomonas aeruginosa underneath the nail. The most common risk factors are due to onycholysis or trauma to the nail bed, as well as exposure to damp environments, soaps, or toxins. Since GNS has a classic appearance, it is rare to see a biopsy performed, and is usually a clinical diagnosis. Herein, we present a case of an 85-year-old female who presented with discoloration of her right thumb nail for several months after exposure to a chemical irritant. On examination, there was dark green-black discoloration of the distal right thumb nail plate. Histologic sections showed subungual hyperkeratosis with heme crust and foci of bacterial organisms. Due to the paucity of histologic examinations of GNS, limited case reports have been written describing the histopathologic findings of this entity.

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