Brown Discoloration of Nails after Coronavirus Disease 2019 Infection
Year: 2025
Type: article
Study design: Case Report
Abstract: A 6- year-old boy presented to the pediatric outpatient department with symptoms of upper respiratory tract infection. Examination of the child incidentally revealed brown nails of both hands and feet [Figures 1 and 2]. After going into detailed history, it was revealed that the brown discoloration of nails developed 3 years ago when the child suffered from coronavirus disease (COVID-19). There was no history suggestive of any fungal infection, trauma, inflammatory skin condition (such as psoriasis and lichen planus), or chronic drug intake.Figure 1: Clinical picture of fingernails showing brown discolorationFigure 2: Clinical picture of toenails showing brown discolorationA number of nail changes associated with COVID-19 have been described in literature.[1] These include nail bed erythema (most common), “red half-moon sign,” leukonychia, splinter hemorrhages, and distal brown discoloration of nails. The pathogenesis of these changes is mostly unknown but is usually attributed to underlying disease process like inflammation and intravascular coagulation. While nail bed erythema is more common in fingernails, distal brown discoloration is the most common nail anomaly in toenails after COVID-19.[2] Other causes of brown nails mostly include longitudinal melanonychia and Addison’s disease which do not match with the clinical profile of our patient. No specific management is required for the condition. COVID-19 should be kept in differential diagnoses for any patient presenting with brown discoloration of nails. Declaration of consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Author: Pulkit Agarwal
Institution: Armed Forces Medical College
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7117570753