To the Editor.—
Onycholysis through a phototoxic mechanism, in patients taking a tetracycline derivative, was described by Orentreich et al1. The following is a report of an unusual manifestation of this reaction.
Report of a Case.—
A 20-year-old undergraduate had painful, swollen fingertips. One week earlier, she had experienced paresthesias in both hands, which had lasted a full day. Two days prior to her visit, her left fourth fingertip became tender and edematous; by the next morning, all fingers, except the thumbs, were similarly involved. There was no history to suggest contact dermatitis or trauma. Apart from studying, her activities included only sunbathing, which she does frequently, and has always tolerated well. Current medications were limited to levothyroxine sodium (Synthroid) (dose unknown) and tetracycline hydrochloride, 250 mg/day, taken for two years.The patient was well tanned and healthy-appearing, and had edematous fingertips. The nail beds were pale, and the
Rothstein MS. Onycholysis Through Phototoxicity. Arch Dermatol. 1977;113(4):520-521. doi:10.1001/archderm.1977.01640040128026