Sir.—Kawasaki syndrome (KS) is a multisystem disorder of unknown origin first described in Japan in 1967.1 Since then, distinctive clinical features have been recognized.2 We describe a patient with KS who developed an unusual nail feature not previously noted.
Patient Report.—A 4-year-old white boy was listless and anorectic, with the onset of conjunctivitis 7 days prior to admission (PTA) to the hospital. He had a high constant temperature of 40°C (rectal), with minimal response to antipyretics 6 days PTA and large tender anterior cervical nodes 5 days PTA. A bright red nonraised rash developed on the bridge of his nose, palms, and ankles 4 days PTA that became generalized within 24 hours. He received amoxicillin, acetaminophen, and a combination product of brompheniramine maleate and phenylpropanolamine hydrochloride (Dimetapp). One day PTA, he developed diarrhea with associated headache, sore throat, and edema of the hands and feet. His
PILAPIL VR, QUIZON DF. Nail Shedding in Kawasaki Syndrome. Am J Dis Child. 1990;144(2):142–143. doi:10.1001/archpedi.1990.02150260020012