There are many disorders affecting the nail in man. Removal of some part or all of a nail by physicians as a treatment of certain conditions, including ingrown toenails, is not an unusual practice.1 In general, total anonychia may be associated with a wide variety of conditions, including nail patella syndrome, trauma, impaired peripheral circulation, alopecia, areata, pemphigus, and idiopathic atrophy of the nails,2 bullous drug eruptions and periodic shedding,2,3 lichen planus,4 congenital abnormalities,5 Stevens-Johnson syndrome,6 and dystrophic epidermolysis bullosa.6,9 We describe what we believe is the first reported case of self-inflicted anonychia.
Left and right, Patient's toes after avulsion of toenails. Note absence of nails, reduced size of nail beds, and small areas of crusting indicative of minor bleeding.
Report of a Case
A 72-year-old man was admitted to the general medical service in May 1981 for fever and shaking chills