Drug-reactive nail disease

　　1, Etiology

　　Therefore, any drug that can cause bullous erythema can cause nail loss.

　　2, Pathogenesis

　　Drugs cause the nail mechanism to be destroyed through the body's reaction.

　　This disease is usually related to excessive use of drugs, so it can cause liver and kidney function damage in clinical practice, manifested as increased ALT and AST, usually more than 3 times higher, some cases may present with explosive liver injury that is life-threatening, even诱发hepatic encephalopathy. Secondly, the serum creatinine and blood urea nitrogen will also increase, but generally will not cause kidney failure.

　　1, Nail defect:Bulbous skin lesions at the fingertips can lead to partial or complete loss of the nail, hence drugs that can cause bullous erythema such as high-dose lincomycin and cefamycin 2 can produce temporary nail loss.

　　2, Changes in nail color:Drugs can also cause changes in the color of the nails, apapine can make the nails appear pale blue, tetracycline can cause yellow staining of the nails, chloroquine can cause blue-black pigmentation on the nail bed, other antimalarial drugs can produce longitudinal pigmented bands on the nail bed, phenolphthalein-type fixed drug eruptions if they occur on the nail bed can present as dark blue, argyria can make the nails appear dark blue-gray, inorganic arsenic can cause longitudinal pigmented bands or white stripes (Mess lines), doxorubicin can make the nails darker, ethylenimine and hydroxylamine can lead to brown pigmentation.

　　3. Nail quality changes:Itraconazole and 13-cis retinoic acid can cause nail dryness, nail plate thinning, brittleness, and some patients may develop pedunculated granuloma tissue near the nail fold.

　　This disease belongs to nail color abnormalities caused by drugs, so the preventive measures should be targeted at the cause. For patients with a confirmed disease, the above-mentioned drug treatment should be carried out, attention should be paid to the dosage and rules of medication, and more water should be drunk to accelerate the excretion of drug metabolites, reduce the occurrence of complications, and prevent and avoid kidney damage caused by drug metabolites.

　　1. Clinical physical examination:This disease is mainly characterized by abnormal nail color, as well as changes in shape and brittleness. Nail color can be dark, pale blue, pale yellow, etc. The recovery time of capillary pressure after pressing is generally less than 3 seconds.

　　2. Laboratory examination:This disease is mainly diagnosed based on the patient's medication history and blood drug concentration tests. At the same time, there may be a basis for excessive medication, and myocardial enzymes, liver function should be checked to determine whether the above-mentioned organ damage is caused by excessive medication.

　　For the diet and health care of patients with drug-induced onychomycosis, it is necessary to pay attention to a light diet, eat more vegetables and fruits rich in vitamins and fiber, avoid spicy and stimulating foods, and eat more tomatoes, carrots, cabbage, winter melon, and other foods; at the same time, appropriate nutrition can be enhanced, and more soy milk, fish, and other foods can be eaten, but attention should be paid not to consume too much sugar and fat, because the occurrence of these diseases is often related to sugar metabolism and fat metabolism, and high-fat and high-carbohydrate foods can worsen the condition.

　　This disease belongs to the side effects after taking medication, or toxic reactions caused by excessive medication. According to the specific situation, stopping medication or reducing the dose of medication can alleviate clinical symptoms. For cases with abnormal liver function and renal function, liver protection treatment should be carried out when the level of liver function exceeds 3 times. BUN and CRE increase should be treated with kidney protection therapy.