case_images: PMC10653707_01
case_images: a The patient presents bilateral green-yellow discoloration of the nail plate and onycholysis of the right nail. b Onychoscopy of the right nail reveals diffuse green-yellow pigmentation and onycholysis of the nail from the matrix. c Onychoscopy of the left nail shows widespread green coloration with proximal yellow irregular discoloration, suggesting the presence of P. aeruginosa.d The patient presents resolution of the infections after 12 weeks of topical treatment. No green or structural alterations could be detected at macroscopic examination. e Onychoscopy of the right nail reveals resolution of the green pigmentation without permanent alteration. f Onychoscopy of the left nail shows the absence of the infections and a regrowing white nail with no structural alterations.
case_images: cde-2023-0015-0001-533923_F01.jpg
case_images: PMC10653707_01_cde-2023-0015-0001-533923_F01.jpg
case_images: F1
case_images: Onychoscopy revealed an intense green color of the nail with shaded and irregular yellow areas, especially in the proximal area, mild onychodystrophy of the entire nail plate, onychomadesis, and distal onycholysis (Fig. 1a-c). A. xylosoxidans, topical therapy with ozenoxacin 1% cream daily for 12 weeks was prescribed. After 12 weeks of application, the patient presented clinical resolution, regrowth of the right nail, and disappearance of the chloronychia of the left nail without any local adverse events (Fig. 1d, e).
case_images: PMC10653707_02
case_images: a The patient presents a greenish pigmentation of the distal part of the toenail. b Onychoscopy of the right nail reveals a diffuse greenish pigmentation and onycholysis, suggestive for P. aeruginosa infection. c The patient presents a resolution of the distal pigmentation and improvement in onycholysis of the toenail. d Onychoscopy of the right nail reveals the complete resolution of the green pigmentation and a light onychomadesis with negative culture.
case_images: cde-2023-0015-0001-533923_F02.jpg
case_images: PMC10653707_02_cde-2023-0015-0001-533923_F02.jpg
case_images: F2
case_images: Onychoscopy revealed a light greenish, circular area of the nail with mild onycholysis (Fig. 2).