TWO FINGERS of a 6-week-old infant were noted to be discolored, "black and red," following removal of mittens (Figure 1) that had been placed on both hands 48 hours earlier to prevent involuntary excoriations of the face by his fingernails. The infant's mother had been advised by her mother-in-law not to trim his fingernails because, according to Hispanic folklore, it is believed that trimming the fingernails of an infant younger than 40 days old may result in poor vision. The infant had exhibited no unusual fussiness or irritability during this time.
The distal phalanx of the left index finger appeared denuded with surrounding erythema (Figure 2). The distal phalanx of the right index finger was necrotic distal to a piece of thread attached circumferentially. Surgical debridement and amputation of the distal phalanx were required (Figure 3). The third toe of another infant with an earlier stage of the same problem is shown in Figure 4.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Pediatrics editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 10
Customize your page view by dragging & repositioning the boxes below.
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.