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Nail Shedding in Kawasaki Syndrome

VIRGILIO R. PILAPIL, MD; DEOGRACIAS F. QUIZON, MD
Am J Dis Child. 1990;144(2):142-143. doi:10.1001/archpedi.1990.02150260020012.
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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

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