Severe self-healing nail dystrophy in a patient on peritoneal dialysis

The increasing role of Acinetobacter species as nosocomial pathogens

Among gram-negative organisms playing a significant role in nosocomial infections, Acinetobacter species have attracted increasing attention in intensive care units during the past two decades. Acinetobacter species are implicated in a wide spectrum of infections (eg, bacteremia, nosocomial pneumonia, urinary tract infections, secondary meningitis, superinfections in burn patients). One of the most striking features of Acinetobacter species is their extraordinary ability to develop multiple resistance mechanisms against major antibiotic classes. They have become resistant to broad-spectrum β-lactams (third-generation cephalosporins, carboxypenicillins, and increasingly to carbapenems); they produce a wide range of aminoglycoside-inactivating enzymes; and most strains are resistant to fluoroquinolones. In Acinetobacter nosocomial infections, the major problems confronting clinicians in intensive care units are related to the severity of Acinetobacter nosocomial infections and to resistance to major antibiotic classes of these organisms.

Idiopathic familial onychomadesis

Onychomadesis is defined as spontaneous separation of the nail plate from the nail bed, beginning at its proximal end and resulting in the shedding of the nail. It has been associated with a variety of clinical settings, including systemic illnesses, generalized skin diseases, and drug therapies. There have been a small number of reports in the older literature of idiopathic onychomadesis occurring in a familial pattern. We report the case of a healthy 12-year-old girl and her mother, both of whom have experienced recurrent onychomadesis affecting multiple digits, and in the absence of any causal disease or medication.