Chloronychia: The Goldman-Fox Syndrome - Implications for Patients and Healthcare Workers.

Nail coloration has many causes and may reflect systemic disease. White nails (leukonychia) are common; rubronychia is rare, whereas green (chloronychia) is occasionally evident. Chloronychia, the Fox-Goldman syndrome, is caused by infection of an often damaged nail plate by Pseudomonas aeruginosa . P. aeruginosa is an opportunistic pathogen known for localized and systemic infections. It can spread cryptically in a variety of ways, whether from an infected nail to a wound either autologously or to a patient as a surgical site infection, and many represent a threat to elderly, neonatal, or immunocompromised patients who are at increased risk of disseminated pseudomonas infection. We will review the Goldman-Fox syndrome as an occupational disorder of homemakers, nurses, plumbers, and others often with wet hands. At a time when hand washing is being stressed, especially in healthcare settings, examination of nails should be emphasized too, recalling the possibility of surgical site infection even with a properly washed and gloved medical care provider. Pseudomonas may be a community-acquired infection or a hospital or medical care setting-acquired one, a difference with therapeutic implications. Since healthcare workers represent a threat of nosocomial infections, possible guidelines are suggested.