A 3 year-old female is brought in by her mother who is worried that her fingernails and toenails are falling off. The child is otherwise well, denies pain, and is not on any medications. She has no pertinent past medical history and mother denies any known drug or environmental allergies. Her younger sibling has recently started to have the same symptoms. Both children were recently ill with a viral illness that resolved with supportive care. Diagnosis?
This is a case of onychomadesis, a spontaneous shedding of the nails. This is typically caused by a viral etiology, which causes a temporary arrest of growth at the nail matrix. It is usually seen in young children after hand-foot-mouth disease. Treatment is supportive.