<\/o:p><\/SPAN><\/B><\/P> <\/o:p><\/SPAN><\/P> Onychomadesis describes complete nail shedding from the proximal portion. <\/SPAN><\/I><\/B>It is consecutive to a nail matrix arrest and can affect both fingernails and toenails. It is a rare disorder in children<\/SPAN><\/I><\/B>. Except for serious generalised diseases or inherited forms, most cases are considered to be idiopathic.<\/SPAN><\/B> Nail matrix arrest has been associated with a variety of drug exposures and systemic illnesses, including infections, and may result in a variety of changes, including transverse ridging (Beau’s lines) and nail shedding (onychomadesis).<\/o:p><\/SPAN><\/B><\/SPAN><\/I><\/P> Hand-foot-mouth disease (HFMD)<\/SPAN><\/I><\/B> is a contagious enteroviral infection occurring primarily in children and characterised by a vesicular palmoplantar eruption and erosive stomatitis. The association of HFMD with Beau’s lines and onychomadesis has been reported by Bernier et al., 2001 [1] and Clementz et al., 2000 [2].<\/SPAN><\/B> <\/o:p><\/SPAN><\/I><\/P> Since 15 June 2008, an increasing number of cases of onychomadesis have been detected in dermatology hospital services. The suspicion of an epidemic started when 14 cases at a kindergarten were reported by the school health care services. Twelve of the cases were children between one- and two-years old. At the same time, a paediatric dermatology clinic notified five cases from others places within Spanish public health surveillance procedures.
Revision of the medical literature did not indicate an ongoing epidemic outbreak of onychomadesis anywhere else in the world. <\/o:p><\/SPAN><\/I><\/P> By the end of this analysis on 30 June 2008, 180 cases in children have been reported to the public health services, after the alert communication to the health care services.* A case was defined as \u201ca child with loss of nails without previous traumatic or systemic disease\u201d. The majority of cases were children at the age of one or two years (see Table).<\/o:p><\/SPAN><\/I><\/P> Table. Number of onychomadesis cases by age, Valencia, Spain, June 2008 <\/o:p><\/SPAN><\/I><\/B><\/P> ![](\"\/blogs\/salud_publica\/wp-content\/blogs.dir\/97\/files\/1250\/o_HFMD-Spain_Table.jpg\")
A preliminary analysis of data from 89 cases revealed an association with ‘hand, foot and mouth’ disease (HFMD) as antecedent of onychomadesis within 30 days after clinical diagnosis<\/SPAN><\/B> from paediatric or dermatology consultation. (Odds for HFMD\/CASE 5.836; CI95%: 2.113-16.120; p<0.001).<\/o:p><\/SPAN><\/I><\/P> A case-control study is being carried out. Habits, diet, previous diseases in the 60 days before onychomadesis, treatments and exposure to other cases of HFMD are been investigated. Blood and faeces samples are been collected from paired cases and controls, aiming to identify the virus related with the illness. Mycosis and heavy metals have been ruled out as the cause by specialised laboratories.<\/o:p><\/SPAN><\/I><\/P> No hypothesis has currently been established, but epidemiologic investigation suggests a strong cause-relation with some enterovirus.<\/SPAN><\/I><\/B> Initial results as of 2 July have detected IgG antibodies against coxsackie virus in 52 subjects (22 positive cases and eight positive controls). Multi-ethnic origin, absence of geographical concentration and age-related concentration excludes a personal characteristic or condition and reinforces the hypothesis virus activity changes.<\/o:p><\/SPAN><\/I><\/P> To our knowledge, such an outbreak has not been described in Spain before.
* On the day of publication of this article, on 3 July 2008, the total number of confirmed cases was 213<\/o:p><\/SPAN><\/I><\/P> <\/P> Consuelo Ib\u00e1\u00f1ez Mart\u00ed, m\u00e9dico salubrista y epidemi\u00f3logo<\/o:p><\/FONT><\/FONT><\/SPAN><\/I><\/B><\/P><\/o:p><\/SPAN><\/I><\/p>\n","protected":false},"excerpt":{"rendered":"Llevo todos estos d\u00edas buscando una definici\u00f3n de \u201cOnicomadesis\u201d por los libros y la web sin encontrar algo que me pueda explicar lo que est\u00e1 pasando en Valencia. Tras mucho buscar he encontrado estas definiciones: La onicomadesis es una inflamaci\u00f3n exudativa del epitelio ungeal que provoca la ca\u00edda de las u\u00f1as sin que haya continuidad con la nueva que empieza a crecer. En t\u00e9rminos m\u00e1s sencillos, este tipo de alteraci\u00f3n consiste en que la u\u00f1a empieza a despegarse desde la ra\u00edz saliendo a continuaci\u00f3n una u\u00f1a nueva. La onicomadesis es una infecci\u00f3n provocada por un virus y que\u2026<\/p>\n","protected":false},"author":74,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0},"categories":[676,665,692],"tags":[],"blocksy_meta":{"styles_descriptor":{"styles":{"desktop":"","tablet":"","mobile":""},"google_fonts":[],"version":4}},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/posts\/96318"}],"collection":[{"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/users\/74"}],"replies":[{"embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/comments?post=96318"}],"version-history":[{"count":0,"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/posts\/96318\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/media?parent=96318"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/categories?post=96318"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.madrimasd.org\/blogs\/salud_publica\/wp-json\/wp\/v2\/tags?post=96318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
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