My Instructive Nail Case

In a recent presentation, a physician shared a case of a 20-year-old patient suffering from significant onycholysis and nail bed hyperkeratosis affecting all ten fingernails, attributed to a contact allergy from gel manicures. The patient reported a year-long painful experience and had a prior history of scalp psoriasis. Upon examination, other causes like onychomycosis were ruled out, leading to further testing which identified an allergic reaction to HEMA, a common allergen found in nail products. The presentation highlighted the rising incidence of acrylate allergies, particularly due to increased DIY gel nail applications during the COVID-19 pandemic. Management of such allergies involves recognizing their presence, conducting extended patch testing, and preventing further exposure to the allergens. After halting the use of gel nails and applying clobetasol ointment, the patient experienced significant improvement, returning to normal nail health within six months. The case underscores the importance of awareness regarding contact allergies linked to nail products.