Basic Fibroblast Growth Factor for Treatment of Onychomadesis with Delayed Regrowth of the Nail

Onychomadesis usually arises from an inflammation of the paronychium or as a result of blisters and hemorrhaging under a nail that has been struck or compressed. No documented interactions between basic fibroblast growth factor (bFGF) and onychomadesis have hitherto been reported. This case report describes a 25-year-old woman with onychomadesis following infection of the ingrown nail of her left thumb. After ten months of observation with no treatment showed no regrowth of her left thumbnail, the external use of bFGF and antibiotic ointment was started. One month later, nail regrowth was observed up to the halfway point of the nail bed, and after treatment for three months, the regrown nail reached the top of the nail bed. Both thumbnails now looked identical. This case suggests that external use of bFGF can promote nail regrowth in cases of onychomadesis with delayed regrowth of the nail. 1. Introduction Onychomadesis usually arises from an inflammation of the paronychium or blisters and hemorrhage under the nail caused by a blow or compression. Systemic diseases, such as hand-foot-and-mouth disease, pemphigus vulgaris, and Stevens-Johnson syndrome, occasionally result in onychomadesis. Normally, simple observation or supportive treatment of inflammation will promote the regrowth of the fallen nail. However, in cases where nail regrowth does not occur, the condition tends to be refractory. Hitherto, there have been no effective treatments that promote the regrowth of fallen nails. In this paper, we report a notable case of onychomadesis after infection of an ingrown nail, in which the external use of basic fibroblast growth factor (bFGF; Trafermin; Fiblast Spray) and antibiotic ointment (Bacitracin-fradiomycin sulfate; Baramycin) led to normal nail regrowth. 2. Case Presentation The case was a 25-year-old woman. She was a nursery teacher and routinely washed her hands many times daily. She had no previous medical history and was taking no medications or dietary supplements. Her left thumb had an ingrown nail, but she had not had it examined in a clinic, since it showed no troublesome symptoms. However, after her ingrown nail became infected, it presented with pain, swelling, and discharge of pus. Those symptoms continued for a month, after which the nail fell off the nail bed. She went to a clinic to have her left thumbnail examined at that time, but underwent observation rather than receiving treatment due to the expectation that it would spontaneously regenerate. No further infections flared up, but no regrowth of her left thumbnail was seen in four