Open AccessOnychodystrophy as the Presenting Sign of Steal Syndrome
Author(s) -
Colleen M. Morken,
Sarah Mortimer,
Richard M. Denney,
Molly Hinshaw
Publication year - 2021
Publication title -
skin appendage disorders
Language(s) - English
Resource type - Journals
eISSN - 2296-9195
pISSN - 2296-9160
DOI - 10.1159/000516305
Subject(s) - medicine , nail (fastener) , emergency department , triage , physical examination , arteriovenous fistula , subclavian steal syndrome , surgery , ischemia , dermatology , cardiology , medical emergency , materials science , psychiatry , metallurgy , subclavian artery
A man in his 70s presented to the dermatology nail clinic with a 1-month history of worsening onychodystrophy, leukonychia, and pain in his left fifth finger. Physical examination revealed a cool hand and absent radial pulse. Ischemia was suspected, and the patient was sent to the emergency department where the diagnosis of steal syndrome was made and his previously required arteriovenous fistula was ligated. This case highlights the clinical features of steal syndrome, that nail changes should be recognized as clinical features, and that urgent triage of these patients to vascular surgery is of critical importance.