Twenty nail onychomadesis: an unusual finding in Cronkhite-Canada syndrome

The term onychomadesis describes the detachment of the nail plate from the proximal nail fold caused by the temporary arrest of nail matrix activity. Onychomadesis at the same level involving several nails suggests a systemic cause, including drug intake (usually cancer chemotherapy agents), systemic illness, or viral diseases.We describe a case of Cronkhite–Canada syndrome (CCS) with typical cutaneous and gastrointestinal manifestations but with previously unreported nail features consisting of onychomadesis of all 20 nails.In our patient, CCS caused recurrent onychomadesis of the 20 nails, related to the systemic illness associated with each acute episode. CCS may be added as a systemic cause of recurrent onychomadesis of all 20 nails.