PINCER NAIL DEFORMITY IN A THREE-MONTH-OLD INFANT WITH KAWASAKI DISEASE AND CORONARY ARTERIES INVOLVEMENT

Kawasaki disease is an acute multisystem vasculitis that primarily occurs in
infants and young children. Pincer nail deformity is not from classic signs of Kawasaki disease and its
occurrence with Kawasaki disease is rare, and concomitant occurrence of it with coronary artery
aneurysm in Kawasaki disease is rarer.
Case report: A three-month-old infant was admitted to hospital with history of high fever, poor
feeding and ill appearing from three days before. In the 4th day after admission, diffuse pincer nail
deformity appeared in all nails of hands and feet. This deformity was transient and after therapy of
Kawasaki disease with IVIG, it completely resolved. In sub-acute phase, after resolution of fever,
severe aneurysms appeared in right and left coronary arteries, so therapy with warfarin and aspirin
were given for patient. In outpatient follow up one year later, fortunately all aneurysms were
completely resolved.
Conclusion: Pincer nail deformity could be a sign of atypical Kawasaki disease and appearance of this
deformity in a patient with Kawasaki disease can be a risk factor for coronary artery involvement.