Nail loss with Hand, Foot and Mouth Disease

I have previously posted entries about Hand, Foot and Mouth disease.  Sometimes, after a case of Hand, Foot and Mouth, children can lose their nails (both fingernails and toenails) in a process called Onychomadesis.  Here are pictures of what this typically looks like:






Onychomadesis is a separation of the growing nail from the nail bed at the nail matrix.  This is caused by a temporary arrest in nail matrix activity, and it may at first look like a dark linear line across the nail, known medically as a "Beau's line".

Nail matrix arrest has been described with a range of medical conditions and was first described in the literature associated with a case of Hand, Foot and Mouth disease in 2000.  The association between the Hand, Foot and mouth virus (a coxsackie virus) and onychomadesis is not very well understood.
The nail changes are temporary and the nails that are affected will regrow spontaneously.  This shedding of the nail is self-limiting, isn't painful and may not bother the child.  It can take up to 6 months to see regrowth of that nail.

The 2017 Dirty Dozen - Produce with the Highest Levels of Pesticides

Every year, I like to summarize the "Dirty Dozen" list - fruits and vegetables that the US Department of Agriculture has deemed the highest in detectable pesticides based on their testing.  This year, nearly 70% of samples of 48 types of fruits and vegetables had detectable pesticide residue.  Scarily, the residue remained on fruits and vegetables even after they were washed, and in some cases, after they were peeled.
Even low levels of pesticides can be harmful to the developing brains of infants, babies and young children.  We would all like to feed our children healthy fruits and vegetables, but "buyer beware" when shopping for them. 

Highest levels of pesticide residue in commercially grown produce:
1.  Strawberries - the most contaminated sample had over 20 pesticides detected! 
2.  Spinach - yikes!  We are all buying this because it has some many great health benefits.
3.  Nectarines
4.  Apples
5.  Peaches
6.  Pears - new on the list this year
7.  Cherries
8.  Grapes
9.  Celery
10.  Tomatoes
11. Sweet bell peppers
12.  Potatoes - also new this year

The solution?  Buy organic and look into locally grown options - growing your own or checking local farmer's markets where you can inquire about their use of pesticides.
The Environmental Working Group has also published this list to help us - their ranking of produce they call the "Clean 15", least likely to contain pesticide residue.  This helps if you are making a grocery list with "organic only" or "nonorganic ok" designations.

1.  Sweet corn
2.  Avocados
3.  Pineapples
4.  Cabbage
5.  Onions
6.  Sweet peas (frozen)
7.  Papayas
8.  Asparagus
9.  Mangoes
10.  Eggplant
11.  Honeydew melons
12.  Kiwi
13.  Cantaloupe
14.  Cauliflower
15.  Grapefruit