Heterogeneous Red-White Discoloration of the Nail Bed and Distal Onycholysis in a Patient with COVID-19

The document describes a case of a 23-year-old male patient with COVID-19 who presented with heterogeneous red-white discoloration of the nail bed and distal onycholysis (separation of the nail from the nail bed) in his nails. The patient had previously experienced fever, sore throat, and joint pain but had not taken any medication. The nail symptoms developed during his COVID-19 illness and were reminiscent of Terry's nails, which are typically associated with systemic diseases but can also occur with normal aging. The patient's nail changes could be related to microvascular damage and inflammation caused by COVID-19, as similar vascular changes have been observed in other COVID-19 patients through nail-fold videocapillaroscopy. However, a nail biopsy was not performed due to the patient's cosmetic concerns, so the exact cause of the nail symptoms could not be definitively determined. This case adds to the growing body of evidence that COVID-19 can affect the nails and may cause unique presentations such as the one described.