The Journal of DermatologyVolume 49, Issue 8 p. e293-e294 LETTER TO THE EDITOR Author reply to “Onycholysis associated with Kawasaki disease: A comment on characteristic nail lesions in Kawasaki disease: Case series and literature review” Tsuyoshi Mitsuishi, Corresponding Author Tsuyoshi Mitsuishi [email protected] orcid.org/0000-0003-2277-0201 Department of Dermatology, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, Japan Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan Correspondence Tsuyoshi Mitsuishi, Department of Dermatology, Japanese Red Cross Saitama Hospital, 1-5 Shintoshin, Chuo-ku, Saitama 330-8553, Japan. Email: [email protected]Search for more papers by this authorKazunori Miyata, Kazunori Miyata orcid.org/0000-0002-7931-6045 Department of Dermatology, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorAkiko Ando, Akiko Ando orcid.org/0000-0003-2842-8909 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorKentaro Sano, Kentaro Sano orcid.org/0000-0002-2436-2036 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorJun-ichi Takanashi, Jun-ichi Takanashi orcid.org/0000-0002-1147-1938 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorHiromichi Hamada, Hiromichi Hamada orcid.org/0000-0002-8990-5265 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, Japan Department of Pediatrics, Chiba University, Chiba, JapanSearch for more papers by this author Tsuyoshi Mitsuishi, Corresponding Author Tsuyoshi Mitsuishi [email protected] orcid.org/0000-0003-2277-0201 Department of Dermatology, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, Japan Department of Dermatology, Japanese Red Cross Saitama Hospital, Saitama, Japan Correspondence Tsuyoshi Mitsuishi, Department of Dermatology, Japanese Red Cross Saitama Hospital, 1-5 Shintoshin, Chuo-ku, Saitama 330-8553, Japan. Email: [email protected]Search for more papers by this authorKazunori Miyata, Kazunori Miyata orcid.org/0000-0002-7931-6045 Department of Dermatology, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorAkiko Ando, Akiko Ando orcid.org/0000-0003-2842-8909 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorKentaro Sano, Kentaro Sano orcid.org/0000-0002-2436-2036 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorJun-ichi Takanashi, Jun-ichi Takanashi orcid.org/0000-0002-1147-1938 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, JapanSearch for more papers by this authorHiromichi Hamada, Hiromichi Hamada orcid.org/0000-0002-8990-5265 Department of Pediatrics, Tokyo Women’s Medical University Yachiyo Medical Center, Chiba, Japan Department of Pediatrics, Chiba University, Chiba, JapanSearch for more papers by this author First published: 23 April 2022 https://doi.org/10.1111/1346-8138.16408Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1Mitsuishi T, Miyata K, Ando A, Sano K, Takanashi JI, Hamada H. Characteristic nail lesions in Kawasaki disease: case series and literature review. J Dermatol. 2022; 49: 232–8. 2Otani A, Iio K, Hataya H. Onycholysis associated with Kawasaki disease: a comment on Mitsuishi et al. J Dermatol. 2022. Online ahead of print. 3Iosub S, Gromisch DS. Leukonychia partialis in Kawasaki disease. J Infect Dis. 1984; 150: 617–8. 4Berard R, Scuccimarri R, Chédeville G. Leukonychia striata in Kawasaki disease. J Pediatr. 2008; 152: 889. 5Banday AZ, Neelam H, Jindal AK. Spatio-temporal evolution of onychomadesis in a child with missed Kawasaki disease. Clin Rheumatol. 2020; 39: 2237–8. 6Singh A, Pilania RK, Thapa B, Vignesh P, Singh S. Onycholysis-an uncommon finding in Kawasaki disease. J Clin Rheumatol. 2020; 26: e128–9. Volume49, Issue8August 2022Pages e293-e294 ReferencesRelatedInformation

Kawasaki disease (KD) is vasculitis of unknown etiology in infants and young children. The diagnostic criteria for KD include major and minor symptoms, but various nail lesions are not described in detail. The aim of this study was to identify symptoms that are relatively found in nail of KD as diagnostic markers. After literature review, various nail lesions are classified as Beau's lines, leukonychia, onychomadesis, orange-brown chromonychia, and pincer nail deformity. The orange-brown chromonychia is the most common nail lesion in KD. In this study, the authors found three cases of KD with orange-brown chromonychia; two of these cases included rare dotted or splinter hemorrhages in the nail bed that were found on dermoscopic examination. The authors propose that these nail lesions, including hemorrhage of the nail bed, could be included as a helpful diagnosis of KD.