{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:47:04Z","timestamp":1775868424640,"version":"3.50.1"},"reference-count":0,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Dermatol"],"abstract":"Green nail syndrome (GNS) is a persistent greenish pigmentation of the nail plate, originally described in 1944 by Goldman and Fox, due to <i>Pseudomonas aeruginosa<\/i> infection. Recently, pulmonary co-infection of <i>P. aeruginosa<\/i> and <i>Achromobacter<\/i> spp. has been described in patients with cystic fibrosis. <i>Achromobacter xylosoxidans<\/i> is a multidrug-resistant (MDR) pathogen involved in lung and soft tissue skin infections. Both <i>Achromobacter xylosoxidans<\/i> and <i>P. aeruginosa<\/i> are mainly found in humid environments or in water. There are no recognized co-infections due to <i>P. aeruginosa<\/i> and <i>A. xylosoxidans<\/i> in the skin and appendages. We describe two cases of GNS, the first due to <i>P. aeruginosa<\/i> associated with <i>Achromobacter xylosoxidans<\/i>; the other due to MDR <i>P. aeruginosa<\/i>, both successfully treated with topical ozenoxacin 1% cream daily for 12 weeks. The clinical management of GNS can be confusing, especially when the bacterial culture result is inconsistent or when non-<i>Pseudomonas<\/i> bacteria are isolated. In our case, due to the co-infection of <i>P. aeruginosa<\/i> and <i>Achromobacter<\/i> spp., local treatment with ozenoxacin \u2013 the first nonfluorinated quinolone \u2013 could be a safe and effective treatment in case of MDR nail infections. Further studies are required to evaluate clinical isolation from nail infections and the co-presence of <i>P. aeruginosa<\/i> and <i>A. xylosoxidans<\/i>. <\/jats:p>","DOI":"10.1159\/000533923","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T22:01:26Z","timestamp":1700172086000},"page":"217-224","source":"Crossref","is-referenced-by-count":5,"title":["Green Nail Syndrome Treated with Ozenoxacin: Two Case Reports"],"prefix":"10.1159","volume":"15","author":[{"given":"Terenzio","family":"Cosio","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosalba","family":"Petruccelli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Gaziano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Fontana","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Favaro","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paola","family":"Zampini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrico Salvatore","family":"Pistoia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Diluvio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flavia","family":"Lozzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Bianchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena","family":"Campione","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2023,11,16]]},"container-title":["Case Reports in Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/cde\/article-pdf\/15\/1\/217\/4114769\/000533923.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/cde\/article-pdf\/15\/1\/217\/4114769\/000533923.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:41:25Z","timestamp":1745422885000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000533923"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,16]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12,21]]}},"URL":"https:\/\/doi.org\/10.1159\/000533923","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.24559903","asserted-by":"subject"}]},"ISSN":["1662-6567"],"issn-type":[{"value":"1662-6567","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,16]]}}}