Now Available from Bako Diagnostics

The most common cause of bacterial nail infection, Pseudomonas aeruginosa, is now included in our onychodystrophy panel*

*Pseudomonas aeruginosa testing not currently available in the State of New York.


Green nail syndrome, characterized by a greenish black discoloration of the nail, is caused by the growth and colonization of P. aeruginosa. Predisposing conditions can include: onycholysis, onychomycosis, diabetes mellitus, as well as occupations where feet are frequently exposed to wet conditions.

The addition of P. aeruginosa to our onychodystrophy panel enables clinicians to identify one of the non-fungal causes of infectious onychodystrophy and treat it appropriately.

–  Dr. Wayne L. Bakotic,
Dermatopathologist and BakoDx Co-Founder

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The Importance of Including the Detection of Green Nail Syndrome (GNS) with PCR in Onychodystophy Testing

  • Fungal infection stimulates bacterial colonization within the nail and overgrowth of P. aeruginosa in culture inhibits the isolation of fungus1

  • Screening for fungal coinfections and, if needed antifungal treatment, in patients with GNS is critical1

  • Molecular testing is needed to detect GNS because of a strong relation between fungal and P. aeruginosa nail infection.2

  • Coinfection with “Trichophytan rubrum and Pseudomonas, (are) a common occurrence.”3

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  1. Müller S, Ebnöther M, Itin P, Green Nail Syndrome (Pseudomonas aeruginosa Nail Infection): Two Cases Successfully Treated with Topical Nadifloxacin, an Acne Medication. Case Rep Dermatol 2014;6:180-184
  2. Alessandrini A, Starace M, Piraccini B, M, Dermoscopy in the Evaluation of Nail Disorders. Skin Appendage Disord 2017;3:70-82
  3. Anderson, Bryan, and Christie Regula. “Green Nail Syndrome (GNS, Pseudomonas Nail Infection, Chloronychia, Green Striped Nails, Chromonychia).” Dermatology Advisor,