Toenails falling off with no trauma

Patient

Q: Hi! I have recently (over the course of a month) have lost 4 toenails. No pain (except for my pinky toenail) and not trauma or discoloring that I can think of. When I lost the first one I figured it mustve been from stubbing it. Now that I am on toenail number 4 Im a little concerned. The doctor at my college is bogus. He looked and said that it maybe my shoes were too tight. My iron levels are also a tad bit low. hemoglobin tested 11.2. Not sure if that has anything to do with it. I have noticed that my lymph nodes in my neck and under my arms are a little swollen and very tender to touch but no other symptoms including sore throat.

Symptoms:  Toenails falling off, lethargic, swollen lymph nodes
Doctor

A:   Hello,
Thanks for choosing "Ask the Doctor" for posting your query.

The medical condition in which toe nail gets separated from nail bed is known as onycholysis. The common causes for this condition are fungal infection, vitamin deficiency or traumatic injury. But falling of 4 nails without any injury should not be ignored. Associated tender and swollen lymphadenopathy may or may not be associated to the condition. However, certain diseases like microbial infection, sarcoidosis, etc do exhibit the combined picture.
You need to visit your doctor and get yourself properly evaluated, diagnosed and treated.
He would prescribe you antibiotic therapy and order complete blood counts. DO keep keen watch on the growth of your lymph nodes' size and your weight loss, if any. Consult the doctor if there is any significant observation.
Hope I am able to answer your concerns.
If you have any further query, I would be glad to help you in future.

Wish you good health!

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