She said the case could be the first documented instance of onychomadesis ever caused by fish. You put your feet in a tub of water filled with tiny fish who eat your dead skin.
When a young US woman began losing her toenails, her doctors were baffled.
"I wouldn't say it necessarily poses a significant risk to humans, but it did illustrate that they may be carrying things which are nasty both to fish and humans". These fish typically eat plankton, but if plankton aren't available, they will eat dead human skin.
Sheri Lipner, an assistant professor of dermatology, told Gizmodo: 'While the mechanism of action is not entirely clear, it is likely due to the fish traumatizing the nail matrix'.
After performing an examination and taking a patient history, Dr Shari Lipner, director of the nail division, determined that the most likely cause of the nail plate shedding, a condition called onychomadesis, was a so-called "fish pedicure" that the woman had received - yes, you guessed it - about six months previously.
"This is not uncommon in women with a Greek foot ... who wear high heels and pinpointed shoes", Tosti said, referring to feet whose second toes are longer than the first, like Greek statues.
There have even been two recorded cases of serious staph infections tied to fish pedicures, Lipner noted.
Fish pedicures involve having small fish nibble at your feet while they're soaked in a tub of warm or room temperature water. It's a typical byproduct of hand-foot-and-mouth disease, a viral infection common in children that appears as a rash on the hands and feet, so it's unclear how the infection was spread through the fish pedicure.
Lipner said the woman's nails may grow back - but it'll take as long as 18 months. Lipner was not able to identify the fish species involved in this case. They hit their peak in popularity in the U.S. around a decade ago, but have since been banned in at least 10 states, including NY, largely because of health concerns.
"We did have some concerns about the welfare of these animals being transported around the world, often by people with limited experience", he said.
Several spas in the USA and Canada offer fish pedicures but they are controversial.