In the new case report, the young woman complained of six months of abnormal toenail growth. She had no history of toenail problems.
That's because we know that fishpedicures pose a risk of transmitting infections, as the fish are often used on more than one customer.
Months after her nails stopped growing and fell off, the woman went to visit her dermatologist, who ruled out other known causes of onychomadesis, including major illness or side effects from medications.
Garra rufa, or "doctor fish", pick dead skin from a spa visitor's feet in April 2006 in Hakone, Japan. The toothless carp fish - which are plant eaters - voraciously feast on dead human skin.
Fish pedicures have boomed since the first USA fish spa opened in Virginia in 2008, Lipner claims in the paper, due to what she calls "unfounded claims" that the treatment leaves feet smoother and less pungent, removes bacteria and fungus and increases circulation.
"While the mechanism of action is not entirely clear, it is likely due to the fish traumatising the nail matrix", Sheri Lipner, an assistant professor of dermatology at Columbia University's Weill Cornell Medicine and the woman's treating doctor, told Gizmodo via email.
"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. Spas can also mistake the toothy chinchin fish, which draws blood, for the doctor fish, further increasing the risk of infection, the Centers for Disease Control and Prevention said.
As for Lipner's patient, her nails will grow back, though it'll take time.
Fish pedicures involve having small fish nibble at your feet while they're soaked in a tub of warm or room temperature water. The most likely culprit, then, was the fish pedicure.
But while there's no way to know for sure what caused the patient's toenail issues, there have been some concerns about fish pedicures in the past.
While Lipner believes that the woman's problems stemmed from the physical impact of the fish biting at the nail, she noted that there have been past reports of infections associated with fish pedicures, too.
In the United Kingdom, an investigation was conducted by the UK's Fish Health Inspectorate discovered bacteria outbreak among the fish used in these spas. They hit their peak in popularity in the USA 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.
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Some of them have decided that they are joining the Lakers if the 14-time All-Star will be playing there next season. Sporting News' Sean Deveney reported James is willing to sign with the Lakers without a fully-constructed roster.
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It was never comfortable with the West being one bloc", said a European official involved in EU-China diplomacy. Containers are seen at the Yangshan Deep Water Port in Shanghai, China April 24, 2018.
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