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Frontiers in Pediatrics 2022Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood as it represents approximately 5% of the whole Juvenile Idiopathic Arthritis (JIA)... (Review)
Review
Juvenile psoriatic arthritis (JPsA) is a relatively rare condition in childhood as it represents approximately 5% of the whole Juvenile Idiopathic Arthritis (JIA) population. According to International League of Associations of Rheumatology (ILAR) classification, JPsA is defined by the association of arthritis and psoriasis or, in the absence of typical psoriatic lesions, with at least two of the following: dactylitis, nail pitting, onycholysis or family history of psoriasis in a first-degree relative. However, recent studies have shown that this classification system could conceal more homogeneous subgroups of patients differing by age of onset, clinical characteristics and prognosis. Little is known about genetic factors and pathogenetic mechanisms which distinguish JPsA from other JIA subtypes or from isolated psoriasis without joint involvement, especially in the pediatric population. Specific clinical trials testing the efficacy of biological agents are lacking for JPsA, while in recent years novel therapeutic agents are emerging in adults. In this review, we summarize the clinical features and the current evidence on pathogenesis and therapeutic options for JPsA in order to provide a comprehensive overview on the clinical management of this complex and overlapping entity in childhood.
PubMed: 35722498
DOI: 10.3389/fped.2022.884727 -
Current Opinion in Pediatrics Aug 2020Nail disorders represent an uncommon subset of complaints seen in pediatric dermatology. There is a wide array of disorders that can affect the nail unit in children,... (Review)
Review
PURPOSE OF REVIEW
Nail disorders represent an uncommon subset of complaints seen in pediatric dermatology. There is a wide array of disorders that can affect the nail unit in children, including infectious, inflammatory, neoplastic, congenital, and traumatic processes. In order to enhance familiarity with pediatric nail conditions, we review the background and treatment of the more common entities seen in pediatric onychology, including onychomycosis, onychomadesis, nail psoriasis, trachyonychia, longitudinal melanonychia, onychophagia, and onychocryptosis.
RECENT FINDINGS
Nail involvement in pediatric patients with psoriasis may indicate increased risk for both overall disease severity and the development psoriatic arthritis. In the evaluation of longitudinal melanonychia, the clinical findings that raise concern for subungual melanoma in adults are often found in benign nail unit nevi in children. In the systemic treatment of pediatric onychomycosis, new data raises the possibility that laboratory monitoring may be approached differently. In the approach to onychophagia, emerging pharmacotherapies include N-acetylcysteine.
SUMMARY
Most nail disorders in pediatric patients have an overall favorable prognosis. However, nail abnormalities can lead to patient and parental anxiety, decreased quality of life, pain, and functional impairment. Clinicians should be aware of these more common diverse entities in order to identify them and apply state of the art management for these issues. Additionally, the reader will learn factors related to these nail disorders, which may require systemic work-up and/or specialist referral.
Topics: Adult; Animals; Child; Humans; Melanoma; Nail Diseases; Onycholysis; Onychomycosis; Presbytini; Psoriasis; Quality of Life
PubMed: 32692049
DOI: 10.1097/MOP.0000000000000921 -
Skin Appendage Disorders May 2017Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation of many nail disorders. In daily... (Review)
Review
Nail dermoscopy was initially used only in the assessment of nail pigmentation, but now it is widely utilized for the evaluation of many nail disorders. In daily practice, dermoscopy may confirm clinical diagnoses and guides in the management of nail diseases and treatments, permitting a better visualization of symptoms. Dry dermoscopy is required for evaluation of the nail plate surface, while gel as an interface is necessary for assessment of nail pigmentation and onycholysis, as well as for the evaluation of the distal nail margin. In this review, we describe the dermoscopic features of the most important nail disorders, looking at the different areas of the nail. Dermatoscopic changes that usually accompany specific nail diseases are also reviewed.
PubMed: 28560217
DOI: 10.1159/000458728 -
Dermatology Online Journal Dec 2014A patient with Ollier disease presenting with onycholysis and nail dystrophy related to a subungual enchondroma is presented.
A patient with Ollier disease presenting with onycholysis and nail dystrophy related to a subungual enchondroma is presented.
Topics: Adult; Enchondromatosis; Fingers; Humans; Male; Nails; Onycholysis
PubMed: 25756487
DOI: No ID Found -
Skin Appendage Disorders Apr 2024The growing demand for natural treatments has raised concerns among clinicians due to limited scientific evidence supporting their use. This review article addresses the... (Review)
Review
The growing demand for natural treatments has raised concerns among clinicians due to limited scientific evidence supporting their use. This review article addresses the issue by assisting dermatologists and general practitioners in recommending natural treatments for the following common nail disorders: nail brittleness, onychomycosis, periungual verrucae, paronychia, chloronychia, nail psoriasis, nail lichen planus, onychocryptosis, onycholysis, and congenital malalignment of the great toenail. One limitation is the scarcity of existing reviews on natural treatment options for nail disorders in the literature. Through a comprehensive review of existing literature, this article consolidates the available evidence on natural treatment options for these conditions. Although some natural treatments for nail disorders are supported by scientific evidence, the indiscriminate use of such remedies may lead to severe poisoning and health problems. Given the widespread and increasing use of natural treatments, clinicians play a pivotal role in educating patients about evidence-based remedies and debunking misleading claims. By doing so, clinicians can enhance patient safety and improve treatment outcomes. It is essential for healthcare professionals to be well-informed and equipped with the knowledge to differentiate between effective natural treatments and unverified claims, ensuring that patients receive appropriate care.
PubMed: 38572187
DOI: 10.1159/000534629 -
Taiwanese Journal of Obstetrics &... Sep 2019Nail change after chemotherapy is relatively unfamiliar with gynecological oncologist. It often occurs after docetaxel treatment. For gynecological tract cancers,...
OBJECTIVE
Nail change after chemotherapy is relatively unfamiliar with gynecological oncologist. It often occurs after docetaxel treatment. For gynecological tract cancers, paclitaxel might be most frequently used but nail change after paclitaxel treatment is seldom reported before.
CASE REPORT
Two patients treated with the postoperative dose-dense weekly schedule of paclitaxel 80 mg/m plus cisplatin 20 mg/m every three weeks were complicated with nail problems during the treatment. They included onycholysis, subungual hemorrhage, proximal white subungual collections of pus obscuring the lunula (onychophosis), dystrophy, Beau's lines, pigmentation, and melanonychia. Topical use of anti-fugal cream and oral antibiotics stopped the nail disease progression and both patients had completed their chemotherapy without interruption.
CONCLUSION
Clinicians should be aware of paclitaxel-induced nail toxicities. Adequate information, detailed preventive intervention, and early use of prophylactic and/or therapeutic agents to minimize the occurrence of severe morbidity, such as cellulitis and subsequent sepsis is important for women who need the continuous dose-dense paclitaxel chemotherapy.
Topics: Adult; Antineoplastic Agents, Phytogenic; Carcinoma; Female; Humans; Middle Aged; Nail Diseases; Ovarian Neoplasms; Paclitaxel
PubMed: 31542098
DOI: 10.1016/j.tjog.2019.07.023 -
Dermatologic Clinics Apr 2015"Nails protect the fingertips and toes. Diseases affecting the nail can cause cosmetic disfigurement and social embarrassment. Physical functioning may be impaired.... (Review)
Review
"Nails protect the fingertips and toes. Diseases affecting the nail can cause cosmetic disfigurement and social embarrassment. Physical functioning may be impaired. Disorders of the nail bed may cause pain or create difficulty grasping fine objects. The nail bed is the area beneath the nail plate between the lunula and the hyponychium. Disorders of the nail bed can cause onycholysis, subungual hyperkeratosis, and/or onychogryphosis. Ventral pterygium is less common. Tumors of the nail bed are rare and commonly missed."
Topics: Abnormalities, Multiple; Contracture; Facies; Glaucoma; Glomus Tumor; Humans; Keratosis; Melanoma; Nail Diseases; Nails, Malformed; Onycholysis; Skin Neoplasms
PubMed: 25828715
DOI: 10.1016/j.det.2014.12.006 -
The Journal of Dermatology Mar 2021Pathogenesis of palmoplantar pustulosis (PPP) is not fully understood and whether PPP is a variant of plaque psoriasis (PsO) is still controversial. Psoriatic nail...
Pathogenesis of palmoplantar pustulosis (PPP) is not fully understood and whether PPP is a variant of plaque psoriasis (PsO) is still controversial. Psoriatic nail changes are among the clinical features common to both diseases, and understanding them could lead to the understanding of the correlation between both diseases. However, only limited numbers of studies have reported nail involvement pattern in PPP. In this study, we conducted a retrospective review of the medical records and photographs of patients diagnosed with PPP to understand the nail involvement features in PPP patients. We compared the results with the data from our previous study that analyzed the pattern of nail involvement in PsO. As a result, nail involvement was observed in 66.3% of the patients and its severity was correlated with the severity of cutaneous lesions (r = 0.34, P = 0.01). Onycholysis and crumbling were more frequent in PPP than in PsO. Crumbling was associated with higher severity of PPP (P = 0.01), while onycholysis was associated with lower severity (P = 0.03). In PPP, nail changes in the first digits were less prominent than those in other digits when compared with PsO. Risk factors for nail involvement in PPP included female sex (odds ratio [OR] = 9.44, P < 0.001), younger age at diagnosis (OR = 1.08, P = 0.01), and higher severity (OR = 1.15, P = 0.01). Presence of psoriatic arthritis did not show significant association with nail involvement (OR = 1.62, P = 0.77). In conclusion, although PPP shares some nail features with PsO, differences were noted in the commonly observed features and in the distribution of involved nails.
Topics: Arthritis, Psoriatic; Female; Humans; Nail Diseases; Nails; Psoriasis; Retrospective Studies
PubMed: 33305841
DOI: 10.1111/1346-8138.15716 -
Dermatologic Clinics Oct 2018Onychoscopy is the examination of the nail unit using a dermoscope. The dermoscopic criteria for a valid diagnosis have been developed and assessed in numerous papers.... (Review)
Review
Onychoscopy is the examination of the nail unit using a dermoscope. The dermoscopic criteria for a valid diagnosis have been developed and assessed in numerous papers. However, in all nail alterations that are suspicious or potentially malignant, a surgical intervention with subsequent histopathological evaluation should be performed. A simple visualization may not be helpful in diagnosing many nail conditions nor is a nail biopsy diagnostic in all cases. Onychoscopy is a valuable aid in enhancing visible nail features and in revealing cryptic features of diagnostic value.
Topics: Dermoscopy; Humans; Hyperpigmentation; Melanoma; Nail Diseases; Onycholysis; Skin Neoplasms
PubMed: 30201152
DOI: 10.1016/j.det.2018.05.010 -
Journal of Fungi (Basel, Switzerland) Feb 2022The relationship between psoriasis and onychomycosis is controversial, and the exact nature of this association remains to be clearly elucidated. In healthy nails, the... (Review)
Review
The relationship between psoriasis and onychomycosis is controversial, and the exact nature of this association remains to be clearly elucidated. In healthy nails, the compact nail plate acts as a barrier, preventing any infection. In psoriatic nails, the nail plate involvement, together with abnormalities in the blood capillaries, may lead to decreased natural defenses against microorganisms. Moreover, onycholysis (detachment of the nail plate) induces a humid environment that may favor fungal proliferation. Treatment with immunosuppressive drugs may additionally enhance onychomycosis. In this comprehensive review, we present data regarding the incidence and pathogenic action of dermatophytes and other fungi in the development of fungal infection in psoriatic nails.
PubMed: 35205908
DOI: 10.3390/jof8020154