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Human Factors Sep 2023Spacesuits are designed to be reliable personal spacecraft that preserve the life and well-being of the astronaut from the extremes of space. However, materials,... (Review)
Review
OBJECTIVES
Spacesuits are designed to be reliable personal spacecraft that preserve the life and well-being of the astronaut from the extremes of space. However, materials, operating pressures, and suit design requirements often result in a risk of musculoskeletal discomfort and injury to various areas of the body. In particular, this investigation looked at fingernails and their risk of developing onycholysis.
METHODS
An onycholysis literature review was followed by a retrospective analysis of injury characteristics, astronaut suited training and spaceflight events, hand anthropometry, glove sizing, and astronaut demographics. Multiple logistic regression was used to assess the likelihood of onycholysis occurrence by testing potential risk variables against the dataset compiled from the retrospective data mining.
RESULTS
The duration of event exposure, type of glove used, distance (delta) between the fingertip and the tip of the glove, sex, and age were found to be significantly related to occurrence of onycholysis (whether protective or injurious).
CONCLUSION
An initial risk formula (model) for onycholysis was developed as a result of this investigation. In addition to validation through a future study, further improvement to this onycholysis equation and spacesuit discomfort and injury in general can be aided by future investigations that lead to better definition of the threshold between safe and risky exposure for each type of risk factor.
APPLICATION
This work described a potential method that can be used for EVA spacesuit glove onycholysis injury risk analysis for either iterative glove design or between glove comparisons, such as during a product downselect process.
Topics: Humans; Astronauts; Extravehicular Activity; Nails; Onycholysis; Retrospective Studies; Space Flight
PubMed: 34961336
DOI: 10.1177/00187208211062299 -
Acta Dermato-venereologica Sep 2021Nail dermoscopy (onychoscopy) is a valuable diagnostic tool for evaluating diseases in the nail apparatus. It is non-invasive, allowing clinicians to prioritize... (Review)
Review
Nail dermoscopy (onychoscopy) is a valuable diagnostic tool for evaluating diseases in the nail apparatus. It is non-invasive, allowing clinicians to prioritize particular nails for biopsy. Thus, it can improve diagnostic accuracy and expedite treatment. Evaluating inflammatory nail disorders using onychoscopy is a relatively new approach to clinical assessment and has the potential to augment clinical care. This review highlights key dermoscopic features of major inflammatory nail disorders, including trachyonychia, nail psoriasis, nail lichen planus, onychotillomania, nail lichen striatus and allergic contact dermatitis due to artificial nails. It also illustrates their management and differential diagnoses, including onychomycosis, onycholysis, nail dystrophy due to systemic amyloidosis and malignant nail tumours. Limitations of this review included the low amount of literature on this topic and non-standardized terminology used among research-ers. As onychoscopy is a relatively new technique, further studies and standardization of terminology are warranted to consolidate the role of dermoscopy in evaluating inflammatory nail disorders.
Topics: Humans; Lichen Planus; Nail Diseases; Nails; Onychomycosis; Psoriasis
PubMed: 34490472
DOI: 10.2340/00015555-3917 -
Clinical Obstetrics and Gynecology Mar 2015Physicians may often mistake normal physiological skin changes in pregnancy for pathologic changes, so being able to recognize the skin manifestations unique to... (Review)
Review
Physicians may often mistake normal physiological skin changes in pregnancy for pathologic changes, so being able to recognize the skin manifestations unique to pregnancy is of the utmost importance to avoid unnecessary testing and stress for the obstetric patient. Most physiological skin changes will resolve postpartum, so reassurance and expectant management is indicated in almost all cases.
Topics: Erythema; Female; Hair Diseases; Hemangioma; Hirsutism; Humans; Hyperpigmentation; Melanosis; Nail Diseases; Neurofibromatosis 1; Onycholysis; Pregnancy; Skin Neoplasms; Skin Physiological Phenomena; Striae Distensae; Varicose Veins
PubMed: 25517755
DOI: 10.1097/GRF.0000000000000077 -
Skin Appendage Disorders Apr 2021Acrokeratosis paraneoplastica (Bazex syndrome) is a rare paraneoplastic dermatosis associated with internal malignancies. Clinical presentation is characterized by... (Review)
Review
Acrokeratosis paraneoplastica (Bazex syndrome) is a rare paraneoplastic dermatosis associated with internal malignancies. Clinical presentation is characterized by erythematous or violaceous scaly plaques involving the digits, nose, ears, palms, and soles. Nail changes commonly present concurrently with cutaneous manifestations. In this review, we characterize nail changes associated with acrokeratosis paraneoplastica. A total of 48 cases were analyzed. Nail findings were nonspecific, with the most common being nail plate thickening, onycholysis, subungual hyperkeratosis, longitudinal ridging, discoloration, and nail plate loss. In most patients, nail changes involved the majority of fingernails and toenails and most often appeared prior to the diagnosis of malignancy. The most common associated underlying malignancies were squamous cell carcinomas of the head and neck. A diagnosis of acrokeratosis paraneoplastica should be considered in patients with onychodystrophy involving multiple nails with accompanying atypical psoriasiform dermatoses. Screening for internal malignancies may significantly decrease morbidity and mortality for these patients.
PubMed: 34055903
DOI: 10.1159/000513828 -
Psoriasis (Auckland, N.Z.) 2017Psoriasis is the skin disease that most frequently affects the nails. Depending on the very nail structure involved, different clinical nail alterations can be observed.... (Review)
Review
Psoriasis is the skin disease that most frequently affects the nails. Depending on the very nail structure involved, different clinical nail alterations can be observed. Irritation of the apical matrix results in psoriatic pits, mid-matrix involvement may cause leukonychia, whole matrix affection may lead to red lunulae or severe nail dystrophy, nail bed involvement may cause salmon spots, subungual hyperkeratosis, and splinter hemorrhages, and psoriasis of the distal nail bed and hyponychium causes onycholysis whereas that of the proximal nail fold causes psoriatic paronychia. The more extensive the involvement, the more severe is the nail destruction. Pustular psoriasis may be seen as yellow spots under the nail or, in case of acrodermatitis continua suppurativa, as an insidious progressive loss of the nail organ. Nail psoriasis has a severe impact on quality of life and may interfere with professional and other activities. Management includes patient counseling, avoidance of stress and strain to the nail apparatus, and different types of treatment. Topical therapy may be tried but is rarely sufficiently efficient. Perilesional injections with corticosteroids and methotrexate are often beneficial but may be painful and cannot be applied to many nails. All systemic treatments clearing widespread skin lesions usually also clear the nail lesions. Recently, biologicals were introduced into nail psoriasis treatment and found to be very effective. However, their use is restricted to severe cases due to high cost and potential systemic adverse effects.
PubMed: 29387608
DOI: 10.2147/PTT.S126281 -
Clinical Rheumatology Jul 2022Nail disease in psoriasis has been found to be associated with psoriatic arthritis (PsA); however, which subtype of nail disease holds greater relevance to PsA remains...
Nail disease in psoriasis has been found to be associated with psoriatic arthritis (PsA); however, which subtype of nail disease holds greater relevance to PsA remains unclear. This study was performed to explore the associations between three subtypes of fingernail disease (pitting, onycholysis, and hyperkeratosis) and PsA among patients with psoriasis. Patients with psoriasis attending five dermatology clinics in Shanghai between January 2020 and May 2021 were examined for skin, joint, and fingernail changes. Multivariate logistic regression analyses were utilized to test the strength of associations between subtypes of fingernail disease and PsA. The receiver operator characteristic (ROC) curve with area under curve (AUC) was used to evaluate their accuracies in diagnosing PsA. Sensitivity and specificity were also calculated. Of 1985 patients with psoriasis included, 228 (11.5%) patients were diagnosed with PsA, and the remaining patients were cutaneous-only psoriasis (PsC). One-hundred and fifty-seven (68.9%) patients with PsA and 748 (42.6%) patients with PsC had fingernail disease. Adjusted models showed that onycholysis and hyperkeratosis were the only type of fingernail disease independently associated with PsA. This association was further confirmed by the forward conditional stepwise regression model (OR, 95% CI for onycholysis: 2.34, 1.79 to 4.27, p < 0.01; for hyperkeratosis: 1.62, 1.12 to 2.66, p = 0.037). ROC analysis showed that, compared to pitting and hyperkeratosis, onycholysis had higher AUC (0.630) and sensitivity (52.6%). The psoriatic fingernail onycholysis and hyperkeratosis hold greater relevance to PsA than pitting. Clinically, psoriatic patients with fingernail onycholysis and hyperkeratosis should be assessed for arthritis. Key Points • Psoriatic fingernail onycholysis and hyperkeratosis, rather than pitting, are significantly associated with PsA • Clinically, psoriatic patients with fingernail onycholysis and hyperkeratosis should be assessed for arthritis.
Topics: Arthritis, Psoriatic; China; Humans; Keratosis; Nail Diseases; Nails; Onycholysis; Psoriasis; Severity of Illness Index
PubMed: 35182271
DOI: 10.1007/s10067-022-06107-0 -
Archives of Disease in Childhood. Fetal... Mar 2016
Topics: Humans; Infant, Newborn; Male; Onycholysis
PubMed: 26586734
DOI: 10.1136/archdischild-2015-309888 -
Australian Family Physician Mar 2016
Topics: Adult; Diagnosis, Differential; Humans; Male; Onycholysis; Onychomycosis; Psoriasis
PubMed: 27052048
DOI: No ID Found -
Giornale Italiano Di Dermatologia E... Dec 2016The authors describe a case of onychomycosis by Paecilomyces lilacinus in an 81-year-old Caucasian woman. The infection was characterized clinically by yellow-brown...
The authors describe a case of onychomycosis by Paecilomyces lilacinus in an 81-year-old Caucasian woman. The infection was characterized clinically by yellow-brown discoloration of the nail plate, distal-lateral onycholysis and subungual hyperkeratosis of the first left toenail. Microscopic examination showed irregular hyphae. Four cultures showed the development of lilac and powdery colonies. Conidiophores with divergent long narrow terminal phialides were observed at microscopic examination of culture samples. Therapy with amorolofine nail laquer, itraconazole and terbinafine was uneffective. This is the sixth case published in the literature of Paecilomyces lilacinus onychomycosis, and the second Italian case of Paecilomyces lilacinus infection.
Topics: Aged, 80 and over; Antifungal Agents; Female; Foot Dermatoses; Humans; Onychomycosis; Paecilomyces
PubMed: 27824223
DOI: No ID Found -
Clinics in Podiatric Medicine and... Oct 2021Disappearing nail bed (DNB) is a condition characterized by irreversible epithelialization of the nail bed following long-standing onycholysis. This phenomenon can occur... (Review)
Review
Disappearing nail bed (DNB) is a condition characterized by irreversible epithelialization of the nail bed following long-standing onycholysis. This phenomenon can occur in fingernails and toenails. Factors implicated in the development of DNB include trauma, manicuring, and onychotillomania and dermatologic conditions like psoriasis and dermatitis. Specifically for the toenail, contributing factors also include increasing age, history of trauma, surgery, onychomycosis, and onychogryphosis. A grading system that stages the progression of onycholysis to DNB has been proposed to aid clinicians in the diagnosis and treatment of these conditions. Several methods have been designated for the treatment of DNB.
Topics: Humans; Nail Diseases; Nails; Onycholysis; Onychomycosis; Psoriasis
PubMed: 34538429
DOI: 10.1016/j.cpm.2021.06.001