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Indian Dermatology Online Journal 2020Leprosy is a disease primarily affecting skin and nerve. Nail involvement, although indirect, is observed in several patients. This is a study to determine the pattern...
INTRODUCTION
Leprosy is a disease primarily affecting skin and nerve. Nail involvement, although indirect, is observed in several patients. This is a study to determine the pattern of nail changes in leprosy.
METHODS
It was an observational study involving 125 patients. Apart from cutaneous and neurological examination, nails were examined. Diagnosis was confirmed by previous records in already diagnosed cases, while by slit skin smear and histopathologically in new cases. Patients were grouped as per Ridley-Jopling classification and further subdivided as per age, sex, and duration and reaction status. Nail changes in these groups were summarized and compared.
RESULTS
Overall prevalence of nail changes was 80% with 66.6% in TT patients, 79.4% in BT patients 50% in BB patients, 83.7% in BL patients and 84.3% in LL patients. Longitudinal melanonychia and longitudinal ridges were frequent finger nail changes with longitudinal melanonychia being more common among tuberculoid pole and longitudinal ridges among lepromatous pole. Brachyonychia, subungual hyperkeratosis and brown black pigmentation were frequent finger nail changes, with onychorrhexis being commonest among TT patients, subungual hyperkeratosis among BT patients, while brachyonychia among BL and LL patients. Anonychia and rudimentary nails were not found in tuberculoid pole. Beau's lines, terry nails, pterygium, pincer nail, and onychorrhexis were significantly more frequent in ENL patients. Onychomadesis, which is not reported yet in leprosy, was found in one patient after severe ENL.
CONCLUSION
Various changes in leprosy are due to multiple causes like neuropathic, traumatic, vascular, osseous, infections and drugs reflecting extensive systemic morbidity caused by Mycobacterium leprae.
PubMed: 32477978
DOI: 10.4103/idoj.IDOJ_172_19 -
The British Journal of Dermatology Aug 2017Cronkhite-Canada syndrome is an acquired inflammatory polyposis syndrome in which alopecia, onychomadesis and hyperpigmentation occur concurrently with gastrointestinal...
Cronkhite-Canada syndrome is an acquired inflammatory polyposis syndrome in which alopecia, onychomadesis and hyperpigmentation occur concurrently with gastrointestinal symptoms. The pathophysiology of alopecia in Cronkhite-Canada syndrome has not been definitively elucidated. We present evidence for alopecia areata incognita as a possible mechanism of hair loss.
Topics: Alopecia Areata; Anti-Inflammatory Agents, Non-Steroidal; Female; Glucocorticoids; Humans; Intestinal Polyposis; Mesalamine; Middle Aged; Pigmentation Disorders; Prednisolone; Syndrome; Vitamins
PubMed: 28029683
DOI: 10.1111/bjd.15293 -
Cureus Feb 2022A majority of pediatric outpatient practice involves managing familiar diseases that present in familiar ways. Occasionally, a familiar disease presents uniquely, which...
A majority of pediatric outpatient practice involves managing familiar diseases that present in familiar ways. Occasionally, a familiar disease presents uniquely, which adds a diagnostic challenge and enhances the clinical experience of the clinician. We describe an 18-month-old male who presented to the clinic with a familiar disease but with unique additional findings. The patient had a one-day history of rash, subjective fever, and several episodes of non-bloody diarrhea. The rash included petechial lesions across his abdomen, groin, back, arms, and legs, as well as vesicular lesions in the mouth and on the palms and soles. A tentative diagnosis of hand, foot, and mouth disease (HFMD) was made. However, the presence of petechiae prompted further laboratory evaluation, including a complete blood count (CBC) and comprehensive metabolic panel (CMP). The CBC was unremarkable, but the CMP revealed an abnormally high serum alkaline phosphatase (ALP) level of 1,353 U/L (normal range: 53-128 U/L). The patient was subsequently diagnosed with an atypical presentation of HFMD associated with transient hyperphosphatasemia (TH). TH is characterized by a benign increase in serum alkaline phosphatase levels with an absence of liver or bone diseases. TH is usually clinically silent. Clinicians should consider the possibility of TH in pediatric patients who are found incidentally to have an elevated ALP, especially with a concomitant viral infection. An awareness and understanding of TH will prevent unnecessary additional testing and avoid undue parental anxiety.
PubMed: 35295353
DOI: 10.7759/cureus.22066 -
Anales de Pediatria (Barcelona, Spain :... Apr 2015Due to the significant increase in the number of cases of hand, foot and mouth disease (HFMD) among pre-school children population during late 2011 and early 2012. A...
INTRODUCTION
Due to the significant increase in the number of cases of hand, foot and mouth disease (HFMD) among pre-school children population during late 2011 and early 2012. A study has been proposed with the aim of describing the HFMD outbreak and analyzing the risk factors associated with suffering onychomadesis.
PATIENTS AND METHODS
A descriptive and analytical case-control study was designed. The study population was 376 children between 6 and 36 months old, living in the Basic Health Catchment area of Peligros (Granada). The study inclued an epidemiological survey of 28 cases and paired controls in order to collect data on the time, person and place, and implementing preventive actions and family health education. Finally a microbiological viral study of stool samples was made.
RESULTS
There were 64% of girls with average age 20.8 months. The clinical signs fornd were, fever (75%), vesicular palmar eruption (71%), plantar eruption (68%), erosive stomatitis (64%), and nail loss (46%). The risk of getting sick was 14 times greater for those children attending a childcare centre and had contact with sick cases (OR 13.8; 95% CI; 3.79-50.18). The average time since onset of symptoms and onychomadesis was 52 days, and its appearance was linked to the presence of ulcers in mouth (P=.006). Five samples were positive to enteroviruses Coxsackie A16.
CONCLUSION
There was an outbreak of HFMD detected by pediatricians and families. The cases presented with marked clinical symptoms, and the nail loss (onychomadesis) generated a social alarm. The cause of the outbreak was an enterovirus Coxsackie A16 transmitted among sick cases and through childcare centres.
Topics: Case-Control Studies; Child, Preschool; Disease Outbreaks; Enterovirus; Female; Hand, Foot and Mouth Disease; Humans; Infant; Male; Nail Diseases; Spain
PubMed: 25027620
DOI: 10.1016/j.anpedi.2014.05.015 -
International Journal of Dermatology Feb 2023A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair...
BACKGROUND
A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection.
METHODS
This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined.
RESULTS
The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 ± 2.77 and 3.64 ± 3.04, respectively, in the hair loss group and were 5.77 ± 3.18 and 2.81 ± 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4-7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222-7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05).
CONCLUSION
The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19.
Topics: Male; Humans; COVID-19; Nail Diseases; Nails; Alopecia; Alopecia Areata; Nails, Malformed; Hair
PubMed: 36281828
DOI: 10.1111/ijd.16454 -
Case Reports in Pediatrics 2019Kawasaki disease is characterized by fever for ≥ five days, bilateral bulbar conjunctival injection without exudate, polymorphous rash changes in the extremities,...
Kawasaki disease is characterized by fever for ≥ five days, bilateral bulbar conjunctival injection without exudate, polymorphous rash changes in the extremities, oral mucosal changes, and cervical lymphadenopathy. We report a 20-month-old boy with Kawasaki disease who had onychomadesis affecting the fingernails and toenails bilaterally. To our knowledge, there were three reported cases of onychomadesis associated with Kawasaki disease, to which we add another one. We suggest keeping in mind the possibility of onychomadesis as a nail sequela of Kawasaki disease.
PubMed: 30944748
DOI: 10.1155/2019/3156736 -
Turk Pediatri Arsivi Jun 2017Valproic acid is an effective, frequently used anticonvulsant drug. Typical adverse effects include weight gain, hair loss, and nausea. Hyperpigmentation, onycholysis,...
Valproic acid is an effective, frequently used anticonvulsant drug. Typical adverse effects include weight gain, hair loss, and nausea. Hyperpigmentation, onycholysis, and onychomadesis are nail changes that can be seen after valproic acid use. Changes occur at the distal and proximal portions of the nail bed in onycholysis and onychomadesis, respectively. Onychomadesis is a very rare disease of childhood with the exception of systemic and genetic diseases. Here, we present a child aged 23 months, the youngest and the earliest isolated patient with onychomadesis, which occurred after valproic acid treatment and worried the family but resolved spontaneously. The improvement of this very rare adverse effect of antiepileptic drugs after cessation of valproic acid without treatment is emphasized.
PubMed: 28747841
DOI: 10.5152/TurkPediatriArs.2015.2630 -
BMC Pediatrics Aug 2018Coxsackievirus A6 (CVA6) is one of the major agents to cause hand, foot and mouth disease (HFMD) outbreaks globally. The objective of this study is to investigate the...
BACKGROUND
Coxsackievirus A6 (CVA6) is one of the major agents to cause hand, foot and mouth disease (HFMD) outbreaks globally. The objective of this study is to investigate the epidemiologic and clinical manifestations of CVA6 outbreak, and thus guide the diagnosis and treatment of the disease, as well as disease prevention.
METHODS
An HFMD outbreak in a kindergarten was reported to Shijingshan District Center for Disease Control and Prevention (SCDC) on November 2, 2015 in Beijing, China. Epidemiological investigation was conducted. We performed a nine-week follow-up study to collect and analyze the clinical manifestations of HFMD cases.
RESULTS
The outbreak yield 56 (15.7%) clinical diagnosed HFMD cases out of 357 registered children in the kindergarten with the mean age of 3.5 years old. This outbreak lasted for three days and ceased after initiating infectious disease controlling procedures, including periodical suspension of the kindergarten activities, environmental disinfection, and family health education. Fifty-one cases were followed for nine weeks. The positive rate of clinical manifestations of rash, fever, desquamation, pigmentation and onychomadesis were 100.0%, 84.3%, 68.6%, 17.6% and 43.1%, respectively. Children developed desquamation within the first 4 weeks after disease onset and developed onychomadesis between the 3th and 8th week after disease onset. Children with desquamation had 9.3 (95%CI: 1.836-47.437) times higher odds of developing onychomadesis compared to those without this manifestation. Ten out of 14 collected samples were CVA6 positive, and five positive samples shared a high degree of similarity in the VP1 nucleotide and amino acid sequences (99.9-100.0% and 100%).
CONCLUSION
This HFMD outbreak was caused by CVA6, featured with delayed symptoms. Emerging CVA6-associated HFMD and its delayed symptoms should be paid more attention to reduce outbreaks and provide more information to doctors and parents.
Topics: Beijing; Child; Child, Preschool; Disease Outbreaks; Disease Transmission, Infectious; Enterovirus; Female; Hand, Foot and Mouth Disease; Humans; Infection Control; Male; Nail Diseases; Phylogeny
PubMed: 30131060
DOI: 10.1186/s12887-018-1253-1 -
JAAD Case Reports Aug 2021
PubMed: 34235239
DOI: 10.1016/j.jdcr.2021.05.027 -
Skin Appendage Disorders Mar 2017Nail involvement in pemphigus vulgaris (PV) is an unusual clinical finding. The most common clinical manifestations include chronic paronychia and onychomadesis. We...
Nail involvement in pemphigus vulgaris (PV) is an unusual clinical finding. The most common clinical manifestations include chronic paronychia and onychomadesis. We report an adult female patient with PV who initially presented with chronic paronychia of multiple fingernails and toenails before the onset of vesiculobullous eruptions. Later on, after complete resolution, there was recurrence of pemphigus presenting as hemorrhagic paronychia of the left index finger. Systemic treatment with corticosteroids and azathioprine led to complete resolution of mucocutaneous lesions as well as nail manifestations. Thus, chronic treatment-resistant paronychia may be an early and important sign of generalized pemphigus in certain patients.
PubMed: 28611998
DOI: 10.1159/000455881