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Wiener Medizinische Wochenschrift (1946) Sep 2023We report the case of a 67-year-old woman who developed onychomadesis on 9 of her fingers 2 months after recovering from COVID-19, with subsequent full nail regrowth...
We report the case of a 67-year-old woman who developed onychomadesis on 9 of her fingers 2 months after recovering from COVID-19, with subsequent full nail regrowth after 4 months. The development of onychomadesis in COVID-19 is probably related to inhibition of nail proliferation due to fever, direct viral damage, or an inflammatory process associated with endothelial damage and obliterative microangiopathy in the nail matrix area. Clinicians should be aware of nail changes and actively seek them out in patients with COVID-19.
Topics: Humans; Female; Aged; COVID-19; Nail Diseases; Fingers; Fever
PubMed: 36441360
DOI: 10.1007/s10354-022-00988-1 -
Acta Dermato-venereologica Oct 2023
Topics: Humans; Nail Diseases; Nails, Malformed
PubMed: 37902467
DOI: 10.2340/actadv.v103.18251 -
European Journal of Case Reports in... 2024In rare dermatology cases the differential diagnosis is challenging, e.g. when one nail is growing below another, the provisional diagnosis could be confusing. It may...
BACKGROUND
In rare dermatology cases the differential diagnosis is challenging, e.g. when one nail is growing below another, the provisional diagnosis could be confusing. It may present as chronic paronychia, candidiasis, bacterial infections, rheumatoid arthritis, psoriasis, subungual tumours, or cysts.
CASE DESCRIPTION
We present a case of iatrogenic rupture of the nails of both big toes following a commonly known recommendation from physiotherapists in the initial stages of hallux valgus or chronic arthritis by using kinesio tape to prevent the big toe from fixation in the valgus position. The initial provisional diagnosis of retronychia was revised, and a final diagnosis of onychomadesis was made. The patient's complaint was solved after around one year without any specific therapy.
CONCLUSION
The differential diagnosis for onychomadesis needs a careful and detailed history that may prevent a patient from a frightening diagnosis and painful, long-lasting treatments.
LEARNING POINTS
The differential diagnosis of retronychia, onychomycosis and onychomadesis is challenging.Both onychomadesis and retronychia share a common pathophysiologic mechanism.A careful and detailed history prevents a patient from a frightening diagnosis and painful, long-lasting treatment of nail disorders.
PubMed: 38455698
DOI: 10.12890/2024_004326 -
BMC Pharmacology & Toxicology Nov 2023Pertuzumab is widely used for the treatment of HER2 + breast cancer. But its safety in the real world should be continuously monitored. So, we evaluated the safety...
BACKGROUND
Pertuzumab is widely used for the treatment of HER2 + breast cancer. But its safety in the real world should be continuously monitored. So, we evaluated the safety of pertuzumab by pharmacovigilance analyze based on related adverse events (AEs) from the FDA Adverse Event Reporting System (FAERS) and find whether potential or uncertain adverse events were present.
METHODS
In disproportionality analysis, four algorithms were employed to detect the signals of pertuzumab from the FAERS between 2012 and 2022. In addition, we also used MYSQL 8.0, Navicat Premium 15, and Microsoft EXCEL 2019 to analyze the potential and high-ROR (reporting odds ratio) signals of pertuzumab. We also collected the onset times of pertuzumab-associated AEs.
RESULTS
From January 2012 to December 2022, there are 39,190,598 AEs reported from the FAERS database, of which 14,707 AEs listed pertuzumab as the 'primary suspected (PS)' drug. A total of 115 (46 potential) significant disproportionality preferred terms (PTs) conforming to the four algorithms were retained. Finally, we detected that the pertuzumab-induced AEs occurred in 12 organ systems. For pertuzumab, unexpected and significant PTs of AEs were found, including but not limited to below PTs: haematotoxicity, cardiotoxicity, cardiomyopathy, mitral valve incompetence, tachycardia, intestinal perforation, hemorrhoids, erysipelas, dehydration, pneumonitis, skin toxicity, onychomadesis, cyanosis, and circulatory collapse. We found there were 9 strong signals (5 potential safety signals) and 68 medium intensity signals (21 potential safety signals) according to IC (information component). The potential strong signals (IC > 3.0) were myelosuppression, cardiotoxicity, cardiac dysfunction, ejection fraction decreased, interstitial lung disease, and onychomadesis. Excluding unreported or unreasonable onset time reports, a total of 2016 AEs reported onset time and the median onset time was 117 days (4, 96), as median (Q1, Q3). Notably, most of the all AEs (n = 1133, 56%) and cardiac-related events (n = 405, 53%) all occurred within one month after pertuzumab therapy.
CONCLUSION
Analysis of FAERS data identified pertuzumab-associated AEs, and our findings supported continuous clinical monitoring, pharmacovigilance, and further studies of pertuzumab. A significant association was detected between pertuzumab and some potential adverse events which should be regarded with some care. We have to pay attention to the first month after pertuzumab therapy and prepare emergency measures, especially for the elderly and patients with cardiovascular diseases.
Topics: Humans; Aged; Female; Cardiotoxicity; Adverse Drug Reaction Reporting Systems; Antibodies, Monoclonal, Humanized; Pharmacovigilance; Breast Neoplasms
PubMed: 37957717
DOI: 10.1186/s40360-023-00702-w -
Acta Dermatovenerologica Alpina,... Dec 2023This review article focuses on cutaneous manifestations in schoolchildren and adolescents 6 to 18 years old connected with various aspects of the severe acute... (Review)
Review
This review article focuses on cutaneous manifestations in schoolchildren and adolescents 6 to 18 years old connected with various aspects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, including personal protective equipment (PPE), SARS-CoV-2 infection, and the SARS-CoV-2 vaccine. The use of PPE has been associated with mask-related acne due to microbiome dysbiosis and disruption of skin homeostasis, leading to the emergence of new acne or exacerbation of preexisting acne. Chilblain-like lesions, erythema multiforme-like eruptions, and cutaneous manifestations of multisystem inflammatory syndrome related to SARS-CoV-2 are the most commonly described skin manifestations of SARS-CoV-2 infection. The proposed mechanisms involve either the direct interaction of the virus with the skin through cutaneous receptor angiotensin-converting enzyme 2 in the epidermal basal layer or hyperactive immune responses. The impact of SARS-CoV-2 infection has also been described on adnexa, including hair changes such as alopecia areata and telogen effluvium, as well as nail changes presenting as onychomadesis and periungual desquamation. Cutaneous adverse effects of the SARS-CoV-2 vaccine have been described in case reports and differ from those in adults. Therefore, there is a need for increased awareness regarding the most prevalent cutaneous manifestations associated with COVID-19 in children because they tend to be mild or nonspecific in nature.
Topics: Adolescent; Child; Humans; Acne Vulgaris; Alopecia Areata; COVID-19; COVID-19 Vaccines; Pandemics; SARS-CoV-2; Skin Diseases
PubMed: 38126100
DOI: No ID Found -
Indian Journal of Dermatology,... May 2024
PubMed: 38841936
DOI: 10.25259/IJDVL_1269_2023 -
Cureus Jan 2024Hand, foot, and mouth disease (HFMD) is a viral illness that predominantly affects infants and children, causing blisters and sores on the hands, feet, and mouth....
Hand, foot, and mouth disease (HFMD) is a viral illness that predominantly affects infants and children, causing blisters and sores on the hands, feet, and mouth. Recurrence is rare, but a case in a six-year-old girl in Saudi Arabia was reported. A six-year-old girl presented with a rash on her palms and soles, which was preceded by a mild sore throat and low-grade fever. She had been in contact with her two-year-old sister, who had similar symptoms but a different rash pattern. During clinical examination, multiple erythematous deep-seated vesicles and papules were noted on the patient's palms and soles, with no involvement of mucous membranes or nails. The diagnosis of hand, foot, and mouth disease (HFMD) was made based on the characteristic clinical presentation, and the rash resolved within seven days without treatment or complications. The patient had experienced a similar presentation six months ago, which was also diagnosed as HFMD, and the rash had resolved spontaneously within one week. In her second episode, the rash was less severe, with milder prodromal symptoms. In both episodes, the lesions were asymptomatic and had no mucosal involvement. The patient had experienced onychomadesis after her first episode, but no nail abnormalities were seen after her second episode. Although HFMD is rare to recur in children, outbreaks can lead to another episode. HFMD prevalence is underestimated in Saudi Arabia due to missed mild cases. Pediatricians and dermatologists should be aware of HFMD incidence and its complications, as early detection is vital in preventing outbreaks and transmission.
PubMed: 38322079
DOI: 10.7759/cureus.51813 -
Kansas Journal of Medicine 2023
PubMed: 38298386
DOI: 10.17161/kjm.vol16.21033 -
Cureus Feb 2024Pemphigus vulgaris (PV) mainly causes blistering of the skin and mucous membranes, with nail unit involvement being rare. Nail involvement may serve as an indicator of...
Pemphigus vulgaris (PV) mainly causes blistering of the skin and mucous membranes, with nail unit involvement being rare. Nail involvement may serve as an indicator of disease severity. We present a case of a 20-year-old male with PV who had both cutaneous and nail findings, with nail changes corresponding with disease severity. The patient with biopsy-confirmed PV, on prednisone and mycophenolate, presented to the emergency department with an acute flare of PV and severe mandibular pain and lymphadenopathy. At follow-up in our outpatient department, the physical examination was significant for onychomadesis and onycholysis of the fingernails. Prednisone and mycophenolate dosages were increased, and rituximab infusions were initiated. Bullae and mucosal lesions resolved on the follow-up, and nail changes improved. This case appends an unusual perspective to the limited literature on PV-associated nail changes, especially in younger patients. It advocates for meticulous history taking and physical examination and supports a correlation between nail symptoms and PV disease severity.
PubMed: 38449993
DOI: 10.7759/cureus.53609