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Indian Journal of Dermatology 2021
PubMed: 33911309
DOI: 10.4103/ijd.IJD_325_19 -
Clinical Rheumatology Jul 2020
Topics: Child; Family; Humans; Mucocutaneous Lymph Node Syndrome; Nail Diseases
PubMed: 32333298
DOI: 10.1007/s10067-020-05100-9 -
Skin Appendage Disorders Jan 2022Onychomadesis occurs when the nail plate separates from the nail matrix and nail bed, eventually leading to shedding of the nail. This condition has been attributed to...
INTRODUCTION
Onychomadesis occurs when the nail plate separates from the nail matrix and nail bed, eventually leading to shedding of the nail. This condition has been attributed to viral infections, autoimmune disorders, drug side effects, and physical trauma. A subset of patients has a recurrent form of onychomadesis without a clear trigger; this phenomenon is not well characterized in the literature.
CASE PRESENTATION
We present a case series of pediatric and adult patients with recurrent toenail onychomadesis in order to better characterize the disorder and explore possible etiologies, risk factors, and treatments.
DISCUSSION/CONCLUSION
For the cases herein, we propose microtrauma associated with footwear as the underlying etiology given the periodicity of nail shedding, exclusion of other etiological factors, and presence of predisposing risk factors in certain patients. Many patients saw improvement with application of urea 40% cream, suggesting this can be a valuable part of a treatment strategy, in addition to minimizing injury to involved digits.
PubMed: 35118126
DOI: 10.1159/000519016 -
Indian Journal of Dermatology 2020Nail toxicity is a relatively uncommon cutaneous adverse effect of chemotherapeutic agents. Rapidly dividing cells of the nail matrix are perturbed by the antimitotic...
INTRODUCTION
Nail toxicity is a relatively uncommon cutaneous adverse effect of chemotherapeutic agents. Rapidly dividing cells of the nail matrix are perturbed by the antimitotic activity of these agents. Although most of these changes are cosmetic and regress once the therapy is completed, a few of these adverse effects are challenging to manage and require temporary or permanent suspension of chemotherapeutic agents.
MATERIALS AND METHODS
A total of 205 patients with various malignancies and under chemotherapy in oncology ward of the hospital over a period of 3 months were screened for nail involvement postchemotherapy. Relevant details, protocol of chemotherapeutic agents were assessed. Nail examination was carried out in daylight and the changes were analyzed.
RESULTS
A total of 124 (60.4%) patients had nail changes due to chemotherapeutic agents. The most common change was diffuse hyperpigmentation in 101 (81.4%) patients commonly due to a combination of cyclophosphamide and adriamycin in 43 (42.5%) patients. Longitudinal melanonychia was seen in 36 (29%), Beau's lines in 31 (25%), onychomadesis in 17 (13.7%), Mees' lines in 15 (12%), paronychia in 12 (9.6%), subungual hyperkeratosis in 10 (8%), and Muehrcke's lines in 4 (3.2%) patients. All the patients who developed Muehrcke's lines were on a combination of cyclophosphamide/doxorubicin/5 FU. Exudative onycholysis was observed in 2 (1.6%) patients; both these patients were on paclitaxel therapy. A total 2 (1.6%) patients who developed exudative onycholysis were advised discontinuation and another substitute chemotherapy was advised. Therapy for 2 (1.6%) patients who developed acute paronychia due to gefitinib was temporarily suspended. Unfortunately, most of the patients were on multiple chemotherapeutic agents hence, we could not pinpoint one drug as a cause. Therefore, a combination of agents was implicated in most cases.
CONCLUSION
Nail toxicities are common with chemotherapeutic agents, however less importance is given to nail involvement. Apart from being cosmetically significant, a few adverse effects may warrant modification of the chemotherapy.
PubMed: 32565559
DOI: 10.4103/ijd.IJD_37_19 -
Veterinary Dermatology Oct 2019Symmetrical lupoid onychomadesis (SLO) is a disease not infrequently seen in bearded collie dogs in Germany.
BACKGROUND
Symmetrical lupoid onychomadesis (SLO) is a disease not infrequently seen in bearded collie dogs in Germany.
OBJECTIVES
The aim of this study was to compare historical and clinical data, as well as the mineral content of the hair and claws of bearded collies with SLO with that of normal control dogs.
ANIMALS
Twenty-eight affected bearded collie dogs and 39 control dogs.
METHODS AND MATERIALS
Owners completed an extensive questionnaire regarding upbringing, environmental conditions and diets. Claw specimens were obtained by claw trimming or gathering lost claws; hairs were obtained by plucking samples from several areas of the body; samples were converted to ash and evaluated in an atomic absorption spectrophotometer.
RESULTS
Clinical signs in affected dogs eventually involved all claws on all paws. In twelve dogs recurrence of onychomadesis was observed. There was no relevant association between gender, housing, diet and health management, physical stress and the development of SLO with exception of the age at which more intense exercise began. The most commonly used treatment combination was fatty acids, pentoxifylline and tetracycline; improvement occurred in 17 animals. Calcium, sodium and phosphorus concentrations were higher in the claws of affected dogs, whereas zinc concentrations were lower. The mineral content of hair samples of the affected dogs was not significantly different than controls.
CONCLUSION AND CLINICAL IMPORTANCE
Symmetrical lupoid onychomadesis in bearded collies is clinically similar to what has been described in other breeds with regard to clinical signs and response to treatment. Early strenuous activity may increase the risk for disease occurrence in this breed.
Topics: Animals; Dog Diseases; Dogs; Female; Male; Nail Diseases; Nails, Malformed
PubMed: 31328335
DOI: 10.1111/vde.12779 -
Journal of Medical Virology Dec 2023An increasing number of studies have reported that atypical hand, foot, and mouth disease (HFMD) is becoming a new concern for children's health. At present, there is no...
An increasing number of studies have reported that atypical hand, foot, and mouth disease (HFMD) is becoming a new concern for children's health. At present, there is no official definition for atypical HFMD, but some studies have defined that it occurs at anatomic sites not listed in the definition of HFMD issued by the World Health Organization. Several pathogens have been reported to cause atypical HFMD, such as Coxsackievirus (CV)A6. As one of the most prevalent enteroviruses in the world, CVA6 seems to affect a wider range of children and causes more severe and prolonged illness than other enteroviruses. The early lesions of atypical HFMD are very similar to the clinical presentations of other diseases, such as eczema, which poses a challenge for clinicians aiming to identify and diagnose HFMD in a timely manner. Here, we report on six atypical HFMD patients caused by recombinant CVA6 variants, and the atypical manifestations include eczema coxsackium, large herpes, rice-like red papules and herpes, purpuric rash, and onychomadesis, as well as and large red herpes on scalp, perianal, testicles, shoulders and neck, and other atypical eruption sites, hoping to draw the attention of other pediatricians. This study will provide scientific guidance for timely diagnosis of HFMD to prevent serious complications.
Topics: Child; Humans; Hand, Foot and Mouth Disease; Phylogeny; Enterovirus; China; Eczema; Antibodies, Viral; Exanthema
PubMed: 38103032
DOI: 10.1002/jmv.29316 -
BMC Infectious Diseases Nov 2019In 2017, an outbreak of onychomadesis occurred in kindergarten H, Hubei province, China. We investigated the field to learn about the magnitude and reason of the...
BACKGROUND
In 2017, an outbreak of onychomadesis occurred in kindergarten H, Hubei province, China. We investigated the field to learn about the magnitude and reason of the outbreak.
METHODS
The case definition was that a child with onychomadesis or transverse ridging (Beau's line) in fingernails and toenails without previous traumatic or systemic disease in kindergarten H from Sep. 1st to Nov. 30th, 2017. A retrospective cohort study was carried out to analyze the epidemiological relationship between onychomadesis and the hand-foot-mouth disease (HFMD) in Primary Class #2, kindergarten H. We also performed a serological survey for neutralizing antibodies against coxsackie virus A6 (CVA6), coxsackie virus A10 (CVA10) among 15 cases and six healthy children in the kindergarten. Meanwhile, some children were carried out with routine blood, fungal microscopic and microelement tests. Indoor environment examinations had been done for all classes.
RESULTS
A total of 20 cases were identified in Kindergarten H. Seventy-five percent (15/20) cases occurred in Primary Class #2. Fifty-five percent of the cases (11/20) had suffered from HFMD within two months. The median time between onychomadesis and HFMD was 45 days (ranging from 31 to 58 days). A retrospective cohort study in Primary Class #2 showed the attack rate was 90.0% among 10 children who suffered from HFMD in the past two months compared to 30.0% among 20 children who didn't (Rate Ratio [RR] =3.0, 95% Confidence Interval [CI] =1.5-6.0). The positive rates of neutralizing antibodies were 66.7% for CVA6 and 26.7% for CVA10 in tested cases. The result of routine blood, fungal microscopic, microelements tests were normal in cases. The indicators of environment were within the normal range.
CONCLUSION
The results of this study suggested that the outbreak of onychomadesis in Hubei province was probably associated with HFMD epidemic within two months.
Topics: Antibodies, Neutralizing; Antibodies, Viral; Child, Preschool; China; Disease Outbreaks; Enterovirus A, Human; Female; Hand, Foot and Mouth Disease; Humans; Incidence; Male; Nail Diseases; Retrospective Studies; Schools
PubMed: 31771520
DOI: 10.1186/s12879-019-4560-8 -
The Journal of Dermatology Feb 2022Kawasaki disease (KD) is vasculitis of unknown etiology in infants and young children. The diagnostic criteria for KD include major and minor symptoms, but various nail... (Review)
Review
Kawasaki disease (KD) is vasculitis of unknown etiology in infants and young children. The diagnostic criteria for KD include major and minor symptoms, but various nail lesions are not described in detail. The aim of this study was to identify symptoms that are relatively found in nail of KD as diagnostic markers. After literature review, various nail lesions are classified as Beau's lines, leukonychia, onychomadesis, orange-brown chromonychia, and pincer nail deformity. The orange-brown chromonychia is the most common nail lesion in KD. In this study, the authors found three cases of KD with orange-brown chromonychia; two of these cases included rare dotted or splinter hemorrhages in the nail bed that were found on dermoscopic examination. The authors propose that these nail lesions, including hemorrhage of the nail bed, could be included as a helpful diagnosis of KD.
Topics: Child; Child, Preschool; Humans; Mucocutaneous Lymph Node Syndrome; Nail Diseases; Nails
PubMed: 34918369
DOI: 10.1111/1346-8138.16276 -
Journal of the American Academy of... Dec 2020Carpal tunnel syndrome (CTS) is commonly seen by general practitioners and often presents with neurologic symptoms of nocturnal pain and paresthesia along the median... (Review)
Review
Carpal tunnel syndrome (CTS) is commonly seen by general practitioners and often presents with neurologic symptoms of nocturnal pain and paresthesia along the median nerve distribution. Approximately 20% of patients also present with cutaneous findings (ulcerations, blistering, sclerodactyly, nail dystrophy) characterizing a severe form called necrotic CTS. Necrotic CTS can also be associated with bone changes (acro-osteolysis). In the author's practice, combined nail and skin findings are not an uncommon presentation of CTS, although this form remains overlooked and underreported in the dermatological textbooks and studies. This manuscript aims to review the literature on CTS cases, with a specific focus on using associated nail findings as diagnostic clues. The literature review along with a few additional recent cases from the author's practice demonstrate that CTS is frequently accompanied by a variety of nail changes including koilonychia, longitudinal fissuring, Beau's lines, onychomadesis, melanonychia, nail thickening, hyperkeratosis, and ischemic ulcerations with paronychia. Furthermore, when these changes are limited to the second and third fingernails, they should prompt the diagnosis of CTS. Once suspected, diagnostic evaluation is not difficult and surgical management can resolve cutaneous findings and prevent irreversible changes such as acro-osteolysis.
Topics: Administration, Topical; Carpal Tunnel Syndrome; Decompression, Surgical; Fingers; Glucocorticoids; Humans; Injections, Intralesional; Median Nerve; Nails; Nails, Malformed; Necrosis; Nitroglycerin; Severity of Illness Index; Splints; Treatment Outcome
PubMed: 32199899
DOI: 10.1016/j.jaad.2020.03.023 -
Skin Appendage Disorders Nov 2022Cuticle reduction and removal techniques are commonly performed by nail technicians for nail cosmesis. However, manipulation of the nail cuticle can lead to localized...
INTRODUCTION
Cuticle reduction and removal techniques are commonly performed by nail technicians for nail cosmesis. However, manipulation of the nail cuticle can lead to localized infection and nail dystrophy.
CASE PRESENTATION
In this case, a 20-year-old woman from the Philadelphia area in the USA presented with onychomadesis secondary to acute paronychia following a "Russian" manicure. In this technique, an electronic filer is used to completely remove the cuticle, leaving the proximal nail fold exposed and vulnerable.
CONCLUSION
As this style of manicure is being inaccurately publicized as safe, it is important that dermatologists are aware of this technique and educate our patients about its potential for harm.
PubMed: 36407651
DOI: 10.1159/000525023