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Kansas Journal of Medicine 2023
PubMed: 38298386
DOI: 10.17161/kjm.vol16.21033 -
Skin Appendage Disorders Feb 2024Nail unit infestation by scabies mites (ungual scabies) is uncommon. It usually presents with distal subungual lesions, leading to recurrent and persistent disease by...
INTRODUCTION
Nail unit infestation by scabies mites (ungual scabies) is uncommon. It usually presents with distal subungual lesions, leading to recurrent and persistent disease by acting as a reservoir of infection. Periungual involvement in scabies with nail loss is rare and may lead to severe nail damage.
CASE PRESENTATION
We report a 14-year-old boy on chemotherapy for acute lymphocytic leukemia (ALL) who presented with extensive scaling and crusted plaques of scabies. Nail unit revealed periungual crusted plaques with paronychia and onychomadesis involving five digits. It was associated with partial to complete nail loss. Dermoscopy of periungual crusted plaques showed greyish-white scales with brown dots and globules. A sinuous burrow with a brown-triangular structure was visualized in the web space. KOH mount from skin scrapings showed the scabies mites. Treatment of scabies led to a marked improvement.
CONCLUSION
Though ungual scabies is generally a benign disease, proximal periungual involvement with damage to nail matrix is possible, leading to nail loss. We review manifestations of nail unit scabies reported in literature. Treatment options used and outcomes are also analyzed. The importance of nail-directed therapy in preventing relapses of scabies cannot be undermined.
PubMed: 38318430
DOI: 10.1159/000533881 -
Journal of the European Academy of... Sep 2022
Topics: COVID-19; Chilblains; Humans; Nail Diseases; Nails, Malformed; SARS-CoV-2
PubMed: 35535454
DOI: 10.1111/jdv.18208 -
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 -
Dermatologic Therapy Nov 2020
Topics: Antiviral Agents; COVID-19; Female; Humans; Middle Aged; Nail Diseases; Risk Factors; SARS-CoV-2; Skin Diseases, Viral; COVID-19 Drug Treatment
PubMed: 32935910
DOI: 10.1111/dth.14309 -
Journal of the European Academy of... Sep 2019Very few studies have been conducted to establish the nature and prevalence of nail disorders in children.
BACKGROUND
Very few studies have been conducted to establish the nature and prevalence of nail disorders in children.
OBJECTIVES
To determine the frequency of various nail conditions in the paediatric setting and to report their management and follow-up.
METHODS
This was a retrospective study between 2007 and 2017 of children under 18. All the patients were evaluated in our paediatric nail clinic at the dermatology department of Queen Fabiola Children's University Hospital. The data were synthesized from information obtained through medical records as well as from photographs taken during consultation. Follow-up was completed by phone interview.
RESULTS
Three hundred and one patients were included. The majority of nail abnormalities involved the toenails (57.6%). The most common clinical signs were, in descending order, Beau's lines, pachyonychia, subungual hyperkeratosis and onycholysis. The most frequent diagnoses were fever-related Beau's lines or onychomadesis (9.7%), trachyonychia (8.4%), longitudinal melanonychia (8.1%) and congenital malalignment of the great toenail (8.1%). The main diagnoses by age group were as follows: congenital hypertrophy of the lateral nail folds (21.4%) [0-2 years old]; fever-related Beau's lines or onychomadesis (21%) [2-6 years old]; trachyonychia (22%) [6-12 years old]; and juvenile ingrown nail (21.4%) [12-18 years old]. Management included clinical observation for 119 patients and specific advices for 108 patients. A treatment was prescribed for 134 patients, topical in 76.5% of cases. Follow-up demonstrated complete healing in 50.6% of patients and improvement in 19.7%.
CONCLUSION
The most frequent nail disorders are benign, and their distribution varies with age. Management mainly involves conservative care, and the prognosis is favourable in the majority.
Topics: Adolescent; Belgium; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Male; Nail Diseases; Prevalence; Retrospective Studies
PubMed: 30835872
DOI: 10.1111/jdv.15542 -
Transplant International : Official... Oct 2020Upper extremity allotransplantation (UEA) is the more common type of vascularized composite allotransplantation of which more than 80 patients have benefited worldwide....
Upper extremity allotransplantation (UEA) is the more common type of vascularized composite allotransplantation of which more than 80 patients have benefited worldwide. These allografts include - along with the skin - the nail unit, a specialized epithelial appendage which may be the target of graft rejection. We report an UEA recipient who developed, as an initial manifestation of graft rejection, onychomadesis, that is shedding of the nail plate starting from the proximal nail bed. On this occasion, we reviewed the nail changes we have observed in a series of eight patients with UEA who were grafted and followed in our hospital since 1998 (mean follow-up period of 9.75 years). We also reviewed the relevant literature reporting nail changes in UEA recipients. A brief discussion on the significance of these changes in the context of UEA is provided with emphasis on onychomadesis, a finding usually related to graft rejection in this specific setting.
Topics: Allografts; Graft Rejection; Humans; Retrospective Studies; Upper Extremity; Vascularized Composite Allotransplantation
PubMed: 32621769
DOI: 10.1111/tri.13689 -
Cureus Jul 2021Syphilis is a sexually transmitted disease caused by the spirochetal bacteria . It can cross the blood-brain barrier within days of the infection, causing neurosyphilis...
Syphilis is a sexually transmitted disease caused by the spirochetal bacteria . It can cross the blood-brain barrier within days of the infection, causing neurosyphilis and ocular syphilis at any stage of the disease. Ocular syphilis can manifest in any part of the eye but usually as posterior uveitis and pan-uveitis or various types of inflammatory or immune-mediated optic neuritis. Misdiagnosing ocular syphilis as a non-infectious disease has been reported even when seen by ophthalmologists due to the wide variety of possible presentations. In this case report, we describe a case of ocular syphilis that presented with a non-arteritic anterior ischemic optic neuropathy (NA-AION), which to our knowledge, has not been described before in the literature.
PubMed: 34466324
DOI: 10.7759/cureus.16694 -
Journal Der Deutschen Dermatologischen... Dec 2023
PubMed: 38082509
DOI: 10.1111/ddg.15253_g -
British Journal of Clinical Pharmacology Aug 2022Sézary syndrome is a systemic variant of cutaneous T-cell lymphoma characterized by erythroderma, lymphadenopathy and circulating atypical lymphocytes (Sézary cells)....
Sézary syndrome is a systemic variant of cutaneous T-cell lymphoma characterized by erythroderma, lymphadenopathy and circulating atypical lymphocytes (Sézary cells). It may present with nonspecific lesions on multiple digits. We describe an atypical case of brentuximab-induced splinter nail haemorrhages in a patient with Sézary syndrome, associated with a poor prognosis during follow-up. Concomitantly with the appearance of nail lesions, significant lymphocytosis was detected as well as infiltration of bone marrow and nail matrices. The lesions followed a precise sequence, which can be traced back to the monthly application of brentuximab and its direct cytotoxic effect on CD30+ T lymphocytes in the nail matrix. Brentuximab-induced nail lesions might be associated with decreased efficacy of brentuximab in this patient with advanced cutaneous T-cell lymphoma.
Topics: Antibodies, Monoclonal; Antineoplastic Agents; Hemorrhage; Humans; Ki-1 Antigen; Sezary Syndrome; Skin; Skin Neoplasms
PubMed: 35088431
DOI: 10.1111/bcp.15247