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Indian Journal of Dermatology,... May 2024
PubMed: 38841936
DOI: 10.25259/IJDVL_1269_2023 -
The Journal of Experimental Medicine Aug 2024Coxsackievirus A10 (CV-A10) infection, a prominent cause of childhood hand-foot-and-mouth disease (HFMD), frequently manifests with the intriguing phenomenon of...
Coxsackievirus A10 (CV-A10) infection, a prominent cause of childhood hand-foot-and-mouth disease (HFMD), frequently manifests with the intriguing phenomenon of onychomadesis, characterized by nail shedding. However, the underlying mechanism is elusive. Here, we found that CV-A10 infection in mice could suppress Wnt/β-catenin signaling by restraining LDL receptor-related protein 6 (LRP6) phosphorylation and β-catenin accumulation and lead to onychomadesis. Mechanistically, CV-A10 mimics Dickkopf-related protein 1 (DKK1) to interact with Kringle-containing transmembrane protein 1 (KRM1), the CV-A10 cellular receptor. We further found that Wnt agonist (GSK3β inhibitor) CHIR99021 can restore nail stem cell differentiation and protect against nail shedding. These findings provide novel insights into the pathogenesis of CV-A10 and related viruses in onychomadesis and guide prognosis assessment and clinical treatment of the disease.
Topics: Animals; Wnt Signaling Pathway; Low Density Lipoprotein Receptor-Related Protein-6; Mice; Intercellular Signaling Peptides and Proteins; Humans; beta Catenin; Nail Diseases; Nails; Cell Differentiation; Mice, Inbred C57BL; Hand, Foot and Mouth Disease; Phosphorylation; Coxsackievirus Infections; Glycogen Synthase Kinase 3 beta; Pyridines; Pyrimidines
PubMed: 38836810
DOI: 10.1084/jem.20231512 -
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 -
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 -
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 -
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 -
Kansas Journal of Medicine 2023
PubMed: 38298386
DOI: 10.17161/kjm.vol16.21033 -
Gan To Kagaku Ryoho. Cancer &... Dec 2023A 79-year-old man underwent a radical resection for cecal cancer. The pathological diagnosis was pT4a, N1a, M0, pStage Ⅲb(Japanese Classification of Colorectal,...
A 79-year-old man underwent a radical resection for cecal cancer. The pathological diagnosis was pT4a, N1a, M0, pStage Ⅲb(Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma, 9th edition). He was treated with oral UFT/LV as adjuvant chemotherapy for 6 months. At 7 months, after the end of treatment, he lost all the nail plates on his fingers and toes. A dermatologist examined him and diagnosed these as side effects of the anticancer drugs. Due to this issue, he was unable to perform routine, fine work using his fingertips. Approximately 1 year and 5 months after the completion of treatment, his nail plates regenerated to the extent that about half of his nail beds were covered. At 2 years after the completion of treatment, the nail plates began to cover the entire nail beds. Although there have been very few reports of onychomadesis as a delayed adverse event of anticancer drugs, oncologists must be aware of this possibility, as onychomadesis may impact patients' quality of life significantly.
Topics: Humans; Male; Aged; Follow-Up Studies; Quality of Life; Anus Neoplasms; Awareness; Antineoplastic Agents
PubMed: 38247080
DOI: No ID Found -
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 -
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