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Actas Dermo-sifiliograficas May 2022Nail involvement in psoriasis is common. It is seen in up to 80% of patients with psoriatic lesions and may be the only manifestation in 6% of cases. Nail psoriasis is... (Review)
Review
Nail involvement in psoriasis is common. It is seen in up to 80% of patients with psoriatic lesions and may be the only manifestation in 6% of cases. Nail psoriasis is correlated with more severe disease, characterized by earlier onset and a higher risk of psoriatic arthritis. Accordingly, it can also result in significant functional impairment and reduced quality of life. Psoriasis involving the nail matrix causes pitting, leukonychia, red lunula and nail dystrophy, while nail bed involvement causes splinter hemorrhages, onycholysis, oil spots (salmon patches), and subungual hyperkeratosis. Common evaluation tools are the Nail Psoriasis Severity Index (NAPSI), the modified NAPSI, and the f-PGA (Physician's Global Assessment of Fingernail Psoriasis). Treatment options include topical therapy, intralesional injections, and systemic and biologic agents. Treatment should therefore be assessed on an individualized basis according to the number of nails involved, the part of the nail or nails affected, and the presence of concomitant nail and/or joint involvement.
Topics: Arthritis, Psoriatic; Humans; Nail Diseases; Nails; Psoriasis; Quality of Life; Severity of Illness Index
PubMed: 35697407
DOI: 10.1016/j.ad.2022.01.006 -
American Journal of Clinical Dermatology Mar 2022Changes in nail color can provide important clues of underlying systemic and skin disease. In particular, white discoloration (leukonychia) has a high prevalence with a... (Review)
Review
Changes in nail color can provide important clues of underlying systemic and skin disease. In particular, white discoloration (leukonychia) has a high prevalence with a wide array of potential relevant causes, from simple manicure habits to life-threatening liver or kidney failure. Therefore, a reliable assessment of the patient with leukonychia is essential. In the past, two classifications for leukonychia have been presented. The morphological classifies the nail according to the distribution of the white lines: total, partial, transversal, and longitudinal leukonychia. Mees' and Muehrcke's lines are examples of transversal leukonychia, while Terry's and Lindsay's nails are examples of total and partial leukonychia. The anatomical classifies according to the structure responsible for the white color: the nail plate in true leukonychia, the nail bed in apparent leukonychia, and the surface only in pseudoleukonychia. In this review, both morphological and anatomical features have been combined in an algorithm that enables clinicians to approach leukonychia efficiently and effectively.
Topics: Algorithms; Habits; Humans; Nail Diseases; Nails; Nails, Malformed
PubMed: 35112320
DOI: 10.1007/s40257-022-00671-6 -
Skin Appendage Disorders Mar 2015Leukonychia totalis and leukonychia partialis are rare nail findings characterized by complete or partial whitening of the nail plate. Leukonychia totalis and...
Leukonychia totalis and leukonychia partialis are rare nail findings characterized by complete or partial whitening of the nail plate. Leukonychia totalis and leukonychia partialis are usually inherited or associated with systemic disease. Here, we report the case of a 25-year-old man with idiopathic acquired leukonychia totalis and leukonychia partialis and review the literature on this topic.
PubMed: 27172289
DOI: 10.1159/000380956 -
Skin Appendage Disorders Mar 2022Buerger disease, or thromboangiitis obliterans, is an inflammatory and occlusive process involving small and medium size arteries and veins, which generally affects the...
INTRODUCTION
Buerger disease, or thromboangiitis obliterans, is an inflammatory and occlusive process involving small and medium size arteries and veins, which generally affects the lower limbs of young adult male with the habit of smoking.
CASE PRESENTATION
This paper reports 2 patients who developed nail lesions as the first sign of Buerger disease.
CONCLUSION
Signs and symptoms of Buerger's disease are secondary to the inflammatory process and arterial occlusion which results in severe ischemia. Involvement of nails is not common, but we found 2 different clinical features which have not been previously reported in the literature: chronic paronychia, and proximal leukonychia or onycholysis and nail bed erosion.
PubMed: 35415181
DOI: 10.1159/000518982 -
Anais Brasileiros de Dermatologia 2014Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of... (Review)
Review
Nails are considered epidermal appendages, and as such, are commonly affected in patients with psoriasis, 80% of whom are likely to develop nail psoriasis as a result of their condition. Two patterns of nail disorders have been shown to be caused by psoriasis. Nail matrix involvement can result in features such as leukonychia, pitting (punctures or cupuliform depressions), red spots in the lunula and crumbling. Nail bed involvement, on the other hand, can cause onycholysis, salmon or oil-drop patches, subungual hyperkeratosis and splinter hemorrhages. Nail disease causes aesthetic and functional impairment, and is indicative of more severe forms of psoriasis as well as of joint involvement. The treatment for nail psoriasis involves behavioral interventions, topical medications, or systemic therapy in case of extensive skin or joint involvement. This article presents a review of the main features of nail psoriasis, its clinical presentation, diagnostic and assessment methods, clinical repercussions, and of its available treatment options.
Topics: Humans; Nail Diseases; Psoriasis; Severity of Illness Index
PubMed: 24770509
DOI: 10.1590/abd1806-4841.20142633 -
The FEBS Journal Dec 2016Hereditary leukonychia is a rare genetic nail disorder characterized by distinctive whitening of the nail plate of all 20 nails. Hereditary leukonychia may exist as an...
Hereditary leukonychia is a rare genetic nail disorder characterized by distinctive whitening of the nail plate of all 20 nails. Hereditary leukonychia may exist as an isolated feature, or in simultaneous occurrence with other cutaneous or systemic pathologies. Associations between hereditary leukonychia and mutations in the gene encoding phospholipase C delta-1 (PLCδ1) have previously been identified. However, the molecular mechanisms underlying PLCδ1 mutations and hereditary leukonychia remain uncharacterized. In the present study, we introduced hereditary leukonychia-linked human PLCδ1 mutations (C209R, A574T and S740R) into equivalent residues of rat PLCδ1 (C188R, A553T and S719R), and investigated their effect on the biophysical and biochemical properties of the PLCδ1 protein. Our data suggest that these PLCδ1 mutations associated with hereditary leukonychia do not uniformly alter the enzymatic ability of this protein leading to loss/gain of function, but result in significantly divergent enzymatic properties. We demonstrate here for the first time the importance of PLC-mediated calcium (Ca ) signalling within the manifestation of hereditary leukonychia. PLCδ1 is almost ubiquitous in mammalian cells, which may explain why hereditary leukonychia manifests in association with other systemic pathologies relating to keratin expression.
Topics: Animals; Binding Sites; Biocatalysis; Blotting, Western; Calcium; Circular Dichroism; Enzyme Stability; Humans; Hydrolysis; Hypopigmentation; Kinetics; Models, Molecular; Mutation; Nail Diseases; Phosphatidylinositol 4,5-Diphosphate; Phospholipase C delta; Protein Binding; Protein Domains; Rats; Temperature
PubMed: 27783455
DOI: 10.1111/febs.13939 -
California Medicine Jan 1948
PubMed: 18731355
DOI: No ID Found -
Psoriasis (Auckland, N.Z.) 2015Psoriasis is a common skin disease, with nail involvement in approximately 80% of patients. Nail psoriasis is often associated with psoriatic arthropathy. Involvement of... (Review)
Review
Psoriasis is a common skin disease, with nail involvement in approximately 80% of patients. Nail psoriasis is often associated with psoriatic arthropathy. Involvement of the nails does not always have relationship with the type, gravity, extension, or duration of skin psoriasis. Nail psoriasis can occur at any age and all parts of the nails and the surrounding structures can be affected. Two clinical patterns of nail manifestations have been seen due to psoriasis: nail matrix involvement or nail bed involvement. In the first case, irregular and deep pitting, red spots of the lunula, crumbling, and leukonychia are seen; in the second case, salmon patches, onycholysis with erythematous border, subungual hyperkeratosis, and splinter hemorrhages are observed. These clinical features are more visible in fingernails than in toenails, where nail abnormalities are not diagnostic and are usually clinically indistinguishable from other conditions, especially onychomycosis. Nail psoriasis causes, above all, psychosocial and aesthetic problems, but many patients often complain about functional damage. Diagnosis of nail psoriasis is clinical and histopathology is necessary only in selected cases. Nail psoriasis has an unpredictable course but, in most cases, the disease is chronic and complete remissions are uncommon. Sun exposure does not usually improve and may even worsen nail psoriasis. There are no curative treatments. Treatment of nail psoriasis includes different types of medications, from topical therapy to systemic therapy, according to the severity and extension of the disease. Moreover, we should not underestimate the use of biological agents and new therapy with lasers or iontophoresis. This review offers an investigation of the different treatment options for nail psoriasis and the optimal management of nail disease in patients with psoriasis.
PubMed: 29387579
DOI: 10.2147/PTT.S55338 -
Skin Appendage Disorders Oct 2018Half-and-half nails were originally described as a transverse leukonychia in patients with chronic renal disease; other conditions (such as Behcet's and Crohn's disease)...
Half-and-half nails were originally described as a transverse leukonychia in patients with chronic renal disease; other conditions (such as Behcet's and Crohn's disease) and medications (such as isoniazid) have also been associated with the nail changes. However, longitudinal half-and-half nails (affecting the medial aspects of the nails) have previously been reported on the great toes of an older woman and, in the present case, on the thumbs of an elderly man; neither person had Behcet's, Crohn's, or kidney disease or was receiving isoniazid. The woman had a true leukonychia, bilateral hallux valgus deformity, and chronic trauma to her medial nail folds. The man had a nontraumatic apparent leukonychia and bilateral koilonychia; the non-white lateral area of his left thumb also had a linear groove (resulting from a digital mucous cyst on the proximal nail fold) and subun gual hyperkeratosis. In conclusion, longitudinal half-and-half nails are a rare phenomenon that has not been associated with either a systemic disease or medication; the acquired nail change can present either as an idiopathic finding or occur secondary to chronic trauma.
PubMed: 30410909
DOI: 10.1159/000487860