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Indian Pediatrics Aug 2014
Topics: Child, Preschool; Female; Fingers; Hand, Foot and Mouth Disease; Humans; Nail Diseases; Nails
PubMed: 25129012
DOI: 10.1007/s13312-014-0481-1 -
Drug Design, Development and Therapy 2017The side effects of chemotherapy drugs have increased in recent years, and some side effects can lead to onychomadesis. A 72-year-old woman who was diagnosed with an... (Review)
Review
The side effects of chemotherapy drugs have increased in recent years, and some side effects can lead to onychomadesis. A 72-year-old woman who was diagnosed with an invasive ductal carcinoma of the right breast underwent a modified radical mastectomy in April 2015, followed by chemotherapy with capecitabine and nanoparticle albumin-bound paclitaxel (nab-paclitaxel). Subsequently, the patient experienced palmoplantar redness, pain, onycholysis, a transparent serous exudate, and onychomadesis. The chemotherapy was discontinued, and the patient was treated with oral vitamin B6, a polymyxin ointment, and a high-energy red light. The palmoplantar redness and pain were alleviated after 1 month. However, although her fingernails improved, dysesthesia symptoms remained, and all her toenails exhibited defects or deformities at a 24-month follow-up. The symptoms of this disorder should be recognized by dermatologists.
Topics: Aged; Albumins; Antineoplastic Combined Chemotherapy Protocols; Breast Neoplasms; Capecitabine; Carcinoma, Ductal, Breast; Female; Follow-Up Studies; Humans; Nail Diseases; Paclitaxel
PubMed: 28860708
DOI: 10.2147/DDDT.S139643 -
Viruses Jun 2019Nail changes, including onychomadesis (nail shedding) and Beau's line, following hand-foot-mouth disease (HFMD) are a common emergence at the stage of late complications...
BACKGROUND
Nail changes, including onychomadesis (nail shedding) and Beau's line, following hand-foot-mouth disease (HFMD) are a common emergence at the stage of late complications of HFMD. However, the exact mechanism is still unknown. Therefore, we conducted this study to elucidate the mechanism of nail changes following HFMD.
METHODS
We collected 11 patients suffering from onychomadesis following HFMD. Nail samples from all of them were collected. Real time reverse transcription polymerase chain reaction (RT-PCR) and sequencing for human enteroviruses (HEV) were performed. Throat swabs for RT-PCR and sequencing for HEV were performed for three cases.
RESULTS
RT-PCR demonstrated the presence of Coxackievirus A6 (CVA6) in nail samples from three patients and one with Echovirus.
CONCLUSION
In conclusion, we believe that the major cause of onychomadesis following HFMD is that certain novel viruses, mostly CVA6, are virulent and may damage nail matrix. Direct injury caused by cutaneous lesions of HFMD around nail matrix is a minor cause. There are still other virulent HEV which may result in onychomadesis. In addition, the novel strain of CVA6 also causes atypical clinical presentations, such as adult involvement and delayed-onset palmar and plantar desquamation. Physicians should be familiar with atypical presentations caused by novel viruses to avoid misdiagnosis and even inform patients of the possibility of onychomadesis that may take place weeks later to reassure patients.
Topics: Adolescent; Adult; Aged; Child, Preschool; Coxsackievirus Infections; DNA, Viral; Enterovirus B, Human; Female; Hand, Foot and Mouth Disease; Humans; Male; Middle Aged; Nail Diseases; Onychomycosis; Phylogeny
PubMed: 31174263
DOI: 10.3390/v11060522 -
Dermatology Online Journal Jul 2009Patients affected by pemphigus vulgaris will occasionally present with associated and characteristic nail changes. This manuscript was prepared as a review of this... (Review)
Review
Patients affected by pemphigus vulgaris will occasionally present with associated and characteristic nail changes. This manuscript was prepared as a review of this unique presentation of pemphigus. Articles describing pemphigus vulgaris of the nail were compiled and reviewed and pertinent information was extracted to provide a concise analysis. The literature on this topic is still maturing. Publications to date suggest the incidence of nail and periungal involvement may correlate with the severity of mucocutaneous symptoms and the duration of the disease. The most common nail manifestations reported were acute or chronic paronychia and onychomadesis, and involvement of the fingernails. The nail changes may precede or develop concurrently with the mucocutaneous presentation. The diagnosis can be made by histologic identification and/or by the presence of IgG and C3 with direct immunoflourescence testing. Systemic treatment is required and highly effective; it includes a tailored combination of anti-inflammatory medications, immunosuppressive agents, and/or immunomodulatory treatments. This review aims to provide a better understanding of pemphigus vulgaris nail changes and guidance for clinical treatment. Unknown etiologies, predisposing factors, discrepancies evident in the literature, and limited research warrant further investigation of pemphigus vulgaris of the nail.
Topics: Adult; Anti-Inflammatory Agents; Candidiasis, Cutaneous; Diagnosis, Differential; Female; Fluorescent Antibody Technique, Direct; Humans; Immunologic Factors; Immunosuppressive Agents; Male; Middle Aged; Nail Diseases; Paronychia; Pemphigus; Prognosis; Staphylococcal Infections
PubMed: 19903430
DOI: No ID Found -
CMAJ : Canadian Medical Association... Feb 2017
Topics: Child; Hand, Foot and Mouth Disease; Humans; Male; Nail Diseases
PubMed: 28246241
DOI: 10.1503/cmaj.160388 -
The Turkish Journal of Pediatrics 2016Hand-foot-mouth disease (HFMD) is a viral disease that is characterized by palmoplantar vesicular eruption and erosive stomatitis. Beau's line and onychomadesis can be...
Hand-foot-mouth disease (HFMD) is a viral disease that is characterized by palmoplantar vesicular eruption and erosive stomatitis. Beau's line and onychomadesis can be observed as late findings following HFMD due to arrest in nail matrix. We aimed to draw attention to HMFD and nail changes, which have been seen more frequently. Demographic characteristics and nail findings of 15 children, who were diagnosed with HFMD in the dermatology clinic of Beykoz State Hospital between August 2015-October 2015 were evaluated. Mean age of the patients was 5.13 years (1-13 years), 66.6% were boys (n=10), and 33.4% were girls (n=5); 53.3% were diagnosed in August (n=8). Dermatologic examinations revealed palmar and plantar vesicular eruptions in all cases, additionally one patient had vesicular eruptions also on hip, legs, and arms. Erosive stomatitis was present in oral mucosa of 60% of patients (n=9). Nail findings were determined after a mean of 4.06 weeks following HFMD. Onychomadesis and Beau's line were present in 66.6% (n=10) and 33.4% of the patients, respectively. Hand-foot-mouth disease is a viral infection of childhood, which may be seen as isolated cases or epidemics, and characterized with palmoplantar vesicular eruption and erosive stomatitis. Being aware that Beau's line and onychomadesis can be seen as late findings of HFMD and should relieve without treatment, will prevent unnecessary diagnostic and invasive interventions.
Topics: Adolescent; Child; Child, Preschool; Female; Hand, Foot and Mouth Disease; Humans; Infant; Male; Nail Diseases; Nails
PubMed: 28266194
DOI: 10.24953/turkjped.2016.03.009 -
Indian Journal of Dermatology 2021
PubMed: 33911309
DOI: 10.4103/ijd.IJD_325_19 -
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 -
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 -
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