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Dystrophic Nail

Twenty-Nail Dystrophy


Presentation

  • Given the common presentation of onychodystrophy, physicians should have a firm grasp of common presentations of conditions like onychomycosis, trachyonychia and psoriasis.[podiatrytoday.com]
  • A 4-year-old boy presents with concern for toenail changes. His toenails were normal at birth. Nine months before presentation his mother noticed three of the nails on his left foot were yellow.[healio.com]
  • If it is dominant type, it presents with less severe form of alopecia and often manifests in later years.[ijtrichology.com]
  • […] of common presentations of conditions like onychomycosis, trachyonychia and psoriasis.[medicalvideos.com]
  • It is possible for the layman to believe a thickened nail must mean a nail fungus is present.[cosmetologyapprenticeship.com]
Sausage Toe
  • Patients may also present with the arthritic component of psoriasis, which may manifest in dactylitis of the digits (sausage toes), enthesitis of the Achilles tendon and distal interphalangeal joint involvement.[podiatrytoday.com]
Nail Deformity
  • A literature search showed no reports of nail deformities due to pernio. Here, we present a pernio case who developed nail deformities after extended exposure to cold, if combined with other facilitating factors.[jpma.org.pk]
  • A pincer nail deformity is inherited or acquired and can be associated with beta-blocker use, psoriasis, onychomycosis, tumors of the nail apparatus, systemic lupus erythematosus, Kawasaki disease, and malignancy.[aafp.org]
  • In adults the most common systemic association is with iron deficiency and haemochromatosis, although the majority of adults with koilonychia demonstrate a familial pattern Pincer nail deformity - is a transverse over-curvature of the nail plate.[pcds.org.uk]
Koebner Phenomenon
  • The Koebner phenomenon, or the appearance of lesions at the site of in Psoriasis jury, can also occur in the nails and may manifest in an asymmetrical presentation.[cosmetologyapprenticeship.com]
  • The Koebner phenomenon, or the appearance of lesions at the site of injury, can also occur in the nails and may manifest in an asymmetrical presentation.[podiatrytoday.com]
Anhidrosis
  • They did not report any abnormal or delayed dentition, abnormal sweating or anhidrosis, musculoskeletal, ocular, or neurologic symptoms. Their mother reported with the history of dystrophic nails since birth.[ijtrichology.com]
Cutis Laxa
  • Que SK, Sloan B, Dadras SS: Trachyonychia, cutis laxa, and easy bruising of the skin. Amyloidosis. JAMA Dermatol 2014;150:1357-1358.[karger.com]

Workup

  • Inspection may reveal localized nail abnormalities that should be treated, or may provide clues to an underlying systemic disease that requires further workup.[aafp.org]

Treatment

  • One should pursue a fungal culture/mycological staining prior to treatment to confirm the clinical diagnosis. Ultimately, one should tailor treatment to the nail disorder present.[podiatrytoday.com]
  • Laser treatment for fungal nails has been approved by the FDA for several years, and some studies have suggested up to 80% success rate.[bergdpm.com]
  • Nail Dystrophy affects a vast portion of the U.S. population and the medical community has had limited treatment options to effectively address this growing problem.[prnewswire.com]
  • Treatment Trachyonychia is a chronic condition. However, it is important to keep in mind that it is neither scarring nor painful, so treatment is often prescribed only for cosmetic reasons and patients may often improve without any treatment.[karger.com]
  • However, the challenging part is treatment of trachyonychia associated with alopecia universalis.[ijtrichology.com]

Prognosis

  • […] on children of alopecia observed that about 46% of the children had nail abnormalities and about 12% had twenty-nail dystrophy. [8] In fact, it is seen that the nail dystrophy may further speed up the progression of alopecia and is a marker of poor prognosis[ijtrichology.com]
  • CT On CT chest, while individual features are non-specific, there may be evidence of sequelae of recurrent pulmonary infections pleural effusions Treatment and prognosis While there is no specific treatment for the syndrome, however some patients are[radiopaedia.org]
  • Managing Median Nail Dystrophy The prognosis for median nail dystrophy caused by physical trauma is usually quite good. While the pathogenesis of the disorder is unknown, treatment is highly effective.[news-medical.net]
  • Causes, treatment and prognosis. J Hand Surg [Am] 9: 247–252 Google Scholar 16. Zook EG (1990) The Perionychium. Hand Clin 6: 1 Google Scholar Copyright information Authors and Affiliations S Guéro 1 S Guichard 1 SR Fraitag 2 1.[link.springer.com]
  • Prognosis for habit-tic deformity is difficult to determine, as most of the literature on the disorder is in the form of isolated case studies.[clinicaladvisor.com]

Etiology

  • Etiology Trauma Systemic infections such as measles. Drug reaction. Brittled nails Etiology Strong soaps Nail polish Vitamin deficiency: Vitamin A and B.[drmhijazy.com]
  • They are organised into groups, and further divided into clinical, etiological or histopathological sub-types.[orpha.net]
  • The etiology of median canaliform nail dystrophy is unknown. 5,7,13,16-18 It usually is an acquired condition.[mdedge.com]
  • Tables 1 1 – 9 and 2 1 , 10 – 15 list nail abnormalities with localized and systemic etiologies.[aafp.org]
  • Its exact etiology is as yet unresolved. What is Median Nail Dystrophy? It is a condition affecting the nail plate of the thumbs, though on rare occasions it may be found in toenails or other finger nails.[news-medical.net]

Epidemiology

  • Articles that reported the epidemiology, disease associations, clinical presentation, histopathology, and treatment options for trachyonychia were included.[karger.com]
  • Prevalence and epidemiology of toenail onychomycosis in diabetic subjects: a multicentre survey. Br J Dermatol. 1998;139(4):665-671. 7. Cribier B, Mena ML, Rey D, et al.[kerydin.com]
  • Whilst not life-threatening, quality of life may be impaired through feelings of stigmatisation (comparable to other skin diseases) and the avoidance of certain activities - eg, swimming or other sports involving communal changing rooms. [ 1 ] Epidemiology[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • There are several types of onychomycosis that one can differentiate by the initial site of involvement and pathophysiology. The classification of onychomycosis is as follows.2 Distal (or distal lateral) subungual onychomycosis.[podiatrytoday.com]

Prevention

  • Nuvail's patented polymer creates a breathable barrier allowing for oxygen transfer to the germinal matrix while blocking water absorption; therefore, preventing the wet-dry cycle that commonly leads to damaged nails.[prnewswire.com]
  • Concurrent tinea pedis must be cleared to prevent reinfection. Additionally, parents and family members should examine themselves in an attempt to identify if a close contact is the source of the infection.[healio.com]
  • Holding a nail technology or cosmetology license does not prevent you from educating yourself beyond the nail technology course. Always follow your state board guidelines regarding this topic when it comes to treating your clients cosmetically.[cosmetologyapprenticeship.com]
  • This type of cut will ensure that patients can go longer in between visits and will prevent ingrown toenails, a common cause for pain and infection.[rainiermeded.com]
  • One can prevent this by procuring the biopsy from the distal nail matrix if possible.[podiatrytoday.com]

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