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Hereditary Distal Onycholysis

Partial Onycholysis with Scleronychia


Presentation

  • Apr 11th, 2018 - Nail apparatus melanomas are rare and may present with a wide variety of clinical presentations.[allmedx.com]
  • Due to varied clinical presentations, imaging is needed to make the diagnosis.[clinicaladvisor.com]
  • A pterygium formation may also be present.[handresearch.com]
  • It often presents with pain but may progress to infection and difficulty with walking.[patient.info]
  • Another unusual clinical scenario to consider is the unusual circumstance when onycholysis is present on multiple digits, and is caused by a primary dermatosis affecting the nail unit, such as psoriasis, which is presenting as onycholysis only.[dermatologyadvisor.com]
Gangrene
  • He denied any other acral rashes, including livedo reticularis, leg ulcers, necrotizing purpura, distal cutaneous ischemia, peripheral gangrene, thrombophlebitis, or hemorrhage, or family history thereof (1).[the-medical-dictionary.com]
Cutaneous Larva Migrans
  • larva migrans clma clinical laboratory management association clock circadian locomotor output cycles kaput clr crossed leg raise cls coffin lowry syndrome clt clotting time cm3 cubic centimeter cmap compound muscle action potential cmcj carpometacarpal[dxy.cn]
Polyneuropathy
  • […] tetraparesis X-linked inheritance Bradykinesia Abnormal electroretinogram Generalized tonic-clonic seizures Tetraparesis Confusion Tetraplegia Recurrent pneumonia Paresthesia Brain atrophy Hypogonadism Immunodeficiency Abnormality of the skin Hypotension Polyneuropathy[mendelian.co]
  • […] syndrome Plasminogen Deficiency, Type I Plica syndrome Plummer-Vinson Syndrome Podder-Tolmie Syndrome POEMS syndrome Poikiloderma, Hereditary Sclerosing Pointer Syndrome Poland syndrome polycystic ovary syndrome Polydactyly Myopia Syndrome Polyendocrine-Polyneuropathy[rgd.mcw.edu]

Workup

Staphylococcus Aureus
  • Acute Paronychia, commonly due to Staphylococcus aureus or Streptococcus pyogenes Extravasated blood visible beneath nail plate caused by damage to longitudunally oriented nail bed capillaries.[brainscape.com]
  • Acute paronychia Erythema, swelling and throbbing pain in the nail fold caused by bacterial infection, most commonly Staphylococcus aureus.[patient.info]
  • aureus and herpes simplex virus (HSV) or, less often, by Gram-negative organisms (Pseudomonas, Proteus).[handresearch.com]

Treatment

  • […] photographs of normal and abnormal skin conditions including images of rare conditions, this easily accessible resource is essential for pediatricians, neonatologists, and dermatologists as well as other healthcare professionals involved in the diagnosis and treatment[books.google.de]
  • Refer early, as timely treatment can prevent destructive permanent nail damage [ 1 ]. Treatment: Injection of steroid into the proximal nail fold is the conventional treatment. Successful treatment with etanercept has been reported [ 12, 13 ].[patient.info]
  • What Treatments Help? Although there are treatments galore marketed for brittle, weak nails, there are many therapeutic myths and certain products can ultimately make brittle nails worse. One common myth is gelatin.[nailsmag.com]
  • Treatment Depending on the cause onycholysis treatment must deal with underlying conditions. Patients should avoid trauma to the affected nail and keep the area dry.[medicaldb.blogspot.com]
  • It is not advised to self-medicate as fungal infections vary and so does its treatment. Do not wait for fungal infections to heal by itself; they won’t. As you wait, the infection may only get worse and treatment may be longer.[2016.mb.com.ph]

Prognosis

  • The prognosis depends on the form of dermatosis. With simple bullous epidermolysis, there is a favorable outcome, and with dystrophic and borderline forms - unfavorable, up to a lethal outcome.[iliveok.com]
  • In particular, the amelanotic subtype can pose a diagnostic challenge, often leading to a poor prognosis related to a delayed diagnosis.[allmedx.com]
  • In another series of 25 patients with subungual melanoma, the prognosis was poor. Only 36% of the patients were alive after 9 months, so the 5-year mortality rate was high ( 49 ).[musculoskeletalkey.com]
  • What is the long-term prognosis with psoriasis? What are complications of psoriasis? Overall, the prognosis for most patients with psoriasis is good. While it is not curable, it is controllable.[rxlist.com]

Etiology

  • Splinter hemorrhages : Longitudinally oriented, dark brown to red hemorrhages, caused by multiple etiologies including trauma and endocarditis.[iacdworld.org]
  • Histologic Findings Onycholysis is a clinical diagnosis and has no specific histology; however, if onychomycosis is the etiology for the onycholysis, hyphae are seen lying between the laminae of nail parallel to the surface.[emedicine.medscape.com]
  • Knowledge of etiology plays an important role in the management of LM. The study is aimed to compare the diagnosis of LM in different age groups.[allmedx.com]
  • Causes and Risk Factors Etiological factors may be exogenous, endogenous, hereditary or idiopathic. Contact irritants, trauma and moisture are the most common causes for onycholysis.[medicaldb.blogspot.com]
  • References Etiology Endogenous, exogenous, hereditary, and idiopathic factors can cause onycholysis. Contact irritants, trauma, and moisture are the most common causes of onycholysis, but other associations exist.[misc.medscape.com]

Epidemiology

  • Psoriatic arthritis: epidemiology, clinical features, course, and outcome. Ann Rheum Dis 2005; 64(Suppl II):ii14–ii17. Ogdie A, Weiss P. The epidemiology of psoriatic arthritis. Rheum Dis Clin North Am 2015; 41:545–568.[clevelandclinicmeded.com]
  • To provide Australian epidemiological data on the frequency of ... Pediatric Dermatology Photoquiz: Refractory Purulent Paronychia in a Young Girl.... Preview Pediatric Dermatology; Oguz Topal I, Duman H et. al.[allmedx.com]
  • However, very little information has been assembled regarding the phenotype, genetics and epidemiology of the more recently discovered autoinflammatory disorders.[ojrd.biomedcentral.com]
  • Docetaxel [10, 11] Hydroxylamine Other factors in onycholysis These include the following: Congenital onycholysis Hereditary partial onycholysis Idiopathic acquired onycholysis Hereditary distal onycholysis [12] Foreign body implantation References Epidemiology[misc.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • For other systemic associations, the pathophysiology of onycholysis has not been clearly established. Systemic Implications and Complications The list of systemic disorders associated with onycholysis is extensive.[dermatologyadvisor.com]
  • Etiology and pathophysiology The pathogenesis of subungual exostosis is unknown, but current theories include trauma, infection, tumor, hereditary abnormality, or activation of a cartilaginous cyst.[clinicaladvisor.com]
  • Back to Top Pathophysiology Multiple factors contribute to the pathogenesis of PsA, including genetic, environmental, and immunologic factors.[clevelandclinicmeded.com]
  • "Pathogenesis and Treatment of Psoriasis: Exploiting Pathophysiological Pathways for Precision Medicine." Clin Exp Rheumatol 33 (Suppl. 93): S2-S6. Arndt, Kenneth A., eds., et al. "Topical Therapies for Psoriasis."[rxlist.com]

Prevention

  • Docetaxel-induced onycholysis may be prevented by wearing a frozen glove for 90 minutes during infusion of the chemotherapeutic agent. [15, 16] Passier A, Smits-van Herwaarden A, van Puijenbroek E.[emedicine.medscape.com]
  • Trimming away as much loose nail as can be done comfortably will prevent the nail from being pried upwards. Cleaning under the nail is not recommended as this only serves to separate the nail further.[en.wikipedia.org]
  • However, even the best over-the-counter treatments may not prevent a fungal infection from coming back.[naildoctors.com]
  • Once you learn the reason for onycholysis, prevent it. Prevention is a lot less complicated compared to therapy. Patience is crucial with onycholysis, fingernail or toenails are slow to develop and take some time to restore themselves.[remedyland.com]

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