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]
Dermatology Quiz Case presentation An 8-year-old boy presents with a scaly erythematous lesion on his left palm that has been present for six months (Figure 1). His thumbnail of the same hand became dystrophic four months ago (Figure 2). [medicinetoday.com.au]
If it is dominant type, it presents with less severe form of alopecia and often manifests in later years. [ijtrichology.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]
[…] of common presentations of conditions like onychomycosis, trachyonychia and psoriasis. [medicalvideos.com]
Hematological
- Easy Bruising
Que SK, Sloan B, Dadras SS: Trachyonychia, cutis laxa, and easy bruising of the skin. Amyloidosis. JAMA Dermatol 2014;150:1357-1358. [karger.com]
Entire Body System
- Malnutrition
Beau's Grooves 1 mm wide depression in the nail plate that extends horizontally from one lateral nail groove to the other All nails are simultaneously affected Most commonly develop following dramatic illness such as MI and periods of high fever or malnutrition [dermweb.com]
However, brittle nails may also indicate a more serious disease, including malnutrition, hyperthyroidism, or some other endocrine disorder. [naildystrophy.com]
The lines are associated with chemotherapy, malnutrition, and such systemic diseases as diabetes, psoriasis, syphilis, and myocarditis. [clinicaladvisor.com]
In many cases chronic malnutrition, growth retardation and anemia may ensue. [debra.org]
[…] erythematosus, occupational exposure to petroleum-based solvents, nail-patella syndrome 10 Mees lines Arsenic poisoning, 1 other heavy metal poisoning, renal failure 11 Muehrcke lines ( Figure 12 ) Hypoalbuminemia, nephrotic syndrome, liver disease, malnutrition [aafp.org]
- Sepsis
Pernio is a reaction to cold, and although genetic factors, bad nutritional habits, anorexia, hormonal changes, systemic diseases, focal sepsis, dysproteinaemia and myelodysplastic diseases play roles in its etiology, which remains unclear. 5 Some studies [jpma.org.pk]
Cellulitis, osteomyelitis, sepsis and necrosis in elderly patients and people with diabetes. Psychosocial problems due to embarrassment at cosmetic appearance. Pain and limitation of function, particularly in older patients. [patient.info]
Nails affected by Beau's lines or onychomadesis regrow normally with time Various nail disorders (images 68-72) Nail cosmetic dystrophy - from, eg artificial nails, can cause onycholysis, ridging, sepsis and marked atrophy Nail biting - the nails are [pcds.org.uk]
Cardiovascular
- Heart Disease
Diseases associated with clubbing: Respiratory diseases : bronchiectesis, chronic bronchitis, bronchogenic carcinoma, emphysema, tuberculosis. Liver diseases : biliary cirrhosis Congenital heart diseases. [drmhijazy.com]
Common causes of finger clubbing include: Cyanotic congenital heart disease, infective endocarditis Lung cancer, pulmonary fibrosis, cystic fibrosis, bronchiectasis, empyema, lung abscess Koilonychia Dystrophy of the nails in which they are thinned and [thefootshop.org.uk]
Skin
- Blister
Where the two layers separate there is a blister. Blistering in the various types of dystrophic EB causes scarring. [debra.org]
— Gonorrhoea with chancres and warts ; small blisters on orifice of urethra and inner surface of prepuce, forming chancre-like ulcers... الصفحة 450 - A young man came to me with a bubo in the left groin. [books.google.com]
[…] humic matter, a sparse bottom fauna, and a high oxygen consumption Examples of dystrophic in a Sentence Recent Examples on the Web Another quest focuses on dystrophic epidermolysis bullosa (DEB), genetic conditions that cause fragile skin, widespread blistering [merriam-webster.com]
It is characterised by an erythematous and erosive lesion, which may blister and crust, but the infection does not produce chronic nail dystrophy. [medicinetoday.com.au]
- Nail Deformity
deformations can suggest nail disorders of severe pernio. [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]
Download Figure: 48 Alopecia areata and t rachyonychia Download Figure: 49 A myxoid cyst (black arrow) affecting nail growth Download Figure: 50 Habit-tic deformity Download Figure: 51 Habit-tic deformity Fir tree appearance Download Figure: 52 Habit-tic [pcds.org.uk]
Neurologic
- Confusion
Do not confuse with subungual haematomas, which ‘grow out’ with the nail. They usually present as a longitudinal pigmented streak. [murtagh.mhmedical.com]
At times it may be confused with habit-tic deformity which comes about by the habitual picking at the proximal nail fold margin. [news-medical.net]
It is very common for psoriasis to be mistaken for dermatitis in children – many children suffer from both conditions, which can add confusion to the clinical picture. [medicinetoday.com.au]
A distinct but commonly confused condition for habit-tic deformity is median canaliform nail dystrophy (MCND). Whereas habit-tic deformity is caused by repeated nail trauma, the cause of MCND is unknown. [clinicaladvisor.com]
Often due to shoegear, the fifth toenail becomes dystrophic and thickened.3 Patients and practitioners alike will confuse this with onychomycosis. [podiatrytoday.com]
- Myelopathy
CHS compression hip screw ネイルプレート(法) CM joint carpometacarpal joint 手根中手関節 CNS central nervous system 中枢神経系 CP clinical psychologist 臨床心理士 CPM continuous passive motion 持続的他動運動 CRPS complex regional pain syndrome 複合性局所疼痛症候群 CSM cervical spondylotic myelopathy [nurseful.jp]
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
Treatment Options Once the cause of the nail dystrophy is determined, appropriate treatment can begin. Again, treatment will be based on the cause of the dystrophy, but sometimes the cause can be unknown. [lexingtonkypodiatry.com]
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]
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
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]
Prognosis The prognosis is variable and depends on the type of infection as well as host factors such as comorbidities and age. [patient.info]
Etiology
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Etiology Trauma Systemic infections such as measles. Drug reaction. Brittled nails Etiology Strong soaps Nail polish Vitamin deficiency: Vitamin A and B. [drmhijazy.com]
The etiology of median canaliform nail dystrophy is unknown. 5,7,13,16-18 It usually is an acquired condition. [mdedge.com]
They are organised into groups, and further divided into clinical, etiological or histopathological sub-types. [orpha.net]
Tables 1 1 – 9 and 2 1, 10 – 15 list nail abnormalities with localized and systemic etiologies. [aafp.org]
Epidemiology
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]
Articles that reported the epidemiology, disease associations, clinical presentation, histopathology, and treatment options for trachyonychia were included. [karger.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]
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
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]
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]
Science Pagina 305 - Silva P (1994) Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by Pagina 465 - Bennett NT, Schultz GS (1993) Growth factors and wound healing: part II. [books.google.it]
Prevention Primary prevention is not practised, except where there is a cause of immunocompromise, such as AIDS, where prophylactic therapy may be considered. [patient.info]
Kerasal® Fungal Nail Renewal™ does not cure or prevent psoriasis or fungal infections. Kerasal® helps improve the appearance of nails damaged by psoriasis or nail fungus. Fungal infections of the nail can only be cured by prescription medication. [kerasal.com]