1/16. Nail involvement in pemphigus vulgaris.Nail involvement in pemphigus vulgaris is relatively rare. We describe a case of severe pemphigus involving both the skin and oral mucosa in which an acute exacerbation was preceded by the onset of nail involvement of all 4 extremities. Nail involvement occurred in the form of hemorrhagic paronychia of multiple digits. Oral, cutaneous, and nail manifestations of the disease were all well controlled by systemic therapy. A review of the literature on nail involvement in pemphigus reveals that this involvement may be manifested in multiple ways, with chronic paronychia and onychomadesis being the most common. Involvement of the nail occurs most frequently either as part of the initial presentation, or just before or concurrent with a flare of pre-existing disease. Nail involvement, when it occurs, is usually present when the disease is severe. Topical therapy is insufficient, and systemic therapy is warranted. In the majority of cases, nail recovery is complete, with no residual damage.- - - - - - - - - - ranking = 1keywords = vulgaris (Clic here for more details about this article) |
2/16. Subungual squamous cell carcinoma: report of 2 cases.Subungual squamous cell carcinoma (SCC) is a rare malignant tumor with an indolent course. Its etiology is unknown. It often involves the distal phalanx of the thumb or the index finger, and often presents as a chronic ulcer that is commonly misdiagnosed as chronic paronychia, pyogenic granuloma or verruca vulgaris. Approximately 150 cases of subungual SCC, including one in a Taiwanese patient, have been reported. Here, we report two cases of subungual SCC presenting as a chronic ulcer of the nail bed refractory to antibiotic treatment. One case involved the right thumb, while the other involved the right index finger. Radiographs of both cases showed an osteolytic bone lesion involving the distal phalanx. Excision biopsy revealed SCC in both cases. Both patients received amputation of the involved distal phalanx and showed no signs of reoccurrence during 5 years of follow-up. These findings suggest that all recalcitrant ulcers of the nail bed should be biopsied to facilitate early diagnosis and treatment of subungual SCC.- - - - - - - - - - ranking = 0.2keywords = vulgaris (Clic here for more details about this article) |
3/16. Nail manifestations in pemphigus vulgaris.Nail involvement in pemphigus vulgaris is rare. We describe 5 patients with pemphigus vulgaris presenting nail involvement. In this disease, nail manifestations present, by order of frequency, as chronic paronychia, onychomadesis, onycholysis, Beau's lines and trachyonychia. All our 5 cases presented with paronychia, and 1 of them also had Beau's lines. Treatment with prednisone and/or cyclophosphamide controlled mucocutaneous and nail manifestations in all cases.- - - - - - - - - - ranking = 1.2keywords = vulgaris (Clic here for more details about this article) |
4/16. Pachydermoperiostosis and psoriatic onychopathy: an unusual association.A 33-year-old man, suffering from cutaneous psoriasis since the age of 16, in the last 6 years experienced slow and painless enlargement at his fingertips and later at his big toes, which resulted in digital clubbing. Since the age of 31, the patient also presented psoriatic nail changes involving all his fingernails, without joint pain or inflammation. The patient's family history was negative for psoriasis, however, his brother, a 29-year-old healthy man, also presented digital clubbing. The diagnosis of pachydermoperiostosis coexistent with ungual and cutaneous manifestations of psoriasis vulgaris was made. The differential diagnosis with psoriatic onycho-pachydermo-periostitis, as well as other clinical conditions that involve the distal interphalangeal joints is discussed.- - - - - - - - - - ranking = 0.2keywords = vulgaris (Clic here for more details about this article) |
5/16. Trachyonychia: a case report and review of manifestations, associations, and treatments.Trachyonychia ("rough nails") is best considered a reaction or morphologic pattern with a variety of clinical presentations and etiologies. It may involve only 1 or as many as 20 nails (20-nail dystrophy). It can be a manifestation of lichen planus, psoriasis, alopecia areata, immunoglobulin a deficiency, atopic dermatitis, and ichthyosis vulgaris. Nail matrix biopsy results and physical examination findings help in establishing the cause of this condition, though often trachyonychia is an isolated finding. When trachyonychia occurs in childhood as a manifestation of lichen planus, it tends to resolve with time. We review a case of trachyonychia, its association, its diagnostic evaluation, and treatment options.- - - - - - - - - - ranking = 0.2keywords = vulgaris (Clic here for more details about this article) |
6/16. Nail destruction in pemphigus vulgaris.Involvement of the nails in pemphigus vulgaris (PV) is rare and is usually seen when the disease is severe. The most common clinical manifestations are chronic paronychia and onychomadesis. Finger nails are more frequently involved than toe nails. We report a case of severe and persistent PV in which an exacerbation was preceded by an erosive and destructive lesion of the right hallux nail unit. A nail bed biopsy was performed to rule out a subungual tumour. The image of suprabasal acantholysis yielded the diagnosis of PV. This localisation and clinical manifestation of PV have only been reported once.- - - - - - - - - - ranking = 1keywords = vulgaris (Clic here for more details about this article) |
7/16. doxycycline-induced photo-onycholysis.An uncommon manifestation of phototoxicity, photo-onycholysis results in the separation of the distal nail from the nail bed. Photo-onycholysis may follow the use of various medications or may occasionally be idiopathic. We present a case of photo-onycholysis in a patient treated with doxycycline for acne vulgaris.- - - - - - - - - - ranking = 0.2keywords = vulgaris (Clic here for more details about this article) |
8/16. incontinentia pigmenti with painful subungual tumors: a two-generation study.We report 2 cases of painful subungual dyskeratotic tumors occurring in a mother and daughter with incontinentia pigmenti (IP) as a late manifestation of the disease. Both patients had a history of similar lesions appearing over a period of years on the digits of both the hands and feet. biopsy specimens of the current lesions were examined and compared with the previous material available on both patients. The current tumors and the earlier lesions (the latter of which had originally been given diagnoses that included squamous cell carcinoma, keratoacanthoma, and verruca vulgaris) showed similar histopathologic features that were consistent with the late (verrucous) stage of IP. To our knowledge, this is the first reported case of numerous subungual tumors in IP involving more than 1 generation in the same family; the first report of subungual tumors in IP to include a 16-year follow-up; and the first report of a probable recurrence of subungual tumors in IP at the same site of a previously surgically removed tumor.- - - - - - - - - - ranking = 0.2keywords = vulgaris (Clic here for more details about this article) |
9/16. pemphigus vulgaris with nail involvement presenting with vegetating and verrucous lesions.We report the case of a 68-year-old female with longstanding insulin-treated diabetes mellitus, observed for the first time in our department in August 1999 with multiple painful erosive lesions of the oral cavity and many bullous or erosive lesions on the abdominal wall, back, and thigh. She also had vegetating and verrucous lesions, similar to common warts, involving the hands and feet, mainly on the palms, palmar surface of the fingers, and nail folds. Her lesions were present for 1 year. skin and mucous biopsies showed the characteristic histopathologic findings of pemphigus vulgaris, with an epidermal intercellular IgG deposition on direct immunofluorescence. histology of a warty lesion of the finger also showed suprabasal acantholysis. After partial improvement with low doses of oral steroids and azathioprine, her disease progressed to involve the oral cavity, trunk, hands, feet, and scalp. Control of her disease required successive treatments of mycophenolate mofetil and cyclophosphamide, as well as corticosteroids. A partial response was obtained with all these treatments. After being controlled by cyclophosphamide that was slowly tapered, she is now well controlled with azathioprine and oral steroids, showing only discrete lesions of the oral mucosa after 1 year of followup. We report this case of pemphigus vulgaris with unusual clinical aspects, namely vegetating and verrucous lesions as well as nail involvement, rarely described in this disease.- - - - - - - - - - ranking = 1.2keywords = vulgaris (Clic here for more details about this article) |
10/16. Trachyonychia: case report and review of the literature.Trachyonychia is the term used to describe nail plate roughness, pitting, and ridging that may affect 1 to 20 nails. alopecia areata, psoriasis, lichen planus, atopic dermatitis, ichthyosis vulgaris, as well as other skin conditions have been associated with trachyonychia, but the causal relationship is often challenging to demonstrate histologically. Clinical evidence of these cutaneous disorders in conjunction with a nail matrix biopsy may help elucidate an etiology of trachyonychia, but many cases often remain idiopathic. Nail biopsy findings may match skin histology, but more commonly show spongiotic or nonspecific changes. We present an interesting case of a female with progressive development of trachyonychia in all 20 nails coinciding with a new diagnosis of sarcoidosis.- - - - - - - - - - ranking = 0.2keywords = vulgaris (Clic here for more details about this article) |
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