1/5. onycholysis associated with paclitaxel.Chemotherapeutic agents are known to cause a myriad of cutaneous side effects that the dermatologist is often called upon to identify and treat. The taxoid drug paclitaxel is commonly used in oncology. To date, there have been few adverse dermatologic effects reported secondary to paclitaxel use. This is in contrast to the related drug docetaxel. We report a case in which paclitaxel caused onycholysis and nail loss in a patient being treated for lung cancer. To our knowledge, this finding has not previously been reported in the American dermatologic literature, though it has been reported in association with docetaxel use. It is important for clinicians to recognize that onycholysis can be associated with paclitaxel. Prompt recognition may prevent the unnecessary use of antibiotics or antifungal medications. Discontinuation of paclitaxel chemotherapy generally is not required, and regrowth of nails can be expected following completion of therapy.- - - - - - - - - - ranking = 1keywords = onycholysis (Clic here for more details about this article) |
2/5. malassezia furfur in a case of onychomycosis: colonizer or etiologic agent?The etiologic role of malassezia furfur in onychomycosis is a contentious diagnostic problem because its keratinolytic ability has never been verified. This case report describes the isolation of M. furfur from the infected nails of a child clinically diagnosed with onychomycosis, and discusses the role of this organism as an etiologic agent/colonizer. The patient presented with subungual hyperkeratosis and onycholysis without associated paronychia. Budding yeast cells compatible with M. furfur were repeatedly demonstrated in KOH wet mounts of damaged nails, histopathology of hematoxylin and eosin (H&E) and periodic acid-Schiff (PAS) stained sections showed penetration of fungal elements between deeper layers of keratin, and numerous colonies of M. furfur were isolated on three consecutive occasions from nail specimens collected from different areas of hand and toenail lesions. No evidence of nail invasion by dermatophytic or nondermatophytic filamentous fungi were found by direct microscopy or culture. microscopy and culture were negative following 12 weeks of ketoconazole treatment, which resulted in growth of healthy nail plates with normal beds. We can infer from these observations that M.furfur was an etiologic agent rather than a colonizer in the patient's nails even though direct keratinolytic character of this fungus was not demonstrated.- - - - - - - - - - ranking = 0.5keywords = onycholysis (Clic here for more details about this article) |
3/5. A case of melanonychia due to candida albicans.Candida species rarely cause black pigmentation of infected nails and only a few cases have been reported in the literature. We describe a 53-year-old white man who had diffuse melanonychia of the fourth right fingernail due to C. albicans. A progressive dark pigmentation of his nail appeared over 6 months, following paronychial inflammation. The melanonychia was associated with brittleness. There was no onycholysis or hyperkeratosis. Direct examination with potassium hydroxide demonstrated round yeast cells in the specimen. The samples were cultured on Sabouraud glucose agar containing chloramphenicol at 27 degrees C and showed white growth after a few days. The patient was successfully treated with systemic itraconazole.- - - - - - - - - - ranking = 0.5keywords = onycholysis (Clic here for more details about this article) |
4/5. Treatment of onychomycosis by ODT therapy with 20% urea ointment and 2% tolnaftate ointment.20 patients with distal onychomycosis were given daily application of an ointment containing 2% tolnaftate and an ointment containing 20% urea under ODT. Following this, 17 of 20 patients developed onychomalacia and seven of these developed onycholysis 1 or 2 weeks later. The separated nails were cut as short as possible. Similarly to those patients with onychomalacia alone, occlusive dressing technique was continuously performed until the newly developed nails became macroscopically normal and no fungi were observed microscopically (responders). Following treatment, out of 20 patients, 14 responded. 5 patients who had a short course of treatment did not respond. Side-effects such as pain, hemorrhage and infection did not occur.- - - - - - - - - - ranking = 0.5keywords = onycholysis (Clic here for more details about this article) |
5/5. onychomycosis caused by Scytalidium dimidiatum.We report a case of onychomycosis caused by Scytalidium dimidiatum (syn., Hendersonula toruloidea) in a patient who did not live in an endemic area. This nondermatophyte mold may produce disease indistinguishable from dermatophyte fungi, but it does not respond to current systemic antimycotic therapy. Distal subungual onychomycosis, lateral onycholysis followed by lateral nail plate invasion, and chronic paronychia are common nail presentations.- - - - - - - - - - ranking = 0.5keywords = onycholysis (Clic here for more details about this article) |