Cases reported "Nail Diseases"

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1/61. Yellow nails and minimal change nephrotic syndrome.

    We report a case of a 38-year-old man showing the yellow nail syndrome in association with minimal change nephrotic syndrome. Treatment with prednisone and vitamin e resulted in complete resolution of the nephrotic syndrome and slow improvement of the yellow nails, respectively. Although the rare yellow nail syndrome has been described in association with renal disease, this is the first report of the association of this syndrome with minimal change nephrotic syndrome.
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2/61. yellow nail syndrome: the nail that grows half as fast grows twice as thick.

    We report a case of a 51-year-old man with yellow nail syndrome (YNS).1 During a 23-week period of study, the dynamics of thumbnail growth were compared between one affected thumb and the normal contralateral thumb. Longitudinal nail growth was normal (0.46 mm/week) in the normal thumb and double that of the affected thumb (0.23 mm/week). Thickness of nail at the free edge in the affected thumb (0.97 mm) was twice that of the normal thumb (0.57 mm). Within the nail plate in the dorso-ventral axis there were 50% more cells in the affected thumb (358) in comparison with the contralateral control (242). This case illustrates that rate of longitudinal growth does not necessarily reflect nail plate production.
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3/61. yellow nail syndrome: resolution of yellow nails after successful treatment of breast cancer.

    yellow nail syndrome (YNS) is a rare entity of unknown cause in which congenitally hypoplastic lymphatics play a major role in the clinical manifestations of the disease. YNS has been associated with many malignancies and immune disorders. We report a case of new-onset YNS associated with breast cancer and dramatic improvement in the yellow nails with cancer treatment.
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4/61. yellow nail syndrome in a 10-year-old girl.

    A 10-year-old girl with yellow dystrophic nails, bronchiectasis, chronic sinusitis and lower-limb lymphedema is presented. The underlying mechanism remains unknown although it has been postulated to be associated with lymphatic abnormalities. To date no causative treatment exists. Our patient was treated with conservative management, including a low-fat diet supplemented with medium-chain triglycerides. Moderate improvement in the lymphedema of the lower extremities was observed. To our knowledge this is the first case of yellow nail syndrome to be treated with diet.
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5/61. Clear cell syringofibroadenoma (of Mascaro) of the nail.

    Eccrine syringofibroadenoma (ESFA) is a rare disorder. We report the first case of ESFA of the nail apparatus, which presented as a yellow longitudinal onycholytic band of the left fourth finger over an intermittently painful subungual filamentous tumour. Histological examination showed features of ESFA with a digitate pattern of papillomatosis due to the specialized physiological longitudinal arrangement of the ridges in the nail bed. In addition, we describe a new feature of colloidal iron-positive clear cells. In our case, the presence of two types of cells with a central ductal differentiation and a significant amount of mucopolysaccharides in clear cells could suggest differentiation towards both the ductal and the secretory portion of the eccrine gland.
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6/61. yellow nail syndrome: does protein leakage play a role?

    yellow nail syndrome is characterized by primary lymphoedema, recurrent pleural effusion and yellow discoloration of the nails. Although mechanical lymphatic obstruction is assumed to be the underlying pathology, it cannot explain the common finding of high albumin concentration in the pleural space. This paper describes a case of yellow nail syndrome presenting with the classical triad of lymphoedema, recurrent pleural effusion and yellow discoloration of the nails, associated with persistent hypoalbuminaemia and increased enteric loss of albumin. Based on the findings in this case and those in the literature, it is speculated that increased microvascular permeability may contribute to the pathogenesis of this syndrome.
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7/61. yellow nail syndrome associated with thiol compound therapy for rheumatoid arthritis. Two case reports.

    yellow nail syndrome is characterized by ungual dystrophy, lower limb lymphedema, and pleural effusions or bronchiectasis. Rheumatoid arthritis is the autoimmune disorder most often associated with yellow nail syndrome. We report two new cases of yellow nail syndrome in patents receiving thiol compound therapy for rheumatoid arthritis. Eight similar cases have been reported since 1979, suggesting a possible causative effect of this class of drugs.
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8/61. bowen's disease clinically simulating an onychomatricoma.

    Onychomatricoma (OM) is an uncommon benign tumor clinically characterized by a thickened yellowish nail with transverse over curvature. A pigmented variant has recently been described. Histologically, the diagnosis requires 3 prerequisites: (1) a fibroepithelial tumor consisting of 2 portions: the proximal zone (under the proximal nailfold, characterized by deep epithelial invaginations and a fibrillary and fibrocytic stroma), whereas the distal zone (corresponding to the lunula) presents with multiple digitations along its connective tissue axes; (2) a matricial tumor typified by a thick keratogenous zone; and (3) a thick nail plate, perforated by cavities. We describe a case that appears clinically identical to a pigmented OM, but with histologic malignant patterns. Because histologic features were consistent with bowen's disease, we ruled out a malignant OM. We report a new variant of bowen's disease presenting as OM, and this observation underlines the necessity for a histologic assessment of all forms of OM, especially those associated with a pigmented band (a sign sometimes observed in bowen's disease).
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9/61. yellow nail syndrome or diffuse lymphatic network disease.

    We report a man aged 68 years old with pneumothorax and chronic bilateral pleural effusion in association with a history of yellow nails. The diagnosis of yellow nail syndrome based on yellow nails, lymphedema, chronic pleural effusion and intestinal lymphangiectasia.
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10/61. onycholysis and subungual haemorrhages secondary to systemic chemotherapy (paclitaxel).

    paclitaxel is a chemotherapic agent of the taxane family used in treatment of malignant solid tumory. We report here the case of a 40-year old woman referred to our clinic for nail changes involving all 20 digits and developed after 5 months of paclitaxel intake, due to a breast carcinoma. Clinical examination revealed red-brown discoloration of the nails associated with hematomas and onycholysis. The nail changes were very painful and the patient complained of discharge of bad-smelling yellow brown opaque fluid from underneath the nail plate. Hemorrhagic onycholysis and subungual abscesses are a possible side effect of taxane treatment that should be early recognized to prevent serious complications.
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