MyMedR

Trachyonychia

Leung AKC, Leong KF, Barankin B

J Pediatr, 2020 01;216:239-239.e1.

PMID: 31542154 DOI: 10.1016/j.jpeds.2019.08.034

Matched MeSH terms: Nail Diseases/pathology*

Fulltext Pattern and clinical characteristics of patients with nail psoriasis in Sarawak General Hospital, Malaysia

Yap FB, Pubalan M

Indian J Dermatol Venereol Leprol, 2010 Nov-Dec;76(6):703-4.

PMID: 21079320 DOI: 10.4103/0378-6323.72447

Study site: Skin Clinic, Sarawak General Hospital, Malaysia

Matched MeSH terms: Nail Diseases/epidemiology*; Nail Diseases/pathology*; Nail Diseases/therapy

Clinical observations on nail changes in psoriasis

Tham SN, Lim JJ, Tay SH, Chiew YF, Chua TN, Tan E, et al.

Ann Acad Med Singap, 1988 Oct;17(4):482-5.

PMID: 3265604

410 cases of psoriasis [282 males (68%) and 127 females (31%)] were interviewed and examined to study the nail changes. The prevalence of nail changes was 78.0% (males = females). Common changes were pitting (67.5%) and onycholysis (67.2%). Dystrophy of varying degrees occurred in 35.0%, subungual hyperkeratosis in 24.7%, discoloration in 18.4%, loss of nails in 2.8% and pustulation in 1.3%. Pitting and onycholysis was the most common combination (45.6%). Nail changes were significantly more common in patients who have moderate to severe psoriasis as compared with patients with mild psoriasis; in patients who have psoriasis for greater than 5 years as compared with patients who have psoriasis for less than 5 years; and in patients older than age 50 as compared with those aged less than 50. A definite correlation was found between the prevalence of nail changes and the presence of scalp and periungual psoriasis, and the presence of joint involvement.

Matched MeSH terms: Nail Diseases/complications*; Nail Diseases/ethnology; Nail Diseases/epidemiology

Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century

Leung AKC, Lam JM, Leong KF, Sergi CM

Int J Dermatol, 2019 Nov;58(11):1239-1245.

PMID: 31006857 DOI: 10.1111/ijd.14464

Melanonychia striata is characterized by a tan, brown, or black longitudinal streak within the nail plate that runs from the proximal nail fold to the distal part of the nail plate. Melanonychia striata is due to increased activity of melanocytes or melanocytic hyperplasia in the nail matrix with subsequently increased melanin deposition in the nail plate. The most common cause of melanonychia striata associated with melanocytic activation is ethnic melanonychia which occurs in dark-skinned individuals. Other causes of melanonychia striata related to melanocytic activation include pregnancy, chronic local trauma, infections, medications, dermatological disorders, endocrine disorders, alkaptonuria, hemochromatosis, porphyria, graft-vs-host disease, Peutz-Jeghers syndrome, and Laugier-Hunziker syndrome. Causes of melanonychia striata associated with melanocytic hyperplasia include nail matrix melanocytic nevus, nail lentigo, and nail apparatus/subungual in situ and invasive melanoma. In most cases, melanonychia striata is a benign condition, especially in children. Consequently, most investigators advocate a wait-and-see approach. Nail apparatus/subungual melanoma should be suspected if there is an abrupt onset after middle age, personal or family history of melanoma, rapid growth, darkening of a melanonychia band, pigment variegation, blurry lateral borders, irregular elevation of the surface, a bandwidth >3 mm, proximal widening, associated nail plate dystrophy, single rather than multiple digit involvement, and periungual spread of pigmentation onto the adjacent cuticle and/or proximal and/or lateral nail folds (Hutchinson sign). Prolonged follow-up is mandatory for early detection of possible malignant changes.

Matched MeSH terms: Nail Diseases/diagnosis*; Nail Diseases/pathology; Nail Diseases/therapy

Fulltext An adult patient with nail abnormality

Koh KC

Malays Fam Physician, 2011;6(1):34-5.

PMID: 25606219

This is the photograph of an adult male with Human Immunodeficiency Virus -Hepatitis C virus (HIV-HCV) co-infection. He was on highly active antiretroviral therapy (HAART) for HIV infection. The liver function tests showed hypoalbuminemia and elevated serum transaminases while liver ultrasonography showed coarse echotexture compatible with liver cirrhosis.

Matched MeSH terms: Nail Diseases

Fulltext Fungistatic effect of hydroxychloroquine, lessons from a case

Keshavarzi F

Med Mycol Case Rep, 2016 Sep;13:17-18.

PMID: 27709021

A 50-year-old male was prescribed with hydroxychloroquine (HCQ) after osteoarthritis was diagnosed. He had an old nail infection of Aspergillus niger. A remarkable improvement of the symptoms of fungal nail infection was seen after about four weeks of treatment with HCQ. It was very hard to detect the symptoms in the end of the second month of the treatment, both in the finger and toe nails. The symptoms were clearly recurred after HCQ was discontinued.

Matched MeSH terms: Nail Diseases

Synchronous glomus tumors in a distal digit: a case report

Noor MA, Masbah O, Lumpur K

J Hand Surg Am, 1997 May;22(3):508-10.

PMID: 9195463

Glomus tumors occurring synchronously in the subungual region and the pulp of a fingertip are extremely uncommon. Awareness of this will lead to early diagnosis and treatment.

Matched MeSH terms: Nail Diseases/pathology*; Nail Diseases/surgery

Clinical characteristics of patients with facial psoriasis in Malaysia

Syed Nong Chek SR, Robinson S, Mohd Affandi A, Baharum N

Int J Dermatol, 2016 Oct;55(10):1092-5.

PMID: 27061170 DOI: 10.1111/ijd.13307

BACKGROUND: Psoriasis involving the face is visible and can cause considerable emotional distress to patients. Its presence may also confer a poorer prognosis for the patient. This study sought to evaluate the characteristics of facial psoriasis in Malaysia.

METHODS: A cross-sectional study conducted using data from the Malaysian Psoriasis Registry from 2007 to 2011. Specific risk factors, i.e., age, age of onset, gender, duration of disease, obesity group, body surface area, Dermatology Life Quality Index (DLQI), family history of psoriasis, nail involvement, psoriatic arthritis, phototherapy, systemic therapy, clinic visit, days of work/school, and hospital admission due to psoriasis in the last 6 months were analyzed.

RESULTS: A total of 48.4% of patients had facial psoriasis. Variables significantly associated with facial psoriasis are younger age, younger age of onset of psoriasis of ≤ 40 years, male, severity of psoriasis involving >10% of the body surface area, higher DLQI of >10, nail involvement, and history of hospitalization due to psoriasis.

CONCLUSION: This study found that facial psoriasis is not as rare as previously thought. Ambient ultraviolet light, sebum, and contact with chemicals from facial products may reduce the severity of facial psoriasis, but these factors do not reduce the prevalence of facial psoriasis. The association with younger age, younger age of onset, higher percentage of body surface area involvement, higher DLQI of > 10, nail involvement, and hospitalization due to psoriasis support the notion that facial psoriasis is a marker of severe disease.

Matched MeSH terms: Nail Diseases/etiology; Nail Diseases/epidemiology

Fulltext Onychomadesis in a 20-Month-Old Child with Kawasaki Disease

Leung AKC, Leong KF, Lam JM

Case Rep Pediatr, 2019;2019:3156736.

PMID: 30944748 DOI: 10.1155/2019/3156736

Kawasaki disease is characterized by fever for ≥ five days, bilateral bulbar conjunctival injection without exudate, polymorphous rash changes in the extremities, oral mucosal changes, and cervical lymphadenopathy. We report a 20-month-old boy with Kawasaki disease who had onychomadesis affecting the fingernails and toenails bilaterally. To our knowledge, there were three reported cases of onychomadesis associated with Kawasaki disease, to which we add another one. We suggest keeping in mind the possibility of onychomadesis as a nail sequela of Kawasaki disease.

Matched MeSH terms: Nail Diseases

Fulltext Lichen Striatus with Nail Involvement in a 6-Year-Old Boy

Leung AKC, Leong KF, Barankin B

Case Rep Pediatr, 2020;2020:1494760.

PMID: 32047689 DOI: 10.1155/2020/1494760

We describe a 6-year-old boy with an asymptomatic linear eruption on the left index finger with mild erythema of the proximal nail fold, nail dystrophy, and subungual hyperkeratosis of the nail. A diagnosis of nail lichen striatus was made. The child was successfully treated with a topical corticosteroid. Because of its rarity, nail lichen striatus is often under-recognized. Physicians should be familiar with the nail involvement in individuals with lichen striatus so that an accurate diagnosis can be made and unnecessary investigations and treatment avoided.

Matched MeSH terms: Nail Diseases

Fulltext Subungual Glomus Tumours: Is Magnetic Resonance Imaging or Ultrasound Necessary for Diagnosis?

Pandey CR, Singh N, Tamang B

Malays Orthop J, 2017 Mar;11(1):47-51.

PMID: 28435574 DOI: 10.5704/MOJ.1703.020

INTRODUCTION: Diagnosis of subungual glomus tumour is mostly based on detailed history and clinical examination. Recently, Magnetic Resonance Imaging (MRI) and Ultrasound have been proposed as the imaging modality to confirm the clinical diagnosis and in planning the surgical management of these tumours. However, these imaging modalities are not routinely available in rural setting and also are expensive. Due to these limitations, we set out to establish that diagnosis and management of these rare tumours can be based solely on a battery of clinical tests and history taking.

MATERIALS AND METHODS: Retrospectively, we reviewed nine cases of glomus tumour. A clinical evaluation proforma was developed on the basis of clinical history and specific clinical test for diagnosis of these tumours. All the cases were evaluated and treated surgically by a single surgeon with a specific technique. Post-operatively, diagnosis was confirmed by histopathological examination.

RESULTS: Females (77.78%) were predominantly affected in this series and the tumours commonly occurred in the right hand (66.66%). Spontaneous pain, cold sensitivity test and Love's Pin test was positive in all cases (100%). Hildreth's test was positive in 88.89%. In none of the cases the tumours recurred during minimum follow-up of one year. In all cases, histopathological examination confirmed the preoperative diagnosis of glomus tumours.

CONCLUSION: Diagnosis of glomus tumours can be made clinically based on history taking and clinical examination. Magnetic Resonance Imaging and Ultrasound are not necessary for diagnosis and management of typical subungual tumours.

Matched MeSH terms: Nail Diseases

Fulltext A Case of Congenital Syphilis Presenting with Unusual Skin Eruptions

Leung AKC, Leong KF, Lam JM

Case Rep Pediatr, 2018;2018:1761454.

PMID: 29770234 DOI: 10.1155/2018/1761454

Once believed to be a rare disease in developed countries, recent data suggest that there is a surge in incidence of congenital syphilis in many developed countries. Diagnosis of congenital syphilis can be difficult because more than two-thirds of affected infants are asymptomatic at birth, and signs of symptomatic infants may be nonspecific or subtle. On top of this, some affected infants may have atypical presentations. Familiarity with the diverse presentations is essential to diagnosis. We report a 2-week-old male infant with congenital syphilis whose cutaneous manifestations included diffuse, erythematous keratoderma with desquamation and fissures on his hands and feet, multiple linear scaly fissures at the angles of his mouth, and onychauxis of the fingernails and toenails To our knowledge, diffuse, erythematous keratoderma of the hands and feet and thick nails have not been reported previously in congenital syphilis.

Matched MeSH terms: Nail Diseases

Maid abuse

Murty OP

J Forensic Leg Med, 2009 Jul;16(5):290-6.

PMID: 19481715 DOI: 10.1016/j.jflm.2008.12.020

Domestic maid violence is an assault and coercive behaviour, which mainly includes physical, psychological and at times sexual too, by employer or household members of employer against a person hired as a domestic help. Maid abuse is well known but poorly documented in scientific literature. This is an important global issue. In this article, two illustrated cases of maid abuse are discussed. Their employers allegedly subjected both the victims to physical and psychological trauma. The physical examination of the victims showed poor state of clothing, nutrition, and presence of injuries of different duration. The bruises were irregular to patterned, and were inflicted by beating. Both cases had eczematous contact dermatitis over palms and soles, paronechia, and sub-ungal fungal infection due to unprotected working in wet conditions. In both cases, external ears were deformed like cauliflowers due to repeated trauma. All cases had multiple injuries of varying duration. In this paper, medico-legal and social issues related to maid abuse are also discussed in detail. A possible solution to minimise maid abuse is also suggested. This paper highlights and document maid abuse.

Matched MeSH terms: Nail Diseases/pathology

Psoriasis among Sarawakian natives in a tertiary skin centre in Sarawak

Yap FBB

Australas J Dermatol, 2010 Aug;51(3):210-1.

PMID: 20695864 DOI: 10.1111/j.1440-0960.2010.00647.x

A prospective cross-sectional study was done between December 2007 and June 2009 in the skin clinic, Sarawak General Hospital, to determine the clinical characteristics of 138 Sarawakian natives with a clinical diagnosis of psoriasis. Women made up 50.7% and the mean age of the patients was 45.2 years. Of the group, 94.2% had chronic stable plaque psoriasis, 86.9% had a body surface area involvement of less than 10%, 60.9% had nail disease, 22.5% had joint disease and 55.1% had minimal effects to their quality of life because of their psoriasis.

Study site: skin clinic, Sarawak General Hospital

Matched MeSH terms: Nail Diseases/epidemiology

A clinical survey of paraquat formulation workers

Howard JK

Br J Ind Med, 1979 Aug;36(3):220-3.

PMID: 500781

A group of 18 male Caucasian workers from the United Kingdom and a further group of 18 male mixed race (mainly Malay) workers from Malaysia employed in the formulation of paraquat-based herbicides were examined for evidence of chronic ill health after long-term exposure to paraquat. Clinical records were examined, medical and occupational histories were obtained and a clinical examination, particularly of the skin, was undertaken. Skin rashes, nail damage and epistaxes were encountered by most workers as a result of direct contact of skin and mucous membranes with paraquat. These conditions subsided rapidly and no worker reported any sequelae. There was no clinical evidence of long-term effects on skin, mucous membranes or general health following exposure to paraquat over several years in these workers.

Matched MeSH terms: Nail Diseases/chemically induced

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