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Classical nail surgery and removal of the proximal nail fold
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Removing the nail plate is probably one of the most frequently performed surgeries worldwide – and the least indicated! It is almost never a treatment per se and must not be a substitute of a diagnosis. Different techniques are described in the surgical literature, but many are very crude and often result in permanent nail dystrophy. The technique using a sturdy hemostat clamp, running it under the proximal nail fold and then under the nail, firmly grasping the plate and tearing it from the nail bed by rotating the hemostat clamp is extremely traumatizing and, therefore, obsolete. There are two recommended techniques using a blunt nail elevator: the distal and the proximal approach (Figure 21.3).
Dyskeratosis Congenita
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Nail dystrophy is seen in approximately 90% of patients, with fingernail involvement often preceding toenail involvement. Progressive nail dystrophy begins with ridging and longitudinal splitting. Progressive atrophy, thinning, pterygium, and distortion eventuate in small, rudimentary, or absent nails.
Microbiology
Published in Michael McGhee, A Guide to Laboratory Investigations, 2019
Non-dermatophyte moulds are frequently cultured from samples of dystrophic nails, but in the majority of cases they are there simply as saprophytic organisms. More often than not, the primary cause of such nail dystrophy is a dermatophyte infection that may be masked in culture by overgrowth of the mould. In these cases, treatment of the dermatophyte will allow normal nail growth and saprophytic moulds will simply disappear.
Cronkhite-Canada syndrome: a retrospective analysis of four cases at a single medical center
Published in Scandinavian Journal of Gastroenterology, 2022
Xing Yu, Chengdang Wang, Mi Wang, Yinchen Wu, Linlin Zhang, Qinyu Yang, Long Chen
Digestive symptoms were the initial clinical symptoms in all the four patients. The main digestive symptoms were diarrhea (4/4), abdominal pain (2/4), abdominal distension (1/4), hypogeusia (2/4), and bloody stool (1/4). The diarrhea usually occurred 3–5 times per day and occasionally up to 8–10 times with mushy or watery stools. All the patients had at least one symptom of ectodermal dysplasia, including alopecia (3/4) (Figure 1(A)), nail dystrophy (4/4) (Figure 1(B)) and skin hyperpigmentation (3/4), and two patients had all ectodermal symptoms. Scalp hair loss was the most common type of hair loss, which also occurred in the eyebrows, pubic hair, and armpits. Nail dystrophy was characterized by thinning and shedding of nails. Skin hyperpigmentation was mainly observed on the face and limbs. Weight loss (4/4) and edema (2/4) also occurred.
Ribosomopathies and cancer: pharmacological implications
Published in Expert Review of Clinical Pharmacology, 2022
Gazmend Temaj, Sarmistha Saha, Shpend Dragusha, Valon Ejupi, Brigitta Buttari, Elisabetta Profumo, Lule Beqa, Luciano Saso
10) Dyskeratosis congenita is a disorder that affects many parts of the body. Three features are characteristic of this disorder: a) fingernails and toenails that grow poorly or are abnormally shaped (nail dystrophy); b) changes in skin coloring (pigmentation), especially on the neck and chest, in a pattern often described as ‘lacy’; and c) white patches inside the mouth. Individuals with congenital dyskeratosis may develop leukemia, pulmonary fibrosis, eye abnormalities, hair loss, low bone mineralization, and dental problems. They have a higher risk of developing cancer in different body parts [277,278]. In patients affected with this type of disease, mutations in TERT, TERC, DKC1, and TINF2 have been found. hTR and hTER are the main telomerase components produced by TERC and TERT genes, respectively. hTR is an RNA molecule, a chimerical cousin of DNA [279–281].
AL amyloidosis presenting as inflammatory polyarthritis: a case report
Published in Modern Rheumatology Case Reports, 2021
Muhammad Shoaib Momen Majumder, Shamim Ahmed, Md. Nahiduzzamane Shazzad, Mohammad Mamun Khan, Syed Atiqul Haq, Mohammed Kamal, Md. Sohrab Alam, Johannes J. Rasker
On physical examination, the patient was found moderately pale looking, all vital signs were normal. His pulse rate was 80/min, regular with normal volume, blood pressure 120/70 mm of Hg, respiratory rate 18/min, there was no lower limb edoema or lymphadenopathy. There were papules and plaques over the periocular, perinasal, and perioral area, macroglossia with indentation of the tongue, pinch purpura in the oral cavity (Figures 1 and 2). Nail dystrophy was present in some of his fingers. There was no organomegaly, apex beat was situated in the 5th intercostal space along the midclavicular line. Musculoskeletal examination revealed localised, mildly tender, soft tissue swelling of variable size and shape (largest one was 5Х3 cm, Figure 3 over the wrist) over flexor and extensor aspects of wrists and back of knees. Both shoulders were swollen (shoulder pad sign positive, Figure 4), tenderness was present over MCPs, wrists, elbows, and shoulders. He had an antalgic gait. Active and passive movements of wrists and shoulders were painful and restricted. Flexion contracture (30 degrees) was present in the left elbow.