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How to prevent and treat chemotherapy-induced nail abnormalities
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
Furthermore, the patients can be advised about preventative measures to limit nail toxicities (nail plate changes, onycholysis and periungual lesions) (Robert et al. 2015; Lacouture 2015):Keep fingernails as dry as possible.Always use a double pair of gloves (first in cotton and second in vinyl, nitrile, or latex).Avoid repeated trauma or friction from manicuring and restrict frequent use of nail polish and nail polish removers.Use wide and comfortable shoes.Apply topical emollients to cuticles and periungual tissues frequently.Some nail lacquers such as hydroxypropyl chitosan or polyurethane 16% seem to be useful to reduce water evaporation from the nail plate and have a barrier effectCollaboration with a podiatrist can be useful.
Leg, foot and nail disease in the elderly
Published in Robert A. Norman, Geriatric Dermatology, 2020
M. Alam, R. K. Scher, P. I. Schneiderman
Bacterial infection of the nail unit may be acute or chronic81,140. Acute bacterial paronychia may be prurulent, induced by staphylococcus infection, and treated by incision and drainage followed by oral antibiotics. Chronic paronychia appears as red, edematous, tender nail folds, and may be caused by Gram-negative organisms like Proteus or Klebsiella species, or by Candida. Chronic paronychias may deform the nail plate. The nails should be kept dry and treated with a topical antifungal lotion in addition to a topical antiseptic at least twice a day141. Several weeks to months of treatment may be required. The green discoloration of the nail plate caused by Pseudomonas aeruginosa infection can be corrected by removing the onycholytic nail plate and applying topical gentamicin or sulfacetamide three times a day141,142.
Topical Products Applied to the Nail
Published in Heather A.E. Benson, Michael S. Roberts, Vânia Rodrigues Leite-Silva, Kenneth A. Walters, Cosmetic Formulation, 2019
Apoorva Panda, Avadhesh Kushwaha, H.N. Shivakumar, S. Narasimha Murthy
The nail plate chemically comprises of fibrous protein called keratin that provides the necessary mechanical strength to the epithelial cells. Keratins found in humans are either hair keratin or epithelial keratin. Nearly about 80–90% of the keratin present in the nail is the hair keratin, while the rest would be the epithelial keratin. Hair keratin is found to be concentrated in the intermediate layer of the nail plate, while the epithelial keratin is present in the dorsal and ventral layers. Keratin fibres in the nail plate are interconnected through cysteine-rich proteins which are linked via disulphide bridges. This sandwich orientation of keratin fibres imparts the necessary hardness and rigidity to the nail plate (Kobayashi et al., 1999).
Laser microporation facilitates topical drug delivery: a comprehensive review about preclinical development and clinical application
Published in Expert Opinion on Drug Delivery, 2023
Yiwen Zhao, Jewel Voyer, Yibo Li, Xinliang Kang, Xinyuan Chen
Human nail consists of nail plate and four epithelial tissues including nail matrix, nail bed, hyponychium and perionychium. Human nail plate is about 0.25–0.60 mm in thickness and comprised of roughly 25 layers of closely packed dead keratinocytes within a matrix of keratin filaments [90]. The upper layer of the human nail plate is slightly elastic and poorly permeable and acts as a primary barrier for topical drug delivery. Nail illnesses are difficult to cure due to poor permeation of topical medicine into the nail bed, pain from intralesional injections, and patients’ noncompliance with long-term therapy. AFL was used to treat nail plates to generate tiny channels to enhance topical drug delivery in vitro and in vivo (Table 4).
Optimal diagnosis and management of common nail disorders
Published in Annals of Medicine, 2022
Clinically, there are three types of nail fragility: lamellar onychoschizia, onychorrhexis and superficial granulation of keratin. Lamellar onychoschizia, also known as lamellar dystrophy, is characterized by the presence of fine horizontal layers that crack and peel easily from the free margin (Figure 1(A)). Impaired intercellular adhesion of the nail plate is thought to contribute to this condition [2,3,6]. This form of nail fragility is common in patients who wash their hands excessively (e.g. healthcare workers and homemakers) and those with lichen planus [3,5]. Onychorrhexis is defined as longitudinal splitting and fissuring of the superficial nail plate (Figure 1(B)). It is often seen among the elderly and in conjunction with onychoschizia. Its clinical presentation depends on the severity and degree of involvement of the nail matrix. It may result from an isolated split at the free edge of the nail plate that extends proximally [3]. Superficial granulation of keratin presents in the distal nail plate. It is characterized by white-yellow discolouration and striations. The keratins in the nail plate undergo an exfoliative process resulting in formation of patches. This condition is most commonly reported in patients who wear nail varnish often [3,5].
A novel technique to evaluate nail softening effects of different urea formulations
Published in Pharmaceutical Development and Technology, 2021
Hiep X. Nguyen, Yujin Kim, Tejas D. Kekatpure, Emily Lesica, Ajay K. Banga
Nails play an important role in the human body by protecting the distal part of fingers and toes. Nail deformation has been considered a major concern from the aesthetics perspective and protective function. Among various nail diseases and conditions, fungal nail infection (onychomycosis) appears to be the most prominent, which can lead to the thickening of the nail plate. Common strategies to treat fungal nail infections include chemical or surgical removal of the infected nail, and systemic or topical drug therapy. Topical drug delivery appears superior to physical removal of the nail (an invasive strategy) or oral administration (possible adverse effects of first-pass metabolism, hepatotoxicity, and drug-drug interaction). However, the intact and rigid nail plate creates a major barrier to topical drug delivery. This poor penetration of topical compounds from the nail plate to the nail bed (The site of antifungal action) diminishes the efficacy of the treatment.