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Nail in children: Congenital and hereditary diseases
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Type I (Jadassohn and Lewandowsky type): It is due to mutations in keratin 6a and 16. The nails in this syndrome are normal at birth but become progressively discolored and thickened with age, usually in the first year. Wedge-shaped or V-shaped subungual hyperkeratosis is the characteristic finding (Figure 24.5). This may develop in one of two ways: nails that grow to full length but have an upward inclination due to prominent subungual distal hyperkeratosis or “early ending of the nail” and the curving of distal hyperkeratosis. The other associated features include palmoplantar hyperhidrosis, acral bulla, and oral leukokeratosis. Plantar keratoderma poses another limitation in these patients and can be present in 10.4% of affected patients (Figures 24.5 and 24.6). The keratoderma is more prominent at pressure points on the heel and ball of great toe.
Systemic Diseases and the Skin
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Jana Kazandjieva, Razvigor Darlenski, Nikolai Tsankov
Clinical presentation: In hyperthyroidism (Graves’s disease), the skin is most commonly warm, sweaty, soft, and velvety. Palmoplantar hyperhidrosis, facial flushing, skin pigmentation and exophthalmos; fine, soft, and thinned scalp hair; thyroid acropachy (distorted and overgrown nails); and onycholysis are also associated with hyperthyroidism. The explanation of hyperpigmentation in hyperthyroid patients is the increased release of pituitary adrenocorticotropic hormone compensating for accelerated cortical degradation. In addition, pruritus is a common presenting complaint. Thyroid dermopathy is almost always associated with ophthalmopathy (Figure 29.1).
Retinoids in Keratinization Disorders
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
This is a diffuse transgrediens palmoplantar erythrokeratoderma characterized by keratotic knee, elbow, and finger lesions with a perilesional erythematous halo. There may be palmoplantar hyperhidrosis with fetid odor. Severe periodontitis and alveolar bone resorption lead to progressive loss of teeth. Growth and mental deficiencies and brain calcifications have been described.
The pharmacological treatment and management of hyperhidrosis
Published in Expert Opinion on Pharmacotherapy, 2022
Anna Campanati, Stamatis Gregoriou, Adamantia Milia-Argyti, George Kontochristopoulos, Giulia Radi, Federico Diotallevi, Emanuela Martina, Annamaria Offidani
Palmoplantar hyperhidrosis (PPH) is characterized by chronic excessive hand and/or sole sweating (sweaty palms/soles). For clinical study purposes mostly, palmar hyperhidrosis is defined as the secretion of >20 mg sweat pro hand and minute in rest conditions or gravimetrically as 2 standard deviations above mean values for a normal population (50 mg/min/m2) [57,58]. PPH occurs in both sexes and commonly appears around childhood or puberty. Patients with involvement of the palms and soles have the earliest mean age of onset [59]. It may persist for years and tend to spontaneously improve after the age of 25 years. It affects up to 3% of the population and has a noticeable impact on quality of life [59,60].