Biomedical subjects
Publications and source records attributed to R K Scher.
In this article, we have discussed the possible causes of a longitudinal pigmented nail band. A thorough history, physical examination, and, when indicated, biopsy of the origin of the band should reassure the patient with a benign lesion and direct further treatment of a patient with a malignant or potentially malignant lesion.
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Brittle nails effect as much as 20% of the population and are significantly more common in women than in men. The major factor of this condition is dehydration of the nail plate. The causes of this dehydration are discussed with relevance to the structure, function, and development of the nail unit. The current approaches to the management of this difficult problem are also presented.
Disorders of the nails may be brought about by systemic disease or outside influences. Although many of the products available on the market may be of great benefit in offering palliation of abnormalities of the nail plate, they may also be a source of significant adverse effects. Treatment of nail disorders must be predicated on a well-focused history, physical examination, and proper tissue samples.
Nail abnormalities secondary to contact with cosmetic preparations are well documented in the literature. This report documents a case of nail dystrophy apparently secondary to use of a hair spray.
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Explore the source record for details and available documents.
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Idiopathic atrophy of the nails has been described as an acquired condition of childhood wherein the changes may lead to permanent loss with scarring of the nail bed. Three patients with idiopathic atrophy are described here, two of whom are siblings, ages 9 and 11 years. The authors suggest that all family members of patients with this condition be examined for possible involvement.
Onychology (the study of nails) is an important area in dermatology. We discuss the dermatologists' opportunity to educate their patients and colleagues about nail disorders, review the diagnostic techniques for evaluating nails, and describe some of the possible topics for additional research.
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Evaluation of dystrophic nails must include a thorough assessment of the patient's occupation. Unless this is done, it will not be possible to ascertain the correct diagnosis, and without this, successful therapy is impossible. The spectrum of clinical change exhibited by the nails is limited so that every effort must be made to ensure accuracy.
The varied systemic pathologic alterations that occur in patients with diabetes mellitus may result in profound changes that affect the nail unit. These findings vary from simple onycholysis to a spectrum of infectious processes, as well as extensive, irreversible destruction. The influence of the vascular and neurologic systems in producing these clinical findings is presented. The purpose of this review is to alert the physician to another aspect of diabetes mellitus, namely, its effect on the various components of the nail unit.
Reflex sympathetic dystrophy following a nail unit biopsy in a patient with long-standing, mycologically negative onychomycosis is reported. The significance of this complication is discussed, and the literature on the condition itself is reviewed. It is suggested that although adverse effects occur as a result of nail biopsy, they are infrequent and therefore should not dissuade the clinician from performing the procedure. Biopsy is necessary in order to establish a more accurate diagnosis of nail disease and thus administer more appropriate and effective therapy.
Graft versus host disease is associated with a myriad of cutaneous signs and few nail manifestations. A case of documented chronic graft versus host disease with the initial cutaneous presentation of white superficial onychomycosis is presented. The patient developed a lichenoid eruption in an unusual distribution and a reticulated hyperpigmentation of the face. Culture of the nails was positive for Trichophyton rubrum, an uncommon cause of white superficial onychomycosis, this being the third known reported case. Histopathologic examination revealed fungal elements in the superficial nail plate with an absence of fungus in the ventral aspect of the nail plate. A summary of cutaneous skin and nail manifestations in graft versus host disease is presented.
This article describes a number of syndromes affecting the nail unit. When a patient presents with a complaint involving the nails, it is important to consider first the common nail disorders. However, one should evaluate the entire patient to discover associated signs or symptoms that would point toward an underlying syndrome. The dermatologist may have an opportunity to discover a syndrome that might have significant related morbidity or mortality, which may be prevented through early detection. By recognizing the presence of inherited syndromes, the dermatologist may facilitate genetic counseling. It should be noted that most of the syndromes described are of autosomal dominant inheritance, with variable expressivity, and that the individual manifestations can vary widely in severity, making recognition difficult.
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