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At least 973 records · Page 54Linked to original sources
PubMed2004

Innate immune defense of the nail unit by antimicrobial peptides.

BACKGROUND: The nail is susceptible to microbial invasion, yet is usually able to defend itself from infection. This occurs despite isolation from cell-mediated immunity. OBJECTIVE: The aim of this study was to determine whether soluble innate immune molecules are present in the nail environment that can protect against microbial colonization. METHODS: Chromatographic techniques were used to purify cationic antimicrobial molecules from porcine hoof extracts. Sections of human and mouse digits were immunostained with antibodies to each species' cathelicidin antimicrobial peptide. Liquid antimicrobial assays were used to determine the activity of these molecules against relevant pathogens. RESULTS: Human, porcine, and murine nails contain antimicrobial molecules, and the human cathelicidin LL-37 can kill Candida albicans. CONCLUSION: The presence of antimicrobial peptides in nails with activity against relevant nail pathogens may account for the ability of the nail unit to resist infection in the absence of direct access to the cellular immune system.

Animals↗
PubMed2005

Bioadhesive patch-based delivery of 5-aminolevulinic acid to the nail for photodynamic therapy of onychomycosis.

The in vitro penetration of 5-aminolevulinic acid (ALA) across human nail and into neonate porcine hoof when released from a novel bioadhesive patch containing 50 mg cm(-2) ALA is described. ALA is a naturally occurring precursor of the photosensitiser protoporphyrin IX (PpIX). Topical application of excess ALA bypasses negative feedback inhibition and yields photosensitising concentrations of PpIX at the application site. ALA-based photodynamic therapy (PDT) has been extensively investigated in the topical treatment of various skin neoplasias. Recently, its use has been extended to the microbiological field. If sufficient concentrations of ALA could be achieved within the nail matrix, and at the nail bed, PDT may prove to be a useful treatment for onychomycosis. Patch application for 24 h allowed an ALA concentration of 2.8 mM to be achieved on the ventral side of excised human nail. Application for 48 h induced a concentration of 6.9 mM. Application time had no significant effect on the ALA concentration at mean depths of 2.375 mm in neonate porcine, with application times of 24, 48 and 72 h all producing concentrations of 0.1 mM. Incubation of Candida albicans and Trichophyton interdigitale with ALA concentrations of 10.0 mM for 30 min and 6 h, respectively, caused reductions in viability of 87% and 42%, respectively, following irradiation with red light. Incubation with 0.1 mM ALA for 30 min and 6 h, respectively, caused reductions in viability of 32% for Candida albicans and 6% for Trichophyton interdigitale, following irradiation. Drug penetration across nail may be improved using penetration enhancers, or by filing of the impenetrable dorsal surface of the nail. Moreover, iron chelators can be used to increase PpIX production for a given ALA dose. Therefore, with suitable modifications, ALA-PDT may prove to be a viable alternative in the treatment of onychomycosis.

Adhesives↗
PubMed2003

The Marchetti-Vicenzi nail. A DGH experience.

From July 1993 to September 1997, 28 nailings were done on 26 patients using the Marchetti-Vicenzi flexible nail. The minimum length of follow-up was 1 year. All the patients were examined clinically and radiographically. All the 19 tibiae united. Of the nine femur fractures, one required exchange nailing. Complications were delayed union, mal-union, shortening and infection. The complication rate was 3/19 for the tibia and 2/19 for the femur. The mean operative time and the mean fluoroscopy time for the tibia nailings was 36 and 0.22 min and for the femur nailings was 39 and 0.20 min, respectively. This was much lower than that for Russell-Taylor nails.

Adolescent↗
PubMed1980

A double compression medullary nail: preliminary report of an early clinical trial.

The use of the double compression medullary nail in 5 cases of fracture of the femur is reported. The results are very promising as the nail gives excellent stability, affords efficient internal fixation of fractures of the proximal and distal thirds of the shaft, allows very early weight bearing and in this small series has brought about very early strong union with a minimal time in hospital and a short period away from work. There were no complications and no difficulties were encountered in nail extraction. We believe that this nail may prove to be the solution to the various biomechanical limitations of medullary nailing and may be the universal nail for fractures of the femoral shaft.

Adolescent↗
PubMed1984

Yellow nail syndrome.

Yellow nail syndrome was first described in 1964 by Samman and White. The full syndrome consists of the triad yellow nails, lymphedema, and pleural effusions with associated respiratory tract involvement. However, yellow nails alone or with any combination of the triad is termed yellow nail syndrome. We are describing a patient with yellow nails and pulmonary disease, whose nails cleared after resolution of his pulmonary condition. Although various therapeutic approaches have been used, the treatment of pulmonary disease was important in our patient.

Diagnosis, Differential↗
PubMed2004

[Onychomatricoma, a rare lesion of the nail].

Onychomatricoma is a rare fibroepithelial lesion of the nail matrix with peculiar clinical and histological features. Clinically, it is characterized by a longitudinal band of yellow thickening of the nail plate with transverse overcurvature and splinter hemorrhages. Nail avulsion exposes a villous tumor of the matrix with filamentous digitations extending into multiple holes of the nail plate. Histologically, a thick keratogenous zone forms a thickened nail plate. The lesion in its proximal portion is characterized by deep epithelial invaginations and by a stroma organized in two layers. The distal zone corresponds to multiple fibroepithelial projections extending into the nail plate. The diagnosis can be difficult in the presence of misleading clinical features or when the specimen is incomplete or examined with an improper orientation. Surgical resection is the recommended treatment.

Humans↗
PubMed1996

Nail regeneration in digits replanted after amputation through the distal phalanx.

Nail regeneration was studied in 48 digits replanted after amputation through the distal phalanx. Twenty-seven were amputated through Tamai's zone I, at the nailbed level, and 21 digits were amputated through zone II, proximal to the nail. The nails of 9 digits in zone I and 14 in zone II showed almost normal nail regeneration. We observed that replantation after amputations distal to the lunula will show near normal nail regeneration if there is minimal postoperative circulatory disturbance. Amputations proximal to the lunula, however, have a greater chance of causing damage to the germinal matrix, which results in more problems with nail growth.

Adolescent↗
PubMed1995

Retrograde intramedullary nailing of supracondylar femur fractures above total knee arthroplasty. A preliminary report of four cases.

Four supracondylar fractures of the femur in three patients with total knee arthroplasties were treated by retrograde intramedullary nailing using an interlocking renamed nail (GSH Nail, Smith and Nephew Richards, Memphis, TN) specifically designed for fractures of the distal femur. Three cases were acute fractures and one was a refracture through a screw hole of a previously plated supracondylar fracture. All fractures healed and there were no complications. The procedure is performed by closed nailing using fluoroscopic guidance with the nail placed through the intercondylar notch of the femoral prosthesis and interlocking to the fracture fragments with a percutaneous targeting device. The advantages are that the procedure is performed by closed techniques that preserve the fracture hematoma and reduce operative blood loss, the fracture is stabilized by a load-sharing nail, and immediate motion with limited weight bearing is possible.

Aged↗
PubMedDate not supplied

Artificial nails: are they putting patients at risk? A review of the research.

The use of artificial nails has become a popular fashion trend, and many health care workers are following this trend. There is debate whether artificial nails are putting patients at risk of nosocomial infections. Researchers have shown that the colony counts on artificial nails are greater than the colony counts on native nails. Artificial nails have also been linked to poor hand washing practices and more tears in gloves. These factors lead to an increased risk of transmitting bacteria to patients. This transmission could greatly affect patients because the hospitalized patient's risk of nosocomial infection is high. The purpose of this article is to review the data related to the bacterial and fungal contamination of artificial nails and their implications for health care workers. Most of the review describes findings of studies of surgical patients and health care workers who work in surgery departments, but the research applies to any area where there is a risk of transferring potential pathogens to immunocompromised patients.

Bacterial Infections↗
PubMed1998

Calcipotriol ointment in nail psoriasis: a controlled double-blind comparison with betamethasone dipropionate and salicylic acid.

This double-blind randomized study was designed to compare the efficacy and safety of calcipotriol ointment (50 microg/g) with betamethasone dipropionate (64 mg/g) and salicylic acid (0.03 g/g) ointment in the treatment of nail bed psoriasis. Fifty-eight patients applied the given drug to the affected nails twice a day for 3-5 months, depending on clinical response. Efficacy was assessed monthly on the basis of nail thickness, measured in millimetres. Photographs of the treated nails were taken at baseline, and after 3 and 5 months. Tolerability was assessed at 3 and 5 months. In patients with fingernail psoriasis, after 3 months of treatment subungual hyperkeratosis was reduced from 2.3 +/- 0.1 mm (mean +/- SEM) to 1.5 +/- 0.1 mm (-26.5%) in the calcipotriol group and from 2.3 +/- 0.1 mm to 1.6 +/- 0.1 mm (-30.4%) in the betamethasone dipropionate and salicylic acid group [not significant (NS) between treatments, analysis of variance (ANOVA)]. After 5 months, responders showed a 49.2% reduction in hyperkeratosis in the calcipotriol group (from 2.8 +/- 0.1 mm to 1.4 +/- 0.2 mm) and 51.7% (from 2.1 +/- 0.1 mm to 1.0 +/- 0.1 mm) in the betamethasone dipropionate and salicylic acid group (P < 0.001 from baseline, NS between treatments, ANOVA). In patients with toenail psoriasis, after 3 months of treatment there was an overall reduction in hyperkeratosis from 2.6 +/- 0.1 mm to 2.1 +/- 0.1 mm (-20.1%) in the calcipotriol group and from 3.0 +/- 0.1 mm to 2.3 +/- 0.1 mm (-22. 9%) in the betamethasone dipropionate and salicylic acid group (P < 0.001 from baseline, NS between treatments, ANOVA). By the end of the fifth month there was a 40.7% reduction in hyperkeratosis in the calcipotriol group (from 2.1 +/- 0.1 mm to 1.2 +/- 0.1 mm) and 51.9% in the betamethasone dipropionate and salicylic acid group (from 2.7 +/- 0.1 mm to 1.3 +/- 0.1 mm; P < 0.0001 from baseline, NS between treatments, ANOVA). The results of the study show that calcipotriol is as effective as a combination of a topical steroid with salicylic acid in the treatment of nail psoriasis and represents a safe alternative in the topical treatment of nail psoriasis.

Adult↗
PubMed1999

Global nail dystrophy associated with human papillomavirus type 57 infection.

Verrucae vulgares frequently induce nail dystrophy when infection of the nail matrix occurs. Classic periungual warts are easily recognized by the experienced physician. We report a very unusual presentation of human papillomavirus (HPV) infection of the nail matrix and nail bed involving all 20 nails in an otherwise immunocompetent patient. Viral typing by in situ hybridization revealed HPV type 57. To our knowledge, this is the first association between dystrophy of all 20 nails and HPV infection. However, as the ease of HPV typing improves, a variety of previously unrecognized cutaneous lesions is likely to be associated with HPV infection.

Aged↗
PubMed1999

Pincer nail deformity and pseudo-Kaposi's sarcoma: complications of an artificial arteriovenous fistula for haemodialysis.

Pseudo-Kaposi's sarcoma which develops due to arteriovenous fistulae for haemodialysis is relatively well known. In contrast, nail changes associated with pseudo-Kaposi's sarcoma or venous hypertension are rare. We report a novel case of pincer nail deformity associated with pseudo-Kaposi's sarcoma and venous hypertension, complications of an arteriovenous fistula for haemodialysis, and review eight similar cases reported in the literature. Most of the subjects presented with similar findings, having circulatory disturbance due to an arteriovenous fistula and/or increased venous pressure, and swelling, discoloration and papules/nodules of the skin distal to the shunt. Of the nine patients, three had overcurvature of the nails, in which the lateral edge of the nail pressed deeply into the lateral nail fold. Pincer nail deformity associated with pseudo-Kaposi's sarcoma after placement of an arteriovenous fistula may be relatively common and should be recognized as a specific sign of circulatory disturbance due to the arteriovenous fistula.

Arteriovenous Shunt, Surgical↗
PubMed2001

Nail pathology in patients with hemiplegia.

BACKGROUND: It is well known that nails can be involved in some diseases of the central nervous system; however, no systematic study has been carried out in order to evaluate the incidence and the possible mechanisms of these nail changes in hemiplegia. OBJECTIVES: To study the presence of nail pathology specifically associated with hemiplegia and to evaluate its incidence and its temporal relationship with the onset of the neurological deficit. METHODS: In an open study, fingernails and toenails were examined by a dermatologist; 108 were patients with hemiplegia due to a stroke, consecutively admitted to our Department of Neurology between 1995 and 1998, and 121 were normal controls. RESULTS: Onychodystrophy of fingernails and onychomycosis of toenails were found in both patients with hemiplegia and normal controls. However, three conditions (longitudinal reddish striation, neapolitan nails and unilateral clubbing) were only observed in some patients, always affecting fingernails of the limb affected by hemiplegia. Neapolitan nails were present in three (3%) patients with hemiplegia which had its onset 3-14 months earlier. Hemiplegia had occurred approximately 40 months earlier, on average, in six patients (6%) with longitudinal reddish striation, and 60-120 months prior to unilateral clubbing in another two patients (2%). CONCLUSIONS: In this study we were able to assess the presence of three different fingernail conditions that were characteristically associated with hemiplegia (longitudinal reddish striation, neapolitan nails and unilateral clubbing), to evaluate their incidence and to study the delay with which these changes occur after a stroke.

Adult↗
PubMed2004

A nail psoriasis severity index.

BACKGROUND: The Psoriasis Area and Severity Index does not take the severity of nail involvement into account. OBJECTIVES: To devise a system of scoring for nail psoriasis. METHODS: A system of scoring for nail psoriasis was devised that takes into account the site of the pathology, i.e. (i) the matrix, (ii) the subungual tissues distal to the lunula, or (iii) the whole nail unit. RESULTS: The proposed scoring system evaluates several signs of nail psoriasis separately, each on a 1-3 scale: pitting, Beau's lines, subungual hyperkeratosis and onycholysis. CONCLUSIONS: Using this classification it will be possible to assess and grade nail pathology simply and accurately.

Humans↗
PubMed2003

Presence of dermatophytes on the nails of tinea capitis patients. Prospective study in the area of Sfax (Tunisia).

Between January 1995 and December 2000, 512 cases with mycologically confirmed tinea capitis have been diagnosed in our laboratory. In addition, finger nail samples have been taken from 211 patients out of 512. The culture of the nail samples taken was positive for 80 patients (38%). The isolated dermatophytes were the same in the nails and the scalp. Microsporum canis was isolated in 82% of nail samples. Trichophyton violaceum grew only in 18% and Trichophyton quinckeanum in one case. A T. violaceum onychomycosis was found in two patients with tinea capitis. Twenty-one cases of tinea were resistant to 6 weeks treatment with griseofulvin. Thirty per cent of them have had fungal elements in nails. Dermatophyte colonization of the nails in tinea patients could be a factor of tinea capitis transmission and could explain some recurrent tinea capitis cases and therapy resistance.

Antifungal Agents↗
PubMed2000

Keratin 17 expression in the hard epithelial context of the hair and nail, and its relevance for the pachyonychia congenita phenotype.

The hard-keratin-containing portion of the murine hair shaft displays a positive immunoreactivity with an antibody against the soft epithelial keratin, K17. The K17-expressing cell population is located in the medulla compartment of the hair. Consistent with this observation, K17-containing cells also occur in the presumptive medulla precursor cells located in the hair follicle matrix. Western blot analysis of hair extracts prepared from a number of mouse strains confirms this observation and suggests that K17 expression in the hair shaft is a general trait in this species. The expression of K17 in human hair extracts is restricted to eyebrow and facial hair samples. These are the major sites for the occurrence of the pili torti (twisted hair) phenotype in the type 2 (Jackson-Lawler) form of pachyonychia congenita, previously shown to arise from inherited K17 mutations. Given that all forms of pachyonychia congenita show an involvement of the nail, we compared the expression of the two other genes mutated in pachyonychia congenita diseases, K6 and K16, with that of K17 in human nail. All three keratins are abundantly expressed within the nail bed epithelium, whereas K17 protein is expressed in the nail matrix, which contains the epithelial cell precursors for the nail plate. Our data suggest a role for K17 in the formation and maintenance of various skin appendages and directly support the concept that pachyonychia congenita is a disease of the nail bed.

Animals↗
PubMed2002

Treatment of recurrent ingrown great toenail associated with granulation tissue by partial nail avulsion followed by matricectomy with sharpulse carbon dioxide laser.

BACKGROUND: The effectiveness of partial nail avulsion followed by matricectomy with carbon dioxide (CO2) laser for the treatment of ingrown great toenails remains unclear. OBJECTIVE: This study sought to determine the effectiveness of partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of recurrent ingrown great toenails associated with granulation tissue. MATERIALS AND METHODS: Fourteen patients with a total of 18 recurrent ingrown great toenails were randomly selected for participation in this study. Partial nail avulsions followed by matricectomy with sharpulse CO2 laser were performed on the involved nails. After at least 6 months, we evaluated the recurrence of ingrown toenails, regrowth of the nail spike, duration of post-treatment pain and post-treatment infection. RESULTS: Partial nail avulsion followed by matricectomy with sharpulse CO2 laser in the treatment of ingrown toenails resulted in a high cure rate, short postoperative pain duration and low risk of postoperative infection. CONCLUSION: This method we advocate is convenient and effective for the treatment of recurrent ingrown great toenail associated with granulation tissue.

Adolescent↗
PubMedDate not supplied

Prevalence and nature of nail alterations in pediatric patients.

The purpose of this investigation was to explore the frequency and nature of ungual alterations in patients of a pediatric dermatology department at a third-level pediatric hospital. The first 20 patients with nail alterations seen each year during a 5-year period from 1992 through 1996 were included, totaling 100 patients. The rate of nail alterations was 11% (1/9) in pediatric dermatology patients. There were 5 infants, 19 preschoolers (2- to 5-year-olds), 38 school children (6- to 11-year-olds), and 38 adolescents (12- to 17-year-olds). The most frequent diagnoses were onychomycosis (23), nail alterations in a genodermatosis (23), nail alterations associated with dermatoses (16), onychocryptosis (11), and paronychia (10). Toenails were involved in 54 patients, fingernails in 25, and both in 21 patients. Twenty nails were involved in 21 patients. A high prevalence of nail alterations was found in pediatric dermatology patients, some of which were nonspecific, while others provided important diagnostic clues.

Adolescent↗