ABSTRACT
BACKGROUND: Hair and nails are known to be related in their origin and anatomical structures, and they are similar in their structure and growth pattern. Nail changes were first reported to be associated with alopecia areata (AA) in 1898. One of the clinical features of AA is nail abnormalities, and these are found in 7% to 66% of patients with AA. OBJECTIVE: We evaluated the frequency, clinical presentation, and associated factors of nail changes in patients with AA. METHODS: A prospective study of 121 patients with AA was performed. The diagnosis of AA was made on clinical grounds. Patients' medical history was obtained, and thorough examinations were performed. Patients with other diseases associated with nail changes were all excluded from the study. The association between the clinical features of patients with AA and the prevalence of nail changes was evaluated using logistic regression analysis. RESULTS: Of the 121 patients, 40 (33%) presented with nail changes. In multivariable analysis, younger age (compared with ≥19 years old; odds ratio [OR] 3.663, 95% confidence interval [CI] 1.094~12.346, p=0.035), chronicity (disease duration ≥2 years; OR 2.852, 95% CI 1.230~6.613, p=0.015), and disease subtype (alopecia totalis and alopecia universalis); OR 5.846, 95% CI 1.078~31.717, p=0.041) were identified as independent factors associated with nail changes in patients with AA. Among the nail abnormalities identified, nail pitting was the most common, observed in 20 patients (50%). Trachyonychia was present in 7 patients (16%), leukonychia in 7 (16%), and Beau line in 5 (11%). Other changes were also observed, including melanonychia, onycholysis, absence of lunula, and onychoschizia. CONCLUSION: In conclusion, younger age, chronicity, and disease subtype (alopecia totalis and alopecia universalis) were shown to be independent relevant indicators of the nail changes in patients with AA.
Subject(s)
Humans , Alopecia Areata , Alopecia , Diagnosis , Hair , Logistic Models , Nails, Malformed , Odds Ratio , Onycholysis , Prevalence , Prospective StudiesABSTRACT
Darier's disease is an uncommon genodermatosis, characterized by the symmetric eruption of keratotic papules, focal loss of epithelial adhesion and abnormal keratinization. A unilateral, or localized variant has been identified as a mosaic form, involving linear or 'zosteriform' epidermal lesions with clinical and histological features of Darier's disease. Some suggest that unilateral lesions should be classified as acantholytic dyskeratotic epidermal nevi, rather than localized Darier disease. A 17-year-old male presented with unilateral zosteriform distribution of brownish hyperkeratotic papules with ipsilateral v-notching of the thumb nail. A biopsy specimen revealed acantholysis, suprabasal cleft and multiple dyskeratotic cells. We report a case of unilateral Darier's disease which further supports unilateral dermatologic manifestation as a variant of Darier's disease.
Subject(s)
Adolescent , Humans , Male , Acantholysis , Biopsy , Darier Disease , Keratins , Nails , ThumbABSTRACT
Docetaxel is a new taxoid antineoplastic drug widely used for advanced breast cancer , ovarian cancer . Skin and nail toxicity are one of the more frequent nonhematologic adverse reactions. Especially, nail changes include dark pigmentation, subungual hemorrahage, acute paronychia, onycholysis, Beau s line etc. We have observed a striking example of multiple Beau s lines from all fingernails and toenails in a man receiving a docetaxel infusion for treatment of metastatic cancer with unknown-origin.
Subject(s)
Breast Neoplasms , Nails , Onycholysis , Ovarian Neoplasms , Paronychia , Pigmentation , Skin , Strikes, EmployeeABSTRACT
BACKGROUND: At least 30 per cent of diabetics, which is said to comprise over 3% of general population in Korea, have one or more cutaneous complications during the course of the disease. These skin changes may be the consequences of microangiopathy, arteriosclerosis, direct metabolic disturbances and/or the sequelae of chronic therapy. OBJECTIVE: We tried to observe certain cutaneous and nail changes in diabetics and to relate them with systemic complications, blood sugar level and duration of diabetes. METHODS: During the period of 12 months from March, 1992 to February, 1993, a total of 1858 outpatients diagnosed as diabetes mellitus at Eulji General Hospital were examined. RESULTS: The cutaneous manifestations are observed in 79.5% of diabetics examined and cutaneous infections are the most prevalent(52.3%). Pruritus(p<0.01), anogenital pruritus(p<0.01), peripheral dedema(p<0.05) are more common in females and infections, shin spots, finger pebbles(p<0.01) are more common in males. Systemic complications are observed in 50.7% and the cutaneous manifestations are observed more frequently in patients with systemic complications(p<0.05). Shin spots, diabetic foot, peripneral edema diabetic bullosis are observed frequently associated with systemic microangiopathic complications such as retinopathy, nephropathy and neuropathy(p<0.01). There is a significant correlation between blood sugar level and fungal infections and anogenital pruritus(p<0.01). The frequencies of shin spots, diabetic foot and diabetic bullosis increase with the length of time diabetes has been present. Nail changes are observed in 39.6% of diabetics and onychomycosis is the most frequent(34.5%). CONCLUSION: It is suggested that cutaneous shgns especially fungal infections in diabetics are on the increase in Korea. A variety of skin conditions are encountered with diabetes mellitus and the dermatologist may be able to make a significant contribution in the control of diabetes mellitus by identifying skin signs and conditions as diabetic complications.