ABSTRACT
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.
Subject(s)
Nail Diseases/diagnosis , Psoriasis/diagnosis , Humans , Keratoderma, Palmoplantar/diagnosis , Severity of Illness IndexABSTRACT
BACKGROUND: Onychomycosis of the toenail caused by nondermatophyte molds alone or in combination with dermatophytes is difficult to eradicate with standard antifungal therapy. OBJECTIVE: Our purpose was to determine the effectiveness of itraconazole in the treatment of toenail onychomycosis caused by molds alone or in combination with dermatophytes. METHODS: We treated 36 patients with this drug given as continuous dosing (100 or 200 mg/ day) for 6 to 20 weeks or as a 1-week pulse dosing (200 mg twice daily for 1 week per month) for two to four pulses. RESULTS: Patients with toenail onychomycosis with the following organisms were treated: Aspergillus spp. (eight patients), Fusarium spp. (four patients), Scopulariopsis brevicaulis (23 patients), and Alternaria spp. (one patient). Nineteen patients had onychomycosis with a mixed origin. At follow-up, 12 months after therapy was initiated, clinical and mycologic cure was achieved in 15 of 17 patients (88%) with onychomycosis caused by a single mold. In patients with mixed infection, a clinical cure was obtained in 16 of 19 patients (84%) and a mycologic cure in 13 of 19 patients (68%). CONCLUSION: Itraconazole appears to be effective and safe for the treatment of toenail onychomycosis caused by some nondermatophyte molds alone or in combination with dermatophytes.
Subject(s)
Antifungal Agents/therapeutic use , Foot Dermatoses/drug therapy , Itraconazole/therapeutic use , Onychomycosis/drug therapy , Drug Administration Schedule , Follow-Up Studies , Foot Dermatoses/microbiology , Humans , Onychomycosis/microbiology , Treatment OutcomeABSTRACT
In order to discourage her habit of nail biting and to repair her damaged nails, a 50-year-old woman sought cosmetic improvement in a beauty salon, where a manicurist suggested the use of sculptured nails. A permanent paresthesia resulted from this procedure without allergic reaction.
Subject(s)
Acrylic Resins/adverse effects , Beauty Culture , Nail Diseases/chemically induced , Paresthesia/chemically induced , Female , Humans , Middle Aged , Patch Tests/methodsABSTRACT
We present three patients with Bowen's disease of the fingernail folds and beds in which there was polydactylous involvement and add those to five similarly afflicted patients described by other authors. Bowen's disease of the nail is a distinctive type of squamous cell carcinoma that differs from other variants. It is potentially an autochthonous process that can involve more than one nail with the passage of time. Seven-eighths of the patients described in this series were men. A majority had involvement of both hands. No metastases were seen.