Nail Involvement in Alopecia Areata: A Questionnaire-based Survey on Clinical Signs, Impact on Quality of Life and Review of the Literature.

Alopecia areata (AA) is an immune-mediated disease causing temporary or permanent hair loss. Up to 46% of patients with AA also have nail involvement. The aim of this study was to determine the presence, types, and clinical implications of nail changes in patients with AA. This questionnaire-based survey evaluated 256 patients with AA. General demographic variables, specific nail changes, nail-related quality of life (QoL), and treatment history and need were evaluated. Prevalence of nail involvement in AA was 64.1%. The specific nail signs reported most frequently were pitting (29.7%, p = 0.008) and trachyonychia (18.0%). Red spots on the lunula were less frequent (5.1%), but very specific for severe AA. Nail-related QoL was only minimally affected by nail changes. In conclusion, nail involvement is common in patients with AA and presents mostly with pitting and trachyonychia. The presence of these nail changes reflects the severity of the disease, with red spots on the lunula as a predictor for severe alopecia.

[A woman with a tumour on the sole of her foot]. / Een vrouw met een tumor onder haar voetzool.

A 53-year-old woman came to de department of Dermatology with a tumour on the sole of her foot that appeared 5 years ago. A histology test revealed a desmoplastic melanoma. This is a rare type of melanoma that is, in an early stage, frequently mistaken for a benign tumour. Desmoplastic melanoma has a high rate of local recurrence and a low incidence of distant metastases, unlike other melanomas.

Efficacy of microbial cell preparation in improving chronic constipation: a randomized, double-blind, placebo-controlled trial.

BACKGROUND & AIMS: Probiotics is an emerging therapeutic agent which may alleviate the symptoms of constipation. We evaluated the effectiveness of microbial cell preparation (Hexbio(®)) containing fructooligosaccharide, Bifidobacterium and Lactobacillus in improving stool frequency and symptoms of chronic constipation. METHODS: A total of 120 constipated adults diagnosed using Rome III criteria were randomized and given either microbial cell preparation or placebo to be consumed twice daily. Follow-up was done after a 7-day intervention based on a questionnaire which includes an assessment of symptom profile and a stool diary. RESULTS: During the intervention period, the stool frequency was higher (p = 0.001) in the treatment group. Subjects experienced less straining (p = 0.001) and sensation of incomplete evacuation (p < 0.001), as well as improved stool consistency (p < 0.001) compared to the placebo group. While a higher proportion of subjects in the treatment group had a reduction in anorectal blockage sensation and having to defecate by manual maneuvers, the differences were not statistically significant. CONCLUSION: The results suggest that microbial cell preparation is effective in improving stool frequency and stool consistency. Furthermore, it could reduce the symptoms of straining and sensation of incomplete evacuation in adults with chronic functional constipation. MREC REG NO: 866.59 (IRB, UMMC, Malaysia).