Exposome Impact on Nail Health.

Background: The nail unit is a complex system with various components, each serving distinct functions. The exposome, encompassing external and internal factors such as UV radiation, air pollution, dietary habits, and cosmetic product usage, substantially influences nail health and can lead to premature nail aging. Summary: Internal and external exposomal factors can impact differently on nail health, inducing a variety of different clinical conditions. Effective therapeutic strategies exist, but a comprehensive understanding of how the exposome affects nails is lacking. This article aims to bridge this knowledge gap by exploring the relationship between the exposome and nail health, emphasizing it as a central focus of our analysis. Key Messages: (1) The exposome, comprising various external and internal factors, may significantly influence nail health negatively, leading to premature nail aging. (2) Different nail conditions may arise due to the exposomal influence on nails. (3) Understanding the exposome's impact on nail health is crucial for developing solutions to mitigate negative effects and improve overall nail well-being.

Review of the literature on the efficacy and safety of a new cosmetic topical treatment containing Pistacia lentiscus and hyaluronic acid for the treatment of nail plate damages.

OBJECTIVES: The objective of our study is the review of the literature on the efficacy and safety of a novel water-soluble nail strengthened (WSNS) containing hyaluronic acid and Pistacia lentiscus used for the improvement of nail plate diseases. MATERIALS AND METHODS: We conducted literature research on PubMed/MEDLINE to identify all the studies reporting the use of hyaluronic acid and P. lentiscus in the improvements of nail alterations. RESULTS: We found two reports and two posters published in the literature, accounting for 96 patients treated with WSNS containing P. lentiscus and hyaluronic acid. The 83 patients were affected by brittle nails and 13 patients by onychomycosis. CONCLUSIONS: This review demonstrates that the daily application of this new product containing P. lentiscus and hyaluronic acid can be used as a cosmetic adjuvant for improving common nail diseases such as nail fragility and onychomycosis, with significant results on nail quality and appearance. Patients did not report any adverse events and its ease of application and cosmetic qualities contribute to the great compliance to treatment.

Etiopatogenia de las uñas frágiles / Etiopathogenesis of brittle nails

Las uñas frágiles se caracterizan por ser quebradizas, de superficie áspera y descamativa, es una entidad que predomina en mujeres y afecta principalmente las uñas de las manos. En condiciones normales las uñas estás compuestas por agua, cuya concentración oscila entre 7 % al 18 %, lípidos entre 0,1 % y 5%, siendo el colesterol su principal componente, además están compuesta por células queratinizadas sin descamación, dando origen a tres capas histológicas llamadas dorsal, media y ventral. Estas también contienen trazas de elementos como hierro y zinc. La alteración y disminución de estos componentes favorecen está condición. La causa puede ser idiopática o secundaria a enfermedades sistémicas, pueden estar presentes en algunas patologías dermatológicas. Una correcta anamnesis e historia clínica son necesarias para un correcto abordaje terapéutico. Su implicación cosmética nos obliga a tener un conocimiento claro de su etiopatogenia para así poder establecer un tratamiento efectivo y oportuno(AU)

Brittle nails are characterized by being brittle, witha rough and scaly surface, it is an entity that predominates inwomen and mainly affects the fingernails. In normal conditions the nails are made up of water, whose concentration ranges from7% to 18%, lipids between 0.1% and 5%, with cholesterol beingits main component, they are also composed of keratinized cellswithout desquamation, giving rise to three histological layerscalled dorsal, middle and ventral. These also contain traces ofelements such as iron, and zinc. The alteration and decreaseof these components favor this condition. Yhe cause may beidiopathic or secondary to systemic diseases, they may be presentin some dermatological pathologies. A correct anamnesis andmedical history are necessary for a correct therapeutic approach.Its cosmetic involvement forces us to have a clear understandingof its pathogenesis in order to establish an effective and timelytreatment(AU)

Variant NAXOS-Carvajal Syndrome with Rare Additional Features of Systemic Bulla and Brittle Nails: A Case Report and Literature Review.

Skin abnormalities are often indicative of cardiovascular diseases. Such a disease entity is called cardiocutaneous syndrome; however, the details regarding the involvement of bulla and nails remain largely unclear. A 49-year-old man with systemic bulla was admitted for heart failure. His bulla had previously been diagnosed as epidermolysis bullosa, but no known gene mutations for it had been identified. He had a triad of palmoplantar keratosis, curly and fine hair, and cardiomyopathy, which are characteristic of NAXOS-Carvajal syndrome. This case highlights the fact that bulla and brittle nails can accompany NAXOS-Carvajal syndrome, showing that these extra-cardiac findings can help identify otherwise overlooked serious cardiac conditions.

Efficacy and Acceptability of a New Water-Soluble Nail Strengthener Containing Pistacia lentiscus and Hyaluronic Acid to Improve the Appearance of Brittle Nails versus Untreated Nails: In vitro and Clinical Evidence.

INTRODUCTION: Brittle nail syndrome is characterized by dry, weak, easily breakable nails that show inelasticity, splitting and overall nail plate fragility. OBJECTIVE: This paper describes in vitro and clinical studies using bovine hooves designed to assess the efficacy, compatibility and acceptability of a water-soluble nail strengthener (WSNS), containing Pistacia lentiscus and hyaluronic acid, for the treatment of patients affected by brittle nails. METHODS: In the in vitro study, the WSNS was tested versus placebo and a marketed product on bovine hoof membranes, applied once daily for 14 days for evaluation of firmness, viscoelasticity and thickness before and after applications. In a clinical study, 23 female subjects affected by brittle nails were included, and the WSNS was applied once daily for 3 months. Signs and symptoms were rated by the investigators and by the participants during treatment at 28 and 84 days with different methods and dermoscopic images. Subjective efficacy was evaluated by specific questionnaires. RESULTS: In the in vitro study, the daily application of the WSNS and marketed product led to a significant increase in firmness index. In the clinical study, the nails on the treated hand presented an improvement in nail appearance and weakness, after 28 and 84 days of WSNS application, respectively. The nails not treated showed no improvement. The WSNS was well tolerated. CONCLUSIONS: The WSNS containing Pistacia lentiscus and hyaluronic acid was shown to significantly increase nail firmness in the in vitro study. In the clinical study, WSNS significantly improved brittle nail appearance. The hydrosolubility and easy-to-apply format of WSNS were reported to be factors of a good compliance. We consider this product as an important tool to improve and reinforce the aspect of brittle nails.

Clinical and Instrumental Objective Evidence of the Efficacy of a New Water-Based Nail-Strengthening Solution Containing Pistacia lentiscus and Hyaluronic Acid Applied for Up to 6 Months to Improve the Appearance of Weak, Brittle Nails.

INTRODUCTION: Brittle nails are fragile or split nails; they affect 20% of the population and may be primary or secondary to different conditions. The aim of our studies was to evaluate the efficacy and tolerability of a new water-based nail-strengthening treatment containing hyaluronic acid and Pistacia lentiscus with daily application for a period of 1-3 months for one study (n = 30) and up to 6 months for a second study (n = 30). METHODS: In total, we enrolled 60 patients of both sexes with brittle and weak nails due to primary or secondary causes and evaluated the efficacy of this new product using subjective and objective methods: clinical evaluation, assessment of photographs, onychoscopy evaluation, investigator and patient global assessment, dynamic optical coherence tomography (D-OCT) and reflectance confocal microscopy (RCM). RESULTS: Studies subjects presented a statistically significant improvement in global assessment scale (GAS) scores at 14 days (GAS = 1.7 ± 0.6), 1 month (GAS = 1.4 ± 0.7) and at 3 months (GAS = 1±0.7) versus the GAS score obtained before treatment (1.9 ± 0.5) (p < 0.0001). From the Italian study at 6 months (n = 30) 76% of the patients had an improvement in their nail appearance. Reduction in nail plate roughness with improved nail resistance and decreased distal breakage were the most evident benefits, demonstrated on clinical and instrumental evaluations. No side effects were reported. All patients reported an improvement in nail appearance after using the product for 1 month, 3 months and 6 months, and had a positive opinion on the product. CONCLUSIONS: This new product is an effective, safe, and easy-to-use option for topical treatment of brittle nails and primary nail fragility and an adjuvant therapy in secondary nail fragility. Moreover, its ease of application and cosmetic qualities allow good compliance. FUNDING: ISDIN.

What's New in Nail Disorders.

Various advancements in the diagnosis and management of nail diseases have transpired in recent years. To provide the best care for patients with nail complaints, it is essential that physicians be updated on new diagnostic and treatment modalities. The purpose of this article is to discuss new and oncoming diagnostic and management options for nail disorders, including nail psoriasis, retronychia, brittle nails, onychotillomania, trauma, trachyonychia, and pyogenic granulomas.

Biotin for the treatment of nail disease: what is the evidence?

AIM: To describe the pharmacology, mechanism of action, and clinical reports using biotin to treat nail conditions. METHODS: A review of articles indexed for MEDLINE on PubMed using keywords 'biotin' and 'nail' was performed and applicable articles were selected for review. RESULTS: Clinical trials have shown an improvement in firmness, hardness, and thickness of brittle nails with oral biotin. There are some case reports and series demonstrating that oral biotin may improve triangular worn down nails, trachyonychia, and habit tic nail deformity. CONCLUSIONS: Oral biotin has been used to treat several nail conditions with promising results. Further larger clinical trials with controls are necessary to determine efficacy and optimal dosing.

Oral supplementation with specific bioactive collagen peptides improves nail growth and reduces symptoms of brittle nails.

BACKGROUND: Brittle nail syndrome is a common problem among women and refers to nails that exhibit surface roughness, raggedness, and peeling. AIM: The goal of this study was to investigate whether daily oral supplementation with collagen peptides alleviates the symptoms of brittle nails and improves nail growth rate. METHODS: In this open-label, single-center trial, 25 participants took 2.5 g of specific bioactive collagen peptides (BCP, VERISOL® ) once daily for 24 weeks followed by a 4-week off-therapy period. Nail growth rate and the frequency of cracked and/or chipped nails as well as an evaluation of symptoms and global clinical improvement score of brittle nails were assessed by a physician during treatment and 4 weeks after discontinuation. RESULTS: Bioactive collagen peptides treatment promoted an increase of 12% nail growth rate and a decrease of 42% in the frequency of broken nails. Additionally, 64% of participants achieved a global clinical improvement in brittle nails, and 88% of participants experienced an improvement 4 weeks post-treatment. The majority of participants (80%) agreed that the use of BCP improved their nails' appearance, and were completely satisfied with the performance of the treatment. CONCLUSIONS: This study demonstrated that the daily ingestion of BCP increased nail growth and improved brittle nails in conjunction with a notable decrease in the frequency of broken nails.

Tips to treat the 5 most common nail disorders: brittle nails, onycholysis, paronychia, psoriasis, onychomycosis.

Nail disorders are difficult to treat and often frustrating both for patients and clinicians. Because of the slow growth rate of the nail plate and the difficulty of getting the drug actives to penetrate the nail tissues, it is usually necessary to wait several months before seeing the results of treatments. This delay often leads to discontinuation of therapy by the patients. This article therefore helps clinicians to find the right treatment of the 5 most common nail disorders (brittle nails, onycholysis, paronychia, psoriasis, and onychomycosis) and provides practical tips that might improve patients' compliance.