Psoriasiform Onychodystrophy Induced by Photobonded Acrylic Nails.

Multiple cases have reported onychodystrophy secondary to acrylic nails. We present a case of onychodystrophy with psoriasiform nail changes, including onycholysis, splinter hemorrhages, hyperkeratosis, and nail plate thinning, caused by gel manicures. Histopathological analysis of the nail plate and subungual debris revealed neutrophils in the absence of fungal elements. Although the presence of neutrophils in the nail plate material in conjunction with characteristic psoriatic nail changes suggested a diagnosis of psoriasis, certain key features of nail psoriasis, including oil spots, salmon patches, and pitting, were notably absent. The development of these nail changes following gel manicure and pedicure application and the improvement of the onychodystrophy with topical and intralesional steroids support the diagnosis of psoriasiform onychodystrophy.

The effects of gel-based manicure on pulse oximetry.

INTRODUCTION: Pulse oximetry is the standard monitoring technique of functional oxygen saturation (SpO2). As the use of fingernail polish has been described to alter SpO2 readings, its removal is commonly recommended prior to measurement. Gel-based manicures have gained popularity in recent years due to their attractiveness and longevity. However, the removal of gel nail polish requires a specialised procedure. Valuable time and resources can be saved if removal can be avoided. To our knowledge, there are no available studies on the effect of gel-based manicures on pulse oximetry readings. Hence, we evaluated the effect with two oximeters, using different technology and wavelength combinations. METHODS: 17 healthy female adult volunteers were recruited for this single-blind randomised controlled trial. Subjects with hypothermia, hypotension, poor plethysmographic waveform and nail pathology were excluded. Colours tested were: black, purple, navy blue, green, light blue, white, yellow, orange, pink and red. Pulse oximetry was measured at 15- and 30-second intervals using two different pulse oximeters, the Philips M1191BL and Masimo SET®. Means were compared using paired t-tests. RESULTS: Using the Masimo oximeter, light blue (ΔM = 0.97% ± 0.96%; p = 0.001) and orange (ΔM = 0.76 ± 1.17%; p = 0.016) gel nail polish resulted in a statistically significant increase from baseline SpO2 readings. With the Philips oximeter, the limits of agreement ranged from 2% for pink to 17% for black, indicating imprecision. CONCLUSION: Gel-based manicures can result in overestimations of actual readings, delaying detection of hypoxaemia. Gel nail polish should be routinely removed or an alternative monitoring technique sought.

The effects of gel-based manicure on pulse oximetry

INTRODUCTION@#Pulse oximetry is the standard monitoring technique of functional oxygen saturation (SpO). As the use of fingernail polish has been described to alter SpO readings, its removal is commonly recommended prior to measurement. Gel-based manicures have gained popularity in recent years due to their attractiveness and longevity. However, the removal of gel nail polish requires a specialised procedure. Valuable time and resources can be saved if removal can be avoided. To our knowledge, there are no available studies on the effect of gel-based manicures on pulse oximetry readings. Hence, we evaluated the effect with two oximeters, using different technology and wavelength combinations.@*METHODS@#17 healthy female adult volunteers were recruited for this single-blind randomised controlled trial. Subjects with hypothermia, hypotension, poor plethysmographic waveform and nail pathology were excluded. Colours tested were: black, purple, navy blue, green, light blue, white, yellow, orange, pink and red. Pulse oximetry was measured at 15- and 30-second intervals using two different pulse oximeters, the Philips M1191BL and Masimo SET®. Means were compared using paired t-tests.@*RESULTS@#Using the Masimo oximeter, light blue (ΔM = 0.97% ± 0.96%; p = 0.001) and orange (ΔM = 0.76 ± 1.17%; p = 0.016) gel nail polish resulted in a statistically significant increase from baseline SpO readings. With the Philips oximeter, the limits of agreement ranged from 2% for pink to 17% for black, indicating imprecision.@*CONCLUSION@#Gel-based manicures can result in overestimations of actual readings, delaying detection of hypoxaemia. Gel nail polish should be routinely removed or an alternative monitoring technique sought.