Pub Date : 2024-06-01Epub Date: 2024-03-08DOI: 10.1159/000537760
Eric R Bray, Antonella Tosti, Brian W Morrison
Background: Squamous cell carcinoma (SCC) and SCC in situ (Bowen's disease) are the most common malignancies of the nail unit. They are frequently seen in men over 50 and most commonly affect the fingers. The role of high-risk human papillomavirus (HPV) infection has been identified as a key contributor to the development of nail unit SCC.
Summary: In this review, we aimed to summarize the current state of our understanding of how HPV contributes to nail unit SCC, the role of genitodigital transmission of HPV, and the clinical features of HPV-associated nail unit SCC. We also review current advances in the treatment of nail unit SCC, with a focus on the potential role of HPV vaccination in the treatment and prevention of nail unit SCC.
Key messages: Nail unit SCC should be recognized as an HPV-associated disease. HPV vaccination may represent a non-surgical modality for the management of these challenging malignancies in the appropriate clinical setting.
{"title":"Update on Squamous Cell Carcinoma of the Nail Unit: An Human Papillomavirus-Associated Condition.","authors":"Eric R Bray, Antonella Tosti, Brian W Morrison","doi":"10.1159/000537760","DOIUrl":"10.1159/000537760","url":null,"abstract":"<p><strong>Background: </strong>Squamous cell carcinoma (SCC) and SCC in situ (Bowen's disease) are the most common malignancies of the nail unit. They are frequently seen in men over 50 and most commonly affect the fingers. The role of high-risk human papillomavirus (HPV) infection has been identified as a key contributor to the development of nail unit SCC.</p><p><strong>Summary: </strong>In this review, we aimed to summarize the current state of our understanding of how HPV contributes to nail unit SCC, the role of genitodigital transmission of HPV, and the clinical features of HPV-associated nail unit SCC. We also review current advances in the treatment of nail unit SCC, with a focus on the potential role of HPV vaccination in the treatment and prevention of nail unit SCC.</p><p><strong>Key messages: </strong>Nail unit SCC should be recognized as an HPV-associated disease. HPV vaccination may represent a non-surgical modality for the management of these challenging malignancies in the appropriate clinical setting.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11147528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The toes are the distal extension of the foot increasing its weight-bearing area and the security of the stance. The nails are the acral part of the toes and are so intimately linked with the distal interphalangeal joint, its ligaments, and tendons that they were also called musculoskeletal appendages. The big toe is of particular importance for gait and stance. Anatomic alterations of the foot and toe lead to pathological changes of the nails, both directly as well as indirectly. Methods: The author evaluated the clinical photographs of 1,663 patients examined for toenail conditions. Results: It was found that a normal straight axis of the first ray of metatarsal and phalanx bones occurred in less than 10% of the patients with hallux valgus and hallux valgus interphalangeus being extremely frequent. The commonest nail changes observed were compression nail (n = 247), ingrown nail (196), onychomycosis (192), disappeared nail bed (191), congenital malalignment (118), pincer nails (118), and nail overcurvature (114). The most frequent foot-toe abnormalities were hallux valgus (775) and hallux valgus interphalangeus (1,277). Conclusion: Although a direct causal relationship is hard to prove it was realized that most of the nail changes were associated with foot and toe abnormalities. The study reveals that assessing toenail changes requires examination of the entire foot, best in relaxed, standing, and walking conditions.
{"title":"Foot, Toe, and Nail Changes: Are They Interdependent?","authors":"Eckart Haneke","doi":"10.1159/000538531","DOIUrl":"https://doi.org/10.1159/000538531","url":null,"abstract":"Introduction: The toes are the distal extension of the foot increasing its weight-bearing area and the security of the stance. The nails are the acral part of the toes and are so intimately linked with the distal interphalangeal joint, its ligaments, and tendons that they were also called musculoskeletal appendages. The big toe is of particular importance for gait and stance. Anatomic alterations of the foot and toe lead to pathological changes of the nails, both directly as well as indirectly. Methods: The author evaluated the clinical photographs of 1,663 patients examined for toenail conditions. Results: It was found that a normal straight axis of the first ray of metatarsal and phalanx bones occurred in less than 10% of the patients with hallux valgus and hallux valgus interphalangeus being extremely frequent. The commonest nail changes observed were compression nail (n = 247), ingrown nail (196), onychomycosis (192), disappeared nail bed (191), congenital malalignment (118), pincer nails (118), and nail overcurvature (114). The most frequent foot-toe abnormalities were hallux valgus (775) and hallux valgus interphalangeus (1,277). Conclusion: Although a direct causal relationship is hard to prove it was realized that most of the nail changes were associated with foot and toe abnormalities. The study reveals that assessing toenail changes requires examination of the entire foot, best in relaxed, standing, and walking conditions.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glaura Tinoco Plata, Rita Fernanda Cortez de Almeida, V. Tortelly
Background: Lichen planopilaris (LPP) manifests as uni or multifocal patches of scarring alopecia across the scalp. Its symptoms include pruritus, trichodynia, and burning. Trichoscopy is a critical tool for early disease detection. In African descendants, LPP poses additional diagnostic challenges, given the black scalp peculiarities. These specific features include lower hair density, slower growth, and structural differences, compared to Caucasians. Moreover, the healthy black scalp may show distinctive features such as a honeycomb-pigmented network and sparse pinpoint white dots. Summary: In individuals of African descent, the most prevalent scarring alopecia is Central Centrifugal Cicatricial Alopecia, an important differential diagnosis for LPP in this population. LPP trichoscopy in the black scalp reveals unique features such as perifollicular erythema in the early stages, which often manifests as hyperpigmentation. This study aimed to review the literature on trichoscopy findings in LPP on black scalp categorizing them into distinct stages and highlighting their unique yet understudied characteristics. Key Messages: Despite not being as prevalent as nonscarring alopecias and not so frequent in the black scalp, LPP’s aesthetic and devastating psychosocial impact raise concerns. Therefore, early recognition is paramount to halt the progress of LPP, mitigate its psychosocial impact, and prevent misdiagnosis.
{"title":"Trichoscopy of Lichen Planopilaris in Black Scalp: A Literature Review","authors":"Glaura Tinoco Plata, Rita Fernanda Cortez de Almeida, V. Tortelly","doi":"10.1159/000538859","DOIUrl":"https://doi.org/10.1159/000538859","url":null,"abstract":"Background: Lichen planopilaris (LPP) manifests as uni or multifocal patches of scarring alopecia across the scalp. Its symptoms include pruritus, trichodynia, and burning. Trichoscopy is a critical tool for early disease detection. In African descendants, LPP poses additional diagnostic challenges, given the black scalp peculiarities. These specific features include lower hair density, slower growth, and structural differences, compared to Caucasians. Moreover, the healthy black scalp may show distinctive features such as a honeycomb-pigmented network and sparse pinpoint white dots. Summary: In individuals of African descent, the most prevalent scarring alopecia is Central Centrifugal Cicatricial Alopecia, an important differential diagnosis for LPP in this population. LPP trichoscopy in the black scalp reveals unique features such as perifollicular erythema in the early stages, which often manifests as hyperpigmentation. This study aimed to review the literature on trichoscopy findings in LPP on black scalp categorizing them into distinct stages and highlighting their unique yet understudied characteristics. Key Messages: Despite not being as prevalent as nonscarring alopecias and not so frequent in the black scalp, LPP’s aesthetic and devastating psychosocial impact raise concerns. Therefore, early recognition is paramount to halt the progress of LPP, mitigate its psychosocial impact, and prevent misdiagnosis.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141104835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gessienne Clívia Alves e Souza, Rita Fernanda Cortez de Almeida, Daniel Fernandes Melo
Background: Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia characterized by progressive recession of the frontotemporal hairline, affecting mainly postmenopausal and, lately, premenopausal women of African descent. Considering the importance of trichoscopy on FFA diagnosis and the peculiarities found in patients with higher skin phototypes, this study aimed to review the FFA trichoscopy in the black scalp (Fitzpatrick IV–VI), a topic that remains sparsely described in the existing literature. Summary: In black patients, FFA may manifest singular features on presentation posing diagnostic clinical and trichoscopic challenges. This group has lower prevalence of the FFA compared to other alopecias. It may have an earlier age of onset and often exhibits more severe manifestations due to the coexistence of other types of alopecia and delay in diagnosis. The early signs of the disease in black patients may manifest in the eyebrows before scalp hair loss and lichen planus pigmentosus may be a herald sign. Key Messages: Our research analyzes FFA trichoscopy findings in black patients to help precise diagnosis and treatment. Raising awareness of the disease characteristics on trichoscopy contributes to improving hair care in this population.
{"title":"Trichoscopy of Frontal Fibrosing Alopecia Affecting Black Scalp: A Literature Review","authors":"Gessienne Clívia Alves e Souza, Rita Fernanda Cortez de Almeida, Daniel Fernandes Melo","doi":"10.1159/000538795","DOIUrl":"https://doi.org/10.1159/000538795","url":null,"abstract":"Background: Frontal fibrosing alopecia (FFA) is a primary lymphocytic scarring alopecia characterized by progressive recession of the frontotemporal hairline, affecting mainly postmenopausal and, lately, premenopausal women of African descent. Considering the importance of trichoscopy on FFA diagnosis and the peculiarities found in patients with higher skin phototypes, this study aimed to review the FFA trichoscopy in the black scalp (Fitzpatrick IV–VI), a topic that remains sparsely described in the existing literature. Summary: In black patients, FFA may manifest singular features on presentation posing diagnostic clinical and trichoscopic challenges. This group has lower prevalence of the FFA compared to other alopecias. It may have an earlier age of onset and often exhibits more severe manifestations due to the coexistence of other types of alopecia and delay in diagnosis. The early signs of the disease in black patients may manifest in the eyebrows before scalp hair loss and lichen planus pigmentosus may be a herald sign. Key Messages: Our research analyzes FFA trichoscopy findings in black patients to help precise diagnosis and treatment. Raising awareness of the disease characteristics on trichoscopy contributes to improving hair care in this population.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141107985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel C Hill, Onajia Stubblefield, Tracey C. Vlahovic, Shari R. Lipner
Introduction: Onychocryptosis is a common and often painful nail condition, but risk factors have been relatively unexplored. We aimed to analyze associations between onychocryptosis, comorbidities, and income level. Methods: Using the National Institute of Health All of Us Research Program Database, a matched case-control study was performed for patients with onychocryptosis diagnosis and comorbidities and lifestyle factors. Results: A total of 6,246 cases of onychocryptosis and 24,984 controls were analyzed. Patients with onychocryptosis versus controls had increased risk of onychogryphosis (OR 5.66; 95% CI 4.87, 6.58), onychomycosis (2.63; 2.06, 3.36), hallux valgus (1.68; 1.50, 1.87), type 2 diabetes mellitus (1.49; 1.40, 1.60), obesity (1.38; 1.30, 1.48), and peripheral vascular disease (1.24; 1.14, 1.35) compared to controls. Patients who reported living in low-income households more often had onychocryptosis (reference group annual income >200 k; annual income <10 k USD, OR: 1.76; 95% CI: 1.46, 2.12, p < 0.001 vs. annual income 150–200 k USD, OR: 1.26; 95% CI: 0.99, 1.61, p = 0.06). Conclusion: Low income, obesity, PVD, and T2DM were associated with onychocryptosis diagnosis. It is recommended that these at-risk populations be screened for onychocryptosis and counseled on proper nail trimming techniques. Future studies are needed to examine the relationship between household income and onychocryptosis risk.
{"title":"Onychocryptosis Is Associated with Low Income in a Matched Cohort Study Using the All of Us Database","authors":"Rachel C Hill, Onajia Stubblefield, Tracey C. Vlahovic, Shari R. Lipner","doi":"10.1159/000538969","DOIUrl":"https://doi.org/10.1159/000538969","url":null,"abstract":"Introduction: Onychocryptosis is a common and often painful nail condition, but risk factors have been relatively unexplored. We aimed to analyze associations between onychocryptosis, comorbidities, and income level. Methods: Using the National Institute of Health All of Us Research Program Database, a matched case-control study was performed for patients with onychocryptosis diagnosis and comorbidities and lifestyle factors. Results: A total of 6,246 cases of onychocryptosis and 24,984 controls were analyzed. Patients with onychocryptosis versus controls had increased risk of onychogryphosis (OR 5.66; 95% CI 4.87, 6.58), onychomycosis (2.63; 2.06, 3.36), hallux valgus (1.68; 1.50, 1.87), type 2 diabetes mellitus (1.49; 1.40, 1.60), obesity (1.38; 1.30, 1.48), and peripheral vascular disease (1.24; 1.14, 1.35) compared to controls. Patients who reported living in low-income households more often had onychocryptosis (reference group annual income >200 k; annual income <10 k USD, OR: 1.76; 95% CI: 1.46, 2.12, p < 0.001 vs. annual income 150–200 k USD, OR: 1.26; 95% CI: 0.99, 1.61, p = 0.06). Conclusion: Low income, obesity, PVD, and T2DM were associated with onychocryptosis diagnosis. It is recommended that these at-risk populations be screened for onychocryptosis and counseled on proper nail trimming techniques. Future studies are needed to examine the relationship between household income and onychocryptosis risk.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141104696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pediatric nail disorders encompass a broad range of conditions. This article aimed to consolidate current knowledge on pediatric nail disorders to enhance diagnostic proficiency and clinical management among healthcare professionals. Summary: Pediatric nail disorders present a diagnostic challenge due to their diverse nature. Non-syndromic congenital nail disorders encompass various anomalies such as anonychia/hyponychia, congenital malalignment of the great toenail, and racket thumbs, each with distinct clinical presentations and genetic associations. Syndromic congenital nail disorders, often part of complex syndromes, are characterized by unique features and associated abnormalities. Acquired nail diseases in children, like Beau’s lines and onychomadesis, typically result from trauma or infection, while melanonychia, although rare in children, requires careful monitoring for potential malignant alterations, with consideration for biopsy in cases with concerning features. Key Messages: (1) Pediatric nail disorders may pose diagnostic challenges and require a comprehensive understanding of nail anatomy and development. (2) Congenital nail disorders encompass isolated anomalies and syndromic associations, necessitating thorough evaluation for associated systemic conditions. (3) Acquired nail diseases may indicate underlying trauma or systemic illness and require careful assessment.(4) Melanonychia in children requires ongoing monitoring and evaluation, emphasizing the importance of consistent follow-up and histopathological examination when necessary.
{"title":"Pediatric Nail Disorders","authors":"S. Cedirian, Aurora Alessandrini, M. V. Starace","doi":"10.1159/000538835","DOIUrl":"https://doi.org/10.1159/000538835","url":null,"abstract":"Background: Pediatric nail disorders encompass a broad range of conditions. This article aimed to consolidate current knowledge on pediatric nail disorders to enhance diagnostic proficiency and clinical management among healthcare professionals. Summary: Pediatric nail disorders present a diagnostic challenge due to their diverse nature. Non-syndromic congenital nail disorders encompass various anomalies such as anonychia/hyponychia, congenital malalignment of the great toenail, and racket thumbs, each with distinct clinical presentations and genetic associations. Syndromic congenital nail disorders, often part of complex syndromes, are characterized by unique features and associated abnormalities. Acquired nail diseases in children, like Beau’s lines and onychomadesis, typically result from trauma or infection, while melanonychia, although rare in children, requires careful monitoring for potential malignant alterations, with consideration for biopsy in cases with concerning features. Key Messages: (1) Pediatric nail disorders may pose diagnostic challenges and require a comprehensive understanding of nail anatomy and development. (2) Congenital nail disorders encompass isolated anomalies and syndromic associations, necessitating thorough evaluation for associated systemic conditions. (3) Acquired nail diseases may indicate underlying trauma or systemic illness and require careful assessment.(4) Melanonychia in children requires ongoing monitoring and evaluation, emphasizing the importance of consistent follow-up and histopathological examination when necessary.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141109909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Androgenetic alopecia is the most common type of hair loss, and with increasing media integration in medicine, understanding social media consumption of literature is invaluable. Altmetric Attention Score analysis can quantify factors impacting article distribution on media platforms. Methods: To determine factors influencing literature dissemination and reader demographics, a bibliometric analysis was performed on the 100 most cited androgenetic alopecia articles. Results: Articles with top 25th percentile Altmetric Attention Scores were cited more frequently (41.76 vs. 24.59, p < 0.05). Open-access articles had lower odds of being read by healthcare professionals (aOR = 0.16, p < 0.05), while funded studies and journal impact factor increased odds of readership (aOR = 5.80; aOR = 1.55; p < 0.05 for both). Scientists and healthcare professionals showed interest in publications addressing 5α-reductase inhibitors (aOR = 26.08; aOR = 6.13; p < 0.05 for both). Articles with high social media viewership were also highly cited in academic literature. Conclusion: Healthcare professionals appeared more discerning about article readership compared to the public. With many outlets for consumption of media, members of the public not involved in dermatology may have difficulty in identifying reliable sources of material. Overall, Altmetrics can help quantify readership trends and public interest in dermatology research.
{"title":"The 100 Most Cited Androgenetic Alopecia Articles: An Analysis of Altmetrics Data from 2015 to 2022","authors":"A. Ravipati, T. Pradeep, Antonella Tosti","doi":"10.1159/000538913","DOIUrl":"https://doi.org/10.1159/000538913","url":null,"abstract":"Introduction: Androgenetic alopecia is the most common type of hair loss, and with increasing media integration in medicine, understanding social media consumption of literature is invaluable. Altmetric Attention Score analysis can quantify factors impacting article distribution on media platforms. Methods: To determine factors influencing literature dissemination and reader demographics, a bibliometric analysis was performed on the 100 most cited androgenetic alopecia articles. Results: Articles with top 25th percentile Altmetric Attention Scores were cited more frequently (41.76 vs. 24.59, p < 0.05). Open-access articles had lower odds of being read by healthcare professionals (aOR = 0.16, p < 0.05), while funded studies and journal impact factor increased odds of readership (aOR = 5.80; aOR = 1.55; p < 0.05 for both). Scientists and healthcare professionals showed interest in publications addressing 5α-reductase inhibitors (aOR = 26.08; aOR = 6.13; p < 0.05 for both). Articles with high social media viewership were also highly cited in academic literature. Conclusion: Healthcare professionals appeared more discerning about article readership compared to the public. With many outlets for consumption of media, members of the public not involved in dermatology may have difficulty in identifying reliable sources of material. Overall, Altmetrics can help quantify readership trends and public interest in dermatology research.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141108370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: The primary objective of this study was to determine the prevalence of nail diseases and its population in nail consultation. Methods: A retrospective study of clinical records between 2012 and 2022 was conducted. The 1,372 established diagnoses were categorized into nosological groups, which included physical signs, infectious diseases, dermatological diseases, systemic diseases, drug reactions, occupational disorders, congenital diseases, traumatic disorders, and tumors. Results: Overall, 1,239 records were enrolled, with 64% (n = 788) involving female patients. The median age was 50 years. In 71.5% of cases (n = 886), it was possible to establish an etiological diagnosis or a causative relationship based on physical findings, while 28% of patients (n = 347) presented nonspecific physical signs. Conclusion: Onychomycosis was the most prevalent diagnosis and revealed a descending trend over the 10-year period study.
{"title":"Nail Disease in a Nail Consultation at a Tertiary Referral Center: A 10-Year Retrospective Study","authors":"Aureliu Rosca, César Magalhães, Joana Matos, Diogo Teixeira, Rita Guedes","doi":"10.1159/000538834","DOIUrl":"https://doi.org/10.1159/000538834","url":null,"abstract":"Introduction: The primary objective of this study was to determine the prevalence of nail diseases and its population in nail consultation. Methods: A retrospective study of clinical records between 2012 and 2022 was conducted. The 1,372 established diagnoses were categorized into nosological groups, which included physical signs, infectious diseases, dermatological diseases, systemic diseases, drug reactions, occupational disorders, congenital diseases, traumatic disorders, and tumors. Results: Overall, 1,239 records were enrolled, with 64% (n = 788) involving female patients. The median age was 50 years. In 71.5% of cases (n = 886), it was possible to establish an etiological diagnosis or a causative relationship based on physical findings, while 28% of patients (n = 347) presented nonspecific physical signs. Conclusion: Onychomycosis was the most prevalent diagnosis and revealed a descending trend over the 10-year period study.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: There are few studies, mainly case reports, on the involvement of the nail unit in autoimmune bullous disorders. Summary: Nail involvement in autoimmune bullous disorders is a significant clinical phenomenon, marked by a range of manifestations, most often not presenting with blisters like on the skin but rather with alterations of the nail unit such as paronychia, onychomadesis, or onycholysis. This involvement is particularly notable due to the unique immunological features of the nail unit, including the expression of various antigens and the presence of Langerhans cells. Conditions like pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA disease, and bullous systemic lupus erythematosus can lead to nail abnormalities. The prevalence of nail manifestations varies according to the disorder, and diagnosis often relies on histopathological and immunofluorescence testing. Nail involvement correlates with disease severity and duration, sometimes serving as a herald sign. Further research is needed to guide therapeutic approaches for nail involvement in autoimmune bullous diseases. Key Messages: Nail involvement in autoimmune bullous nail disorders may be confusing as there are almost never bullae. One should keep the diagnosis in mind when facing an atypical paronychia.
背景：有关自身免疫性大疱性皮肤病指甲受累的研究很少，主要是病例报告。摘要：自身免疫性大疱性皮肤病的指甲受累是一种重要的临床现象，表现多种多样，最常见的不是皮肤上的水疱，而是甲单位的改变，如甲沟炎、甲沟炎或甲沟炎。由于指甲具有独特的免疫学特征，包括各种抗原的表达和朗格汉斯细胞的存在，这种受累尤其明显。寻常天疱疮、大疱性类天疱疮、获得性大疱性表皮松解症、线性 IgA 病和大疱性系统性红斑狼疮等疾病都可能导致指甲异常。指甲表现的发病率因疾病而异，诊断通常依赖于组织病理学和免疫荧光检测。指甲受累与疾病的严重程度和持续时间有关，有时是一种预兆。需要进一步开展研究，为自身免疫性牛皮癣指甲受累的治疗方法提供指导。关键信息：自身免疫性大疱性甲病的指甲受累可能令人困惑，因为几乎从未出现过大疱。在面对非典型甲旁癣时，应牢记诊断。
{"title":"Current Knowledge on Nail Involvement in Autoimmune Bullous Disorders","authors":"Laura Vollono, Matilde Iorizzo, Bertrand Richert","doi":"10.1159/000538553","DOIUrl":"https://doi.org/10.1159/000538553","url":null,"abstract":"Background: There are few studies, mainly case reports, on the involvement of the nail unit in autoimmune bullous disorders. Summary: Nail involvement in autoimmune bullous disorders is a significant clinical phenomenon, marked by a range of manifestations, most often not presenting with blisters like on the skin but rather with alterations of the nail unit such as paronychia, onychomadesis, or onycholysis. This involvement is particularly notable due to the unique immunological features of the nail unit, including the expression of various antigens and the presence of Langerhans cells. Conditions like pemphigus vulgaris, bullous pemphigoid, epidermolysis bullosa acquisita, linear IgA disease, and bullous systemic lupus erythematosus can lead to nail abnormalities. The prevalence of nail manifestations varies according to the disorder, and diagnosis often relies on histopathological and immunofluorescence testing. Nail involvement correlates with disease severity and duration, sometimes serving as a herald sign. Further research is needed to guide therapeutic approaches for nail involvement in autoimmune bullous diseases. Key Messages: Nail involvement in autoimmune bullous nail disorders may be confusing as there are almost never bullae. One should keep the diagnosis in mind when facing an atypical paronychia.","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luiz Paulo Rocha Zogob, Rita Fernanda Cortez de Almeida, V. Tortelly
Introduction: Central centrifugal cicatricial alopecia (CCCA) is the most common cause of scarring alopecia in middle-aged black women. Trichoscopy is a noninvasive tool for diagnosis and follow-up of hair and scalp disorders. To date, limited studies have focused on its applicability to CCCA in existing literature. Methods: The present study aimed to describe the trichoscopic findings of 11 dark-skinned women with confirmed CCCA and provide a comprehensive discussion of our current knowledge regarding trichoscopy of this disease through a literature review. A thorough understanding of CCCA trichoscopy holds significant promise for early confirmation and treatment. Conclusion: By doing so, it is possible to mitigate the development of complications and alleviate the subsequent impact on patients’ quality of life.
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