1,721,262 research outputs found
Warts of the nail unit: surgical and nonsurgical approaches
No full textBackground: Warts are the most common nail tumor and mostly affect children and young adults. Periungual warts are usually due to HPV-1, 2, and 4. Development of periungual warts is favored by maceration and trauma, especially nail biting. Objective: To discuss the biology, clinical features, and medical and surgical treatment of periungual warts. Methods: Review of the literature and personal experience. Results: The natural course of warts makes aggressive approaches restricted to selected cases. Medical treatments, usually topical, include keratolytic agents, virucidal agents, and immunomodulators. All choices have been utilized successfully, but keratolytic agents are the best first-line approach. Surgical treatments include cryotherapy, surgical excision, electrosurgery, infrared coagulation, localized heating with a radio-frequency heat generator and laser therapy, especially the Er:YAG laser, which has an excellent safety profile. Conclusions: Definitive cure is not guaranteed by any therapy and periungual warts can recur and become larger after correct treatment
Proximal subungual onychomycosis due to Aspergillus niger: report of two cases
No full textNo abstract availabl
The spectrum of fibrosing alopecias
No full textLichen planopilaris (LPP) is a primary lymphocytic cicatricial alopecia considered the most common cause of scarring hair loss in adults. It has been classified into three clinical variants: classical LPP, frontal fibrosing alopecia (FFA) and Graham Little-Piccardi-Lassueur syndrome. Classical LPP usually presents as a circumscribed cicatricial patch on the vertex and FFA as a band-like scarring alopecia of the frontotemporal hairline. Fibrosing alopecia in a pattern distribution (FAPD) and lichen planopilaris diffuse pattern (LPPDP) are two recently described subtypes of LPP that exhibit a diffuse involvement of the androgen-dependent region or the whole scalp, respectively. Classical LPP, FFA, FAPD and LPPDP share trichoscopic (cicatricial areas, absence of follicular openings, perifollicular erythema and hyperkeratosis) and histologic features (interface dermatitis involving follicular epithelium and concentric fibrosing around the isthmus and infundibulum). The remarkable clinical and histological overlap between these entities has led to the concept that these diseases exist along a spectrum. In the effort to identify classical LPP, FFA, FAPD and LPPDP with an umbrella term, we suggest to use ‘lichenoid alopecias’, as the distinguishing hallmark of these diseases is the lichenoid bandlike inflammatory infiltrate in the superficial dermis involving the infundibulum and isthmus of the hair follicle
Dermoscopy of the Nail Unit
No full textNail dermoscopy (onychoscopy) is being used for a more accurate diagnosis of all nail disorders and has become a routine diagnostic instrument. In daily practice, nail signs can be magnified, and dermoscopy may confirm the clinical diagnosis and guides in management of nail diseases and treatments, permitting a better visualization of symptoms. Onychoscopy is used by the experts in almost all nail diseases. It can be performed dry or with ultrasound gel in order to make the stratum corneum translucent, depending on which part of the nail unit has to be evaluated
Allergic contact dermatitis caused by topical timolol for the treatment of infantile hemangioma: An underestimated adverse event?
No full textAllergic contact dermatitis caused by topical timolol for the treatment of infantile hemangiom
Ultrasound Features of Onychopapilloma at High-Frequency and Ultra-High Frequency
No full textObjective: This study aimed to identify the sonographic features of pathologically confirmed onychopapilloma cases. Methods: High-frequency up to 24 MHz and ultra-high frequency-ultrasound up to 71 MHz examinations were performed and correlated with their clinical and pathologic presentations. Results: Twenty-two cases met the criteria. Clinical presentations revealed longitudinal erythronychia in 63.3% of cases. The ultrasound examinations identified a hypoechoic band in the nail bed (86.3%), nail plate abnormalities including upward displacement (68.2%) and thickening (68.1%), focal hyperechoic focal spots on the nail plate (50%) and irregularities of the ventral plate (33.3%). Color Doppler imaging showed no hypervascularity of the nail bed in all studies. These findings correlate with histological characteristics of onychopapilloma, including nail bed acanthosis, papillomatosis, and layered hyperkeratosis. Recurrence occurred in two cases after surgery, with tumors showing proximal extension in the matrix region on ultrasound not evident during clinical examination. Conclusion: High-frequency and ultra-high-frequency can provide anatomical information in onychopapilloma that could enhance understanding and management
CO2Laser-Assisted Avulsion of the Proximal Nail Plate as a New Treatment Strategy in Patients Affected by Retronychia
No full textCO2Laser-Assisted Avulsion of the Proximal Nail Plate as a New Treatment Strategy in Patients Affected by Retronychi
An Open Study to Evaluate Effectiveness and Tolerability of a Nail Oil Composed of Vitamin E and Essential Oils in Mild to Moderate Distal Subungual Onychomycosis.
No full textAbstract
BACKGROUND:
Onychomycosis is the most common nail disease and can affect both fingernails and toenails. When possible, topical treatment is generally preferred both by patients and physicians because it is associated with lower risk of systemic side effects and drug interactions than oral antifungals, avoiding laboratory monitoring.
OBJECTIVE:
The aim of our study was to evaluate the efficacy, tolerability, and patient's compliance of a new topical antifungal containing vitamin E and essential oils of lime, oregano, and tea tree.
PATIENTS AND METHODS:
We enrolled 20 patients with mild-moderate distal subungual onychomycosis due to dermatophytes or non-dermatophyte molds. The product was applied once daily on the periungual tissues and on the nail plate for 6 months. Follow-up without therapy continued for another 6 months in order to evaluate the product's effect maintenance. Periodic evaluation of treatment efficacy was performed by standardized photography and mycological examination (KOH + culture) of the target nail at baseline (T0), after 3 months (T1) and 6 months (T2) of therapy, and after 6 months of follow-up (T3).
RESULTS:
At the end of the 12-month study, the majority of patients achieved a complete cure of onychomycosis (78.5%). All patients were very satisfied by the treatment. No side effects were recorded.
CONCLUSIONS:
The results of our study indicate that this new topical antifungal containing vitamin E and essential oils of lime, oregano, and tea tree is an effective and safe option for topical therapy of onychomycosis. This topical antifungal nail oil restructures the nail appearance, improving patient's adherence to therapy and reducing the risk of relapses, maintaining results over time
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