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John JM, Mathew DE, John CM. Chevron nail - an under-recognised normal variant of nail development. Arch Dis Child 2024; 109:648. [PMID: 38627027 DOI: 10.1136/archdischild-2024-326975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/06/2024] [Indexed: 07/20/2024]
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Shin JO, Roh D, Son JH, Shin K, Kim HS, Ko HC, Kim BS, Kim MB. Onychophagia: detailed clinical characteristics. Int J Dermatol 2021; 61:331-336. [PMID: 34416026 DOI: 10.1111/ijd.15861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/14/2021] [Accepted: 07/30/2021] [Indexed: 12/27/2022]
Abstract
BACKGROUND Onychophagia is a common disorder affecting 20% to 30% of the general population. It is defined as habitual nail biting and can cause various changes in the nail units. However, to date, there has been a paucity of data focusing on nail deformities related to onychophagia. This study was performed to investigate the clinical characteristics of onychophagia in Korea. METHODS This study included 53 patients with onychophagia who visited the Pusan National University Hospital (Busan and Yangsan) over a 10-year period (2011-2020). We retrospectively reviewed medical records and clinical and dermoscopic photographs. RESULTS All 10 fingernails were affected in 37.7% of the patients. The left thumbnail was the most predominantly affected site (81.1%). Clinical findings showed that short nails with ragged distal borders were the most common presentation (100.0%), followed by generalized or patchy rough areas (50.9%), linear and pinpoint hemorrhage (32.1%), longitudinal melanonychia (30.2%), transverse groove (28.3%), brittleness (28.3%), macrolunula (24.5%), washboard nail (13.2%), and pterygium (3.8%). Of the patients, 88.7% had periungual complications, such as periungual exfoliation (77.4%), absent or ragged cuticle (52.8%), hyponychial hyperkeratosis (37.7%), and paronychia (15.1%). CONCLUSIONS Although onychophagia is a common disorder, its clinical characteristics have not been reported in the literature. The results of this study may be helpful in managing patients with onychophagia.
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Affiliation(s)
- Jun-Oh Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University, Yangsan Hospital, Yangsan, Korea
| | - Dongyoung Roh
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University, Yangsan Hospital, Yangsan, Korea
| | - Jin-Hwa Son
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University, Yangsan Hospital, Yangsan, Korea
| | - Kihyuk Shin
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University, Yangsan Hospital, Yangsan, Korea
| | - Hoon-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea
| | - Hyun-Chang Ko
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Department of Dermatology, Pusan National University, Yangsan Hospital, Yangsan, Korea
| | - Byung-Soo Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Moon-Bum Kim
- Department of Dermatology, School of Medicine, Pusan National University, Busan, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
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Lampasi M, Bandinelli D, Abati CN, Bettuzzi C, Salvatori G, Bassi A, Filippeschi C, Oranges T. Nail changes in children with idiopathic congenital clubfoot deformity. Pediatr Dermatol 2021; 38:617-622. [PMID: 33848026 DOI: 10.1111/pde.14609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND/OBJECTIVES Nail alterations are commonly seen in cases of idiopathic clubfoot and may cause parental concern. The nature of and whether these changes are congenital or develop secondary to treatment has been poorly investigated. The aim of this study was to evaluate toenail morphology in clubfoot patients at presentation, to re-evaluate them during the course of treatment for the clubfoot, and to analyze findings in the light of the few literature reports for healthy children of the same age. METHODS Thirty infants (21 males and 9 females) with idiopathic clubfoot were prospectively enrolled at the Anna Meyer Children's University Hospital. Nails of affected and non-affected feet were evaluated by a team of pediatric dermatologists at presentation and re-evaluated once per patient during the bracing period of Ponseti treatment. RESULTS Toenails of affected (47) and non-affected (13) feet were abnormal at presentation in 43.3% of patients, in both clubfeet (40.4%) and non-affected feet (38.5%), but most changes were physiologic or transitory alterations, commonly found in healthy children, with nail concavity (koilonychia) being the most common finding (29.7%). Changes were not related to clubfoot severity or laterality (P > .05). In most (76.9%) unilateral cases, there was concordance of nail changes between clubfoot and non-affected foot. At re-evaluation (follow-up time 410 ± 207 days), nail problems were more frequent (53.3%); ingrown toenail was the most common (21.6%). CONCLUSIONS The presence of nail alterations seems not to be caused by clubfoot pathology and could be related to unfavorable local condition in the brace.
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Affiliation(s)
- Manuele Lampasi
- Ortopediatria Center for Education, Research and Patient Care in Paediatric Orthopedics, Bologna, Italy
| | - Diletta Bandinelli
- Department of Orthopedics and Traumatology, University of Perugia, R. Silvestrini Hospital, Perugia, Italy
| | | | - Camilla Bettuzzi
- Department of Paediatric Orthopedics, Anna Meyer Children's Hospital, Florence, Italy
| | - Giada Salvatori
- Ortopediatria Center for Education, Research and Patient Care in Paediatric Orthopedics, Bologna, Italy.,Department of Paediatric Orthopedics, Anna Meyer Children's Hospital, Florence, Italy
| | - Andrea Bassi
- Dermatology Unit, Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
| | - Cesare Filippeschi
- Dermatology Unit, Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
| | - Teresa Oranges
- Dermatology Unit, Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
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4
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Bellet JS. Pediatric Nail Disorders. Dermatol Clin 2021; 39:231-243. [PMID: 33745636 DOI: 10.1016/j.det.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Many pediatric nail findings are normal variants and are no cause for alarm. Others represent congenital abnormalities or genetic syndromes for which there is no cure. Still others are inflammatory or infectious entities that require treatment. Pediatric nail disorders are reviewed, along with management.
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Affiliation(s)
- Jane Sanders Bellet
- Duke University School of Medicine, 5324 McFarland Drive, Suite 410, Durham, NC 27707, USA.
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5
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Gresset-Kaliebe K, Garzorz-Stark N, Schnopp C, Weins A. [Differential diagnosis of common nail disorders in childhood]. Hautarzt 2021; 72:225-231. [PMID: 33544173 DOI: 10.1007/s00105-021-04762-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Correct diagnosis of nail changes in childhood may be challenging. Knowing the anatomy of the nail apparatus and some pathophysiologic principles helps to categorize nail disorders correctly. OBJECTIVES This article gives a structured overview of nail disorders in childhood, thus, facilitating correct diagnosis of nail abnormalities in childhood. MATERIALS AND METHODS A review of literature and our own experience are presented. RESULTS In the first part we present fundamental anatomical characteristics of the nail apparatus based on embryonal development of the nails. In the main part we categorize nail disorders according to clinical presentation: transient nail changes, congenital nail abnormalities, infectious diseases of the nails, nail changes in the context of chronic inflammatory skin diseases, pigmented nail changes, tumors and nail changes due to trauma.
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Affiliation(s)
- K Gresset-Kaliebe
- Klinik für Dermatologie und Allergologie am Biederstein, Klinikum Rechts der Isar, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland
| | - N Garzorz-Stark
- Klinik für Dermatologie und Allergologie am Biederstein, Klinikum Rechts der Isar, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland.,Division of Dermatology and Venereology, Department of Medicine Solna and Center for Molecular Medicine, Karolinka Institutet, Stockholm, Schweden.,Unit of Dermatology, Karolinska University Hospital, Stockholm, Schweden
| | - C Schnopp
- Klinik für Dermatologie und Allergologie am Biederstein, Klinikum Rechts der Isar, Technische Universität München, Biedersteinerstr. 29, 80802, München, Deutschland.
| | - A Weins
- Kinderdermatologisches Zentrum, Mutter-Kind-Zentrum-Schwaben, Klinik für Dermatologie, Universitätsklinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland
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6
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Tasia M, Lecerf P, Richert B, André J. Paediatric nail consultation in an academic centre in Belgium: a 10‐year retrospective study. J Eur Acad Dermatol Venereol 2019; 33:1800-1805. [DOI: 10.1111/jdv.15542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 02/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- M. Tasia
- Department of Dermatology Saint‐Pierre, Brugmann and Queen Fabiola Children's University Hospitals Université Libre de Bruxelles Brussels Belgium
| | - P. Lecerf
- Department of Dermatology Saint‐Pierre, Brugmann and Queen Fabiola Children's University Hospitals Université Libre de Bruxelles Brussels Belgium
| | - B. Richert
- Department of Dermatology Saint‐Pierre, Brugmann and Queen Fabiola Children's University Hospitals Université Libre de Bruxelles Brussels Belgium
| | - J. André
- Department of Dermatology Saint‐Pierre, Brugmann and Queen Fabiola Children's University Hospitals Université Libre de Bruxelles Brussels Belgium
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Chinazzo M, Lorette G, Baran R, Finon A, Saliba É, Maruani A. Nail features in healthy term newborns: a single-centre observational study of 52 cases. J Eur Acad Dermatol Venereol 2016; 31:371-375. [DOI: 10.1111/jdv.13978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2016] [Accepted: 08/04/2016] [Indexed: 02/01/2023]
Affiliation(s)
- M. Chinazzo
- University François Rabelais Tours; Tours France
- Unit of Paediatric Dermatology; Department of Dermatology; CHRU Tours; Tours France
| | - G. Lorette
- University François Rabelais Tours; Tours France
- Unit of Paediatric Dermatology; Department of Dermatology; CHRU Tours; Tours France
| | - R. Baran
- Nail Disease Center; Cannes France
| | - A. Finon
- University François Rabelais Tours; Tours France
- Unit of Paediatric Dermatology; Department of Dermatology; CHRU Tours; Tours France
| | - É. Saliba
- University François Rabelais Tours; Tours France
- Department of Neonatalogy; CHRU Tours; Tours France
| | - A. Maruani
- University François Rabelais Tours; Tours France
- Unit of Paediatric Dermatology; Department of Dermatology; CHRU Tours; Tours France
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Abstract
The authors herein describe several nail conditions, which the general pediatrician is likely to encounter in the course of routine practice. Because pediatric nail disorders represent a limited component of a general pediatric practice, it can be challenging for practitioners to establish expertise in the diagnosis and treatment of these conditions and to recognize when reassurance is appropriate or when referral to a specialist is necessary. This article summarizes the anatomy of the normal nail unit, as well as the evaluation and management of onychomycosis, melanonychia, trachyonychia, onychomadesis, and nail pitting.
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10
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Perez CI, Maul XA, Catalina Heusser M, Zavala A. Operative Technique with Rapid Recovery for Ingrown Nails with Granulation Tissue Formation in Childhood. Dermatol Surg 2013; 39:393-7. [DOI: 10.1111/dsu.12048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Nail disorders in children can be divided into seven categories. The first is physiologic alterations, which every physician should be aware of in order to reassure parents. These usually disappear with age and do not require any treatment. Among congenital and inherited conditions, the nail-patella syndrome, with its pathognomonic triangular lunula, should not be missed as recognition of the disease allows early diagnosis of associated pathologies. The most common infection is the periungual wart, whose treatment is delicate. Herpetic whitlow should be distinguished from bacterial whitlow as their therapeutic approaches differ. Dermatologic diseases encompass eczema, psoriasis, lichen planus, lichen striatus, trachyonychia, and parakeratosis pustulosa. Lichen planus, when it presents as in adults, is important to recognize because, if not treated, it may lead to permanent nail loss. Systemic or iatrogenic nail alterations may be severe but are usually not the first clue to the diagnosis. Beau lines on several fingernails are very common in children after temperature crest. Tumors are rare in children. Radiographic examination allows confirmation of the diagnosis of subungual exostosis. Other cases should undergo biopsy. Single-digit longitudinal melanonychia in children is mostly due to nevi. Its management should be tailored on a case-by-case basis. Acute trauma should never be underestimated in children and hand surgeons should be involved if necessary. Onychophagia and onychotillomania are responsible for chronic trauma.
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Affiliation(s)
- Bertrand Richert
- Department of Dermatology, University Hospital of Liège, Liège, Belgium.
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12
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Abstract
The diagnosis of onychodystrophy has increased in dermatology consultation. This could be due to its esthetic effect, pain or disability, physician awareness for detecting the disease in the context of dermatologic or systemic diseases, or a greater incidence. One of the first differential diagnoses that should be considered when an onychodystrophic nail is observed is onychomycosis, which is the cause in 50% of cases.
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Affiliation(s)
- Miguel Angel José Allevato
- Department of Dermatology, Universidad de Buenos Aires, UBA, Paraguay 2345, CABA (1121), Buenos Aires, Argentina.
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14
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Leibovici V, Evron R, Dunchin M, Westerman M, Ingber A. A Population-based study of Toenail onychomycosis in Israeli children. Pediatr Dermatol 2009; 26:95-7. [PMID: 19250420 DOI: 10.1111/j.1525-1470.2008.00832.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Onychomycosis is widespread in the adult population, but considered to be rare in children. A number of studies in recent years show a rise in the prevalence of toenail onychomycosis in children. Of these, only a few were population-based. Here, we present a comprehensive cross-sectional population-based survey of toenail onychomycosis in primary school children in Israel. The survey included 1148 children, 598 boys, and 550 girls aged 5 to 14 from primary schools in the Jerusalem vicinity. Each child underwent a physical examination and completed a personal questionnaire, which provided background information of predisposing factors. The survey shows a prevalence of 0.87% of toenail onychomycosis. Although this figure is too small for statistical analysis, some important conclusions could be drawn: prevalence increased with age: boy/girl ratio was 2.2; the dominant etiologic agent was Trichophyton rubrum followed by Trichophyton mentagrophytes and Candida albicans. Infections were probably transferred from adults via the environment to children. Infected children came from different socio-economic backgrounds. This condition should be considered in the differential diagnosis of nail diseases in children.
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Affiliation(s)
- Vera Leibovici
- Department of Dermatology, Hadassah University Hospital, Jerusalem, Israel.
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Sarifakioglu E, Yilmaz AE, Gorpelioglu C. Nail alterations in 250 infant patients: a clinical study. J Eur Acad Dermatol Venereol 2008; 22:741-4. [DOI: 10.1111/j.1468-3083.2008.02592.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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