1
|
Lu CW, Chen CB, Chiu TM, Chen CC, Wei KC, Lin SH, Yu S, Hsu CK, Hsiao PF, Hsu PS, Su J, Chao SC, Yang CT, Chung WH, Luo YH. Consensus of the Taiwanese dermatological association and Taiwan Lung Cancer Society on the prevention and management of tyrosine kinase inhibitor-related skin toxicities in patients with non-small cell lung cancer: An updated version incorporating Taiwanese treatment experience. J Formos Med Assoc 2024:S0929-6646(24)00349-8. [PMID: 39174397 DOI: 10.1016/j.jfma.2024.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 04/09/2024] [Accepted: 07/26/2024] [Indexed: 08/24/2024] Open
Abstract
The 2023 consensus from the Taiwanese Dermatological Association (TDA) and Taiwan Lung Cancer Society (TLCS) addresses the management of tyrosine kinase inhibitor (TKI)-induced skin toxicities in non-small cell lung cancer (NSCLC). Providing a comprehensive overview, the consensus reflects recent advances in understanding causes and developmental processes of TKI-related skin toxicities. Aimed at guiding clinicians in Taiwan, the consensus integrates new treatment perspectives while incorporating experiences from local dermatology experts. Recommendations underwent a voting process, achieving consensus when 75% or more of experts agreed, leading to their inclusion. Approved by over 90% of participants, the recommended treatment algorithms for major skin toxicities offer valuable insights for clinicians managing TKI-associated effects in NSCLC patients.
Collapse
Affiliation(s)
- Chun-Wei Lu
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Tsu-Man Chiu
- Department of Dermatology, Chung Shan Medical University Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Chih-Chiang Chen
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Che Wei
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shang-Hung Lin
- Department of Dermatology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Sebastian Yu
- Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Chao-Kai Hsu
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeresity, Tainan, Taiwan
| | - Pa-Fan Hsiao
- Department of Dermatology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Pei-Sung Hsu
- Department of Pulmonology, Shin Kong Memorial Wu Ho-Su Hospital at Taipei, Taiwan
| | - Jian Su
- Department of Chest Medicine, MacKay Memorial Hospital, Taipei, Taiwan
| | - Sheau-Chiou Chao
- Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung Univeresity, Tainan, Taiwan
| | - Cheng-Ta Yang
- Department of Thoracic Medicine, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Yung-Hung Luo
- School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| |
Collapse
|
2
|
Arnal C, Richert B. Examination of the nails: Main signs. HAND SURGERY & REHABILITATION 2024; 43S:101639. [PMID: 38215879 DOI: 10.1016/j.hansur.2024.101639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/13/2023] [Accepted: 12/13/2023] [Indexed: 01/14/2024]
Abstract
Understanding the anatomy of the nail apparatus is a prerequisite for diagnosing and managing various nail disorders. The latter may be associated with systemic pathologies, or accompany infectious, inflammatory, tumoral, toxic or traumatic dermatoses. Before attempting to identify the cause, a rigorous clinical examination should be conducted to screen for elementary lesions that may affect general nail shape, nail surface, subungual attachments, periungual soft tissue or nail color. All of these guide differential diagnosis.
Collapse
Affiliation(s)
- Charlotte Arnal
- Dermatology Department, Université Libre de Bruxelles, University Hospital Brugmann - Saint-Pierre - Children Hospital Queen Fabiola, Brussels, Belgium.
| | - Bertrand Richert
- Dermatology Department, Université Libre de Bruxelles, University Hospital Brugmann - Saint-Pierre - Children Hospital Queen Fabiola, Brussels, Belgium.
| |
Collapse
|
3
|
Desai AD, Wang Y, Nadarajah CC, Lipner SR. Cross-Sectional Analysis of Paronychias in the National Electronic Injury Surveillance System 1999–2018. Skin Appendage Disord 2022; 8:454-461. [PMID: 36407642 PMCID: PMC9672864 DOI: 10.1159/000525032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Paronychia is the most common hand infection. Prior paronychia studies were limited by small patient numbers. We conducted a national-level analysis over two decades, analyzing demographics, etiologies, and trends in paronychia cases. Methods We conducted a retrospective analysis of paronychia cases in the 1999–2018 National Electronic Injury Surveillance System database. Sex, race, age, and cause were recorded and compared using χ<sup>2</sup>, ANOVA, and t tests. Multivariable linear regression analysis assessed changes in age, weight, and sex over time. Results We analyzed a total of 2,512 cases, with an average age of 27.6 ± 20.6 years, 45.5% females, and 25.6% white and 28.6% black patients. In multivariable linear regression, both age and weight significantly increased over time. Manicuring was the most common etiology (30.9%), increasing in incidence over time and with a higher frequency in adults (p < 0.0001) and females (p < 0.0001). There was a significant decrease in pediatric paronychia cases over time, particularly in 0- to 4-year-olds. Possible limitations include missed paronychia cases or additional non-paronychia cases due to improper coding, infrequent race reporting, and inability to analyze treatments or distinguish between paronychia subtypes. Conclusions Paronychia cases were associated with increased age and weight over time with different presentations by age. Manicuring represents the largest growing paronychia etiology.
Collapse
Affiliation(s)
- Amar D. Desai
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Yu Wang
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Shari R. Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
- *Shari R. Lipner,
| |
Collapse
|
4
|
Li Y, Ma H, Xue L, Chen H, Pang R, Shang Y, Luo J, Xie X, Zhang J, Ding Y, Chen M, Wang J, Wu Q. Imbalanced Dermic Microbiome Aggravates Inflammation in Toenail Paronychia. Front Cell Infect Microbiol 2021; 11:781927. [PMID: 34926325 PMCID: PMC8677670 DOI: 10.3389/fcimb.2021.781927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
The commensal microbiome influences skin immunity, but its function in toenail health remains unclear. Paronychia is one of the most common inflammatory toenail diseases, but antibiotic treatment is seldom effective in clinical cases. In this study, we performed 16S rRNA sequencing to investigate the characteristics of microbes associated with paronychia in order to identify the key microorganisms involved in inflammation. Seventy dermic samples were collected from patients with paronychia and the differences in dermic microbiota were analyzed in patients with different inflammation severities. Distinct clustering of dermal microbiota was observed in the dermis with different inflammation severities. A higher relative abundance of anaerobic microorganisms such as Parvimona, Prevotella, and Peptoniphilus was observed in severe paronychia, whereas Lactobacillus disappeared with disease progression. Co-occurring network analysis suggested that the disturbance of the dermic microbiome and attenuation of antagonism by Lactobacillus against anaerobic pathogens may aggravate inflammation in paronychia. Functional analysis showed that dermic microbiome disturbance may worsen microbial metabolism and tissue repair in the skin. In conclusion, we revealed that an increased abundance of anaerobic microorganisms and loss of Lactobacillus in the dermis may promote paronychia progression and microbiological imbalance may aggravate inflammation in patients with paronychia.
Collapse
Affiliation(s)
- Ying Li
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Han Ma
- Department of Dermatology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Liang Xue
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Huizhen Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China.,School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China
| | - Rui Pang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Yanyan Shang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China.,School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China
| | - Juan Luo
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Xinqiang Xie
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Jumei Zhang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Yu Ding
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Moutong Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Juan Wang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Qingping Wu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| |
Collapse
|
5
|
Retronychia-an uncommon cause of chronic proximal nail fold inflammation. Wien Med Wochenschr 2020; 171:53-56. [PMID: 32955636 DOI: 10.1007/s10354-020-00781-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Abstract
Retronychia is defined as nail plate ingrowth into the proximal nail fold causing pain and perionyxis. We report on a case series of seven patients seen from 2001 to 2020 (mean age 20 years). Xanthonychia was observed in all nails. Total nail avulsion was performed in eight nails. Complete remission was obtained in 100%. During follow-up for up to 24 months, no relapse occurred.
Collapse
|
6
|
Erraji H, Bahtaoui W, Hali F, Baline K, Soussi Abdelaoui M, Chiheb S. [Chronic paronychia and Candida: A descriptive and analytical study of 164 cases]. Ann Dermatol Venereol 2019; 147:143-146. [PMID: 31839272 DOI: 10.1016/j.annder.2019.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 08/09/2019] [Accepted: 11/14/2019] [Indexed: 10/25/2022]
Affiliation(s)
- H Erraji
- Service de dermatologie-vénérologie, CHU Ibn Rochd, quartier des Hopitaux, 20400 Casablanca, Maroc.
| | - W Bahtaoui
- Service de dermatologie-vénérologie, CHU Ibn Rochd, quartier des Hopitaux, 20400 Casablanca, Maroc
| | - F Hali
- Service de dermatologie-vénérologie, CHU Ibn Rochd, quartier des Hopitaux, 20400 Casablanca, Maroc
| | - K Baline
- Service de dermatologie-vénérologie, CHU Ibn Rochd, quartier des Hopitaux, 20400 Casablanca, Maroc
| | | | - S Chiheb
- Service de dermatologie-vénérologie, CHU Ibn Rochd, quartier des Hopitaux, 20400 Casablanca, Maroc
| |
Collapse
|
7
|
Pârvu M, Moţ CA, Pârvu AE, Mircea C, Stoeber L, Roşca-Casian O, Ţigu AB. Allium sativum Extract Chemical Composition, Antioxidant Activity and Antifungal Effect against Meyerozyma guilliermondii and Rhodotorula mucilaginosa Causing Onychomycosis. Molecules 2019; 24:molecules24213958. [PMID: 31683743 PMCID: PMC6865177 DOI: 10.3390/molecules24213958] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 01/10/2023] Open
Abstract
Onychomycosis is a major health problem due to its chronicity and resistance to therapy. Because some cases associate paronychia, any therapy must target the fungus and the inflammation. Medicinal plants represent an alternative for onychomycosis control. In the present work the antifungal and antioxidant activities of Alium sativum extract against Meyerozyma guilliermondii (Wick.) Kurtzman & M. Suzuki and Rhodotorula mucilaginosa (A. Jörg.) F.C. Harrison, isolated for the first time from a toenail onychomycosis case, were investigated. The fungal species were confirmed by DNA molecular analysis. A. sativum minimum inhibitory concentration (MIC) and ultrastructural effects were examined. At the MIC concentration (120 mg/mL) the micrographs indicated severe structural alterations with cell death. The antioxidant properties of the A. sativum extract were evaluated is a rat turpentine oil induced inflammation, and compared to an anti-inflammatory drug, diclofenac, and the main compound from the extract, allicin. A. sativum reduced serum total oxidative status, malondialdehyde and nitric oxide production, and increased total thiols. The effects were comparable to those of allicin and diclofenac. In conclusion, the garlic extract had antifungal effects against M. guilliermondii and R. mucilaginosa, and antioxidant effect in turpentine-induced inflammation. Together, the antifungal and antioxidant activities support that A. sativum is a potential alternative treatment in onychomycosis.
Collapse
Affiliation(s)
- Marcel Pârvu
- Department of Biology, Faculty of Biology and Geology, Babeș-Bolyai University, 42 Republicii Street, 400015 Cluj-Napoca, Romania.
| | - Cătălin A Moţ
- Department of Chemistry, Faculty of Chemistry and Chemical Engineering, Babeș-Bolyai University, 11 Arany Janos Street, 400028 Cluj-Napoca, Romania.
| | - Alina E Pârvu
- Department of Pathophysiology, Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 3 Victor Babeş Street, 400012 Cluj-Napoca, Romania.
| | - Cristina Mircea
- Department of Biology, Faculty of Biology and Geology, Babeș-Bolyai University, 42 Republicii Street, 400015 Cluj-Napoca, Romania.
| | - Leander Stoeber
- Faculty of Medicine, Iuliu Haţieganu University of Medicine and Pharmacy, 3 Victor Babeş Street, 400012 Cluj-Napoca, Romania.
| | - Oana Roşca-Casian
- Alexandru-Borza Botanical Garden, Babeș-Bolyai University, 42 Republicii Street, 400015 Cluj-Napoca, Romania.
| | - Adrian B Ţigu
- Department of Biology, Faculty of Biology and Geology, Babeș-Bolyai University, 42 Republicii Street, 400015 Cluj-Napoca, Romania.
- MEDFUTURE-Research Center for Advanced Medicine, "Iuliu-Hatieganu" University of Medicine and Pharmacy, 23 Marinescu Street, 400337 Cluj-Napoca, Romania.
| |
Collapse
|
8
|
Pietkiewicz P, Bowszyc-Dmochowska M, Gornowicz-Porowska J, Dmochowski M. Involvement of Nail Apparatus in Pemphigus Vulgaris in Ethnic Poles Is Infrequent. Front Med (Lausanne) 2018; 5:227. [PMID: 30155468 PMCID: PMC6102408 DOI: 10.3389/fmed.2018.00227] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/25/2018] [Indexed: 11/21/2022] Open
Abstract
Pemphigus vulgaris lesions have a tendency to localize around natural body orifices. The aim here was to analyze the involvement of nail apparatus in pemphigus vulgaris. Sixty seven ethnic Poles suffering from pemphigus vulgaris on photographic files archiving initial presentation were retrospectively evaluated. Pemphigus vulgaris was diagnosed using combination of clinical data, H+E histology, direct immunofluorescence of plucked scalp hair and/or perilesional tissue also for IgG1 and IgG4 deposits evaluation, indirect immunofluorescence on mosaic substrate and/or monkey esophagus, mono-analyte ELISA with desmoglein 1/3 or multi-analyte ELISA. The nail apparatus involvement was found in 9 of 67 patients (13.4%; 3 females and 6 males). Periungual fingernail lesions were found in 6 patients (2 females, 4 males), whereas periungual toenail lesions in just 3 patients (1 female, 2 males). Our patients nail apparatus changes included, by order of frequency, paronychia, nail discoloration, onychorrhexis, Beau lines, periungual hemorrhages, onychomadesis, cross-ridging, onycholysis, and trachyonychia. The average time between the onset, as recalled by patients, and the diagnosis of pemphigus vulgaris with direct immunofluorescence was not statistically different in PV patients with and without nail apparatus lesions. In this article the molecular and immunological rationale for of periungual involvement is discussed. Our single-center study suggests that nail apparatus involvement is infrequent in pemphigus vulgaris in ethnic Poles. Due to the fact that nail apparatus lesions in pemphigus vulgaris may clinically resemble onychomycosis, giving the proper diagnosis can be difficult particularly when other lesions are overlooked or misinterpreted.
Collapse
Affiliation(s)
- Pawel Pietkiewicz
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
- Surgical Oncology and General Surgery Clinic I, Greater Poland Cancer Center, Poznan, Poland
| | | | | | - Marian Dmochowski
- Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
9
|
Erraji H, Aboutaam A, Hali F, Soussi M, Chiheb S. Paronychies chroniques : une étude de 130 cas. Ann Dermatol Venereol 2018. [DOI: 10.1016/j.annder.2018.03.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
10
|
Rabarin F, Jeudy J, Cesari B, Petit A, Bigorre N, Saint-Cast Y, Fouque PA, Raimbeau G. Acute finger-tip infection: Management and treatment. A 103-case series. Orthop Traumatol Surg Res 2017; 103:933-936. [PMID: 28554808 DOI: 10.1016/j.otsr.2017.03.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 01/22/2017] [Accepted: 03/06/2017] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Acute fingertip infections (AFTI) are common. Surgical treatment is the norm in case of effusion. There is, however, no consensus on treatment modalities, or on adjuvant antibiotic therapy (AT). We present the results of a consecutive cohort of 103 AFTIs treated in emergency consultation. MATERIALS AND METHOD One hundred and one patients were treated by excision and extensive lavage under digital anesthesia, with systematic bacteriological sampling. Patient history, treatment history, location, type of bacteria, complications or recurrences and AT prescription were recorded and analyzed. All patients were reviewed at first dressing (5-7 days) and recontacted at 1 month, to record any pain, stiffness or recurrence. Three groups were distinguished: A: without preoperative AT (n=71); B: under AT before surgery (n=14); C: with postoperative AT (for severe comorbidity) (n=16). RESULTS Mean age was 39.7 years (range: 14-84 years). The three main types of bacteria were: Staphylococcus aureus (58.3%), polymicrobial flora (16.5%), and Streptococcus (12.6%). Mean time to first dressing was 5.7 days. There were no recurrences, whatever the bacterial type or patient group. In 5 patients in group A (8.2%), AT was later prescribed at day 5 (3 for hypercicatrization and 2 for maceration). In groups B and C, progression was unproblematic. At 1 month, all patients considered themselves cured; finger-tip sensitivity was conserved in 10, and 16 were awaiting complete nail regrowth. DISCUSSION Hospital admission, operative treatment under general anesthesia, and AT are factors exacerbating cost and increase the management burden of AFTI. Treatment in emergency consultation seems perfectly feasible. AT does not seem useful in the absence of severe comorbidities if resection is complete. Analysis of bacterial susceptibility and renewal of the initial dressing at 1 week enable progression to be monitored and treatment changed as necessary.
Collapse
Affiliation(s)
- F Rabarin
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France.
| | - J Jeudy
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | - B Cesari
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | - A Petit
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | - N Bigorre
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | - Y Saint-Cast
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | - P-A Fouque
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | - G Raimbeau
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| | -
- Centre de la main, chirurgie de la main, 47, rue de la Foucaudière, 49800 Trélaze, France
| |
Collapse
|
11
|
Arce M, Gutiérrez-Mendoza D. Fungal Paronychia. Clinical, Diagnosis and Treatment Aspects. CURRENT FUNGAL INFECTION REPORTS 2017. [DOI: 10.1007/s12281-017-0286-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
12
|
Sasso BM, Torino ABB, França AFEDC, Velho PENF. Periungual tegumentary leishmaniasis: a diagnostic challenge. An Bras Dermatol 2017; 92:268-269. [PMID: 28538896 PMCID: PMC5429122 DOI: 10.1590/abd1806-4841.20176352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Accepted: 11/06/2016] [Indexed: 12/01/2022] Open
Abstract
Periungual and paronychia-like skin lesions can mimic various diseases, setting
up a diagnostic challenge that invariably requires correlation with
complementary tests. We report a case of an ulcerated tumor of the nailfold
diagnosed as leishmaniasis. Although paronychia-like cutaneous leishmaniasis is
a rare variant, its epidemiological relevance in Brazil should prompt
dermatologists to include it as a plausible diagnosis thus leading to correct
work up and treatment.
Collapse
Affiliation(s)
- Bruna Morassi Sasso
- Department of Clinical Medicine, Dermatology Unit, of the School of Medical Sciences of the State University of Campinas (Unicamp) - Campinas (SP), Brazil
| | - Ana Beatriz Barbosa Torino
- Department of Clinical Medicine, Dermatology Unit, of the School of Medical Sciences of the State University of Campinas (Unicamp) - Campinas (SP), Brazil
| | - Andréa Fernandes Eloy da Costa França
- Department of Clinical Medicine, Dermatology Unit, of the School of Medical Sciences of the State University of Campinas (Unicamp) - Campinas (SP), Brazil
| | - Paulo Eduardo Neves Ferreira Velho
- Department of Clinical Medicine, Dermatology Unit, of the School of Medical Sciences of the State University of Campinas (Unicamp) - Campinas (SP), Brazil
| |
Collapse
|
13
|
Acute felon and paronychia: Antibiotics not necessary after surgical treatment. Prospective study of 46 patients. HAND SURGERY & REHABILITATION 2016; 35:40-3. [DOI: 10.1016/j.hansur.2015.12.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 09/10/2015] [Accepted: 09/22/2015] [Indexed: 11/21/2022]
|
14
|
Lorette G. Montrez-moi vos ongles ! Presse Med 2014; 43:1163-4. [DOI: 10.1016/j.lpm.2014.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Accepted: 09/09/2014] [Indexed: 10/24/2022] Open
|