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Abstract
Changes in nail color can provide important clues of underlying systemic and skin disease. In particular, white discoloration (leukonychia) has a high prevalence with a wide array of potential relevant causes, from simple manicure habits to life-threatening liver or kidney failure. Therefore, a reliable assessment of the patient with leukonychia is essential. In the past, two classifications for leukonychia have been presented. The morphological classifies the nail according to the distribution of the white lines: total, partial, transversal, and longitudinal leukonychia. Mees’ and Muehrcke’s lines are examples of transversal leukonychia, while Terry’s and Lindsay’s nails are examples of total and partial leukonychia. The anatomical classifies according to the structure responsible for the white color: the nail plate in true leukonychia, the nail bed in apparent leukonychia, and the surface only in pseudoleukonychia. In this review, both morphological and anatomical features have been combined in an algorithm that enables clinicians to approach leukonychia efficiently and effectively.
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Fernandez-Nieto D, Jimenez-Cauhe J, Ortega-Quijano D, Diaz-Guimaraens B, Dominguez-Santas M, Martinez-Rubio J. Transverse leukonychia (Mees' lines) nail alterations in a COVID-19 patient. Dermatol Ther 2020; 33:e13863. [PMID: 32779847 PMCID: PMC7323062 DOI: 10.1111/dth.13863] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/14/2020] [Accepted: 06/15/2020] [Indexed: 01/21/2023]
Affiliation(s)
| | - Juan Jimenez-Cauhe
- Dermatology Department, Ramon y Cajal University Hospital, Madrid, Spain
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3
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Piccolo V, Corneli P, Zalaudek I, Argenziano G, Conforti C, Alfano R, Russo T. Mees' lines because of chemotherapy for Hodgkin's lymphoma. Int J Dermatol 2019; 59:e38. [PMID: 31566709 DOI: 10.1111/ijd.14649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/12/2019] [Accepted: 08/27/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Vincenzo Piccolo
- Pediatric Dermatology, Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paola Corneli
- Department of Dermatology, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Department of Dermatology, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Giuseppe Argenziano
- Pediatric Dermatology, Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Claudio Conforti
- Department of Dermatology, Maggiore Hospital of Trieste, University of Trieste, Trieste, Italy
| | - Roberto Alfano
- Department of Anesthesiology, Surgery and Emergency, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Teresa Russo
- Pediatric Dermatology, Dermatology Unit, University of Campania Luigi Vanvitelli, Naples, Italy
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4
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Hair and Nail Manifestations of Systemic Disease. CURRENT DERMATOLOGY REPORTS 2017. [DOI: 10.1007/s13671-017-0169-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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5
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Robert C, Sibaud V, Mateus C, Verschoore M, Charles C, Lanoy E, Baran R. Nail toxicities induced by systemic anticancer treatments. Lancet Oncol 2015; 16:e181-9. [PMID: 25846098 DOI: 10.1016/s1470-2045(14)71133-7] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients treated with systemic anticancer drugs often show changes to their nails, which are usually well tolerated and disappear on cessation of treatment. However, some nail toxicities can cause pain and functional impairment and thus substantially affect a patient's quality of life, especially if they are given taxanes or EGFR inhibitors. These nail toxicities can affect both the nail plate and bed, and might present as melanonychia, leukonychia, onycholysis, onychomadesis, Beau's lines, or onychorrhexis, as frequently noted with conventional chemotherapies. Additionally, the periungual area (perionychium) of the nail might be affected by paronychia or pyogenic granuloma, especially in patients treated with drugs targeting EGFR or MEK. We review the nail changes induced by conventional chemotherapies and those associated with the use of targeted anticancer drugs and discuss preventive or curative options.
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Affiliation(s)
- Caroline Robert
- Gustave Roussy, Département de Médicine Oncologique, Service de Dermatologie, Villejuif, France; Université Paris-Sud, Faculté de Médecine, Le Kremlin Bicetre, France.
| | - Vincent Sibaud
- Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, France
| | - Christina Mateus
- Gustave Roussy, Département de Médicine Oncologique, Service de Dermatologie, Villejuif, France
| | | | - Cécile Charles
- Département Interdisciplinaire de Soins de Support en Oncologie, Villejuif, France
| | - Emilie Lanoy
- Département de Biostatistiques, Villejuif, France
| | - Robert Baran
- Gustave Roussy, Département de Médicine Oncologique, Service de Dermatologie, Villejuif, France
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6
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Abstract
Diagnosing nail matrix diseases requires knowledge of the nail matrix function and anatomy. This allows recognition of the clinical manifestations and assessment of potential surgical risk. Nail signs depend on the location within the matrix (proximal or distal) and the intensity, duration, and extent of the insult. Proximal matrix involvement includes nail surface irregularities (longitudinal lines, transverse lines, roughness of the nail surface, pitting, and superficial brittleness), whereas distal matrix insult induces longitudinal or transverse chromonychia. Clinical signs are described and their main causes are listed to enable readers to diagnose matrix disease from the nail's clinical features.
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Affiliation(s)
- Bertrand Richert
- Dermatology Department, University Hospitals Brugmann, St Pierre and Queen Fabiola's Children Hospital, Université Libre de Bruxelles, Brussels, Belgium.
| | - Marie Caucanas
- Dermatology Department, University Hospitals Brugmann, St Pierre and Queen Fabiola's Children Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Josette André
- Dermatology Department, University Hospitals Brugmann, St Pierre and Queen Fabiola's Children Hospital, Université Libre de Bruxelles, Brussels, Belgium
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Gallouj S, Mernissi FZ. [Transverse leuconychia induced by manicure: is there a contribution from dermoscopy?]. Pan Afr Med J 2014; 18:39. [PMID: 25368728 PMCID: PMC4215373 DOI: 10.11604/pamj.2014.18.39.3761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 05/03/2014] [Indexed: 11/11/2022] Open
Abstract
La leuconychie transversale induite par la manucurie est une leuconychie secondaire au microtraumatisme transmis à la matrice unguéale. Nous rapportant une observation où la dermoscopie avait un intérêt considérable pour l'orientation diagnostic.
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Affiliation(s)
- Salim Gallouj
- Service de Dermatologie, Faculté de Médecine, CHU Hassan II, Fès, Maroc
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8
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Abstract
Nail abnormalities can arise in conjunction with or as a result of systematic pathologies. These pathologies include single-organ diseases, multisystemic diseases, and drug-induced insults. Clinical signs associated with these conditions include dyschromias, vascular alterations, periungual tissue changes, textural dystrophies, contour alterations, and growth-rate alterations. The associated systemic pathologies may affect any part of the nail apparatus, including the nail matrix, the nail plate, the nail bed, the underlying vasculature, and the periungual tissues. The anatomical location and extent of damage determine the clinically manifested anomaly.
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10
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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