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Raja SM. Chronic kidney disease entertained from Lindsay's nails: A case report and literature review. Clin Case Rep 2021; 9:e04426. [PMID: 34257982 PMCID: PMC8259918 DOI: 10.1002/ccr3.4426] [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: 10/07/2020] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 11/15/2022] Open
Abstract
The presence of Lindsay's nails in a patient with a risk factor for chronic kidney disease could be a valuable clue to an underlying long-standing renal impairment, particularly when serum creatinine level is not at hand.
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Affiliation(s)
- Saud Mohammed Raja
- Department of Internal MedicineOrotta National Referral Hospital/Orotta School of Medicine and DentistryAsmaraEritrea
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2
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Tajalli F, Mirahmadi SMS, Mozafarpoor S, Goodarzi A, Nasiri Partovi M, Lakestani D. Mucocutaneous manifestations of patients with chronic kidney disease under hemodialysis: A cross-sectional study of 49 patients. Dermatol Ther 2021; 34:e15015. [PMID: 34080277 DOI: 10.1111/dth.15015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/27/2021] [Accepted: 05/12/2021] [Indexed: 11/29/2022]
Abstract
Chronic kidney disease (CKD) is a common medical problem with well-known dermatologic manifestations, some of which highly disturb the patients' quality of life. This cross-sectional study was designed to identify the prevalence and type of cutaneous involvement in CKD patients. The skin manifestations of 49 patients with CKD undergoing hemodialysis at Akhavan Hospital in Kashan, Iran, were recorded over 2 months. Diabetes (35%) was the most common cause of chronic renal failure in the patients, and the most common skin manifestations were xerosis (95.9%), uremic pigmentation (89.8%), scleral discoloration (87.8%), dental discoloration (85.2% among the patients with natural teeth), dry mouth (65.3%), varicosity (61.2%), pruritus (57.1%), skin atrophy (49%), lentigo (46.9%), subungual hyperkeratosis (42.9%), half and half nail dystrophy (34.7%), and purpura (26.5%). Mucocutaneous involvement has a very high prevalence in CKD patients undergoing hemodialysis, and some of the cases are medically and cosmetically disturbing; therefore, with better knowledge about the type and prevalence of these involvements, the consequences can be better predicted and managed. Further studies are recommended to be conducted on the association between these signs and CKD grade, and clinical trials are also required for establishing the treatment options available for these signs and then assessing the patients' quality of life as a primary outcome measure.
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Affiliation(s)
- Farzam Tajalli
- Department of Urology, Firoozabadi Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | | | - Samaneh Mozafarpoor
- Department of Dermatology, Skin Disease and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Goodarzi
- Department of Dermatology, Rasool Akram Medical Complex, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mitra Nasiri Partovi
- Department of Radiology, Rasool Akram Medical Complex, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Davood Lakestani
- Pediatric Department, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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3
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Daadaa N, Souissi A, Ben Kaab B, Zouaghi MK, Mokni M. Absent lunula: An overlooked finding in chronic kidney disease. Clin Case Rep 2021; 9:576-577. [PMID: 33489220 PMCID: PMC7813076 DOI: 10.1002/ccr3.3471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 10/07/2020] [Accepted: 10/13/2020] [Indexed: 11/16/2022] Open
Abstract
We highlight the importance of a thorough nail examination in every clinical encounter, especially in uremic patients. Absent lunula should prompt the clinician to rule out underlying kidney disease even in the absence of signs of uremia.
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Affiliation(s)
- Najla Daadaa
- Dermatology DepartmentLa Rabta HospitalTunisTunisia
| | | | | | | | - Mourad Mokni
- Dermatology DepartmentLa Rabta HospitalTunisTunisia
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4
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Kulkarni V, Murray A, Mittal R, Spence D, O'Kane G, Incoll I. Microbial counts in hands with and without nail varnish after surgical skin preparation: a randomized control trial. J Hand Surg Eur Vol 2018; 43:832-835. [PMID: 29558848 DOI: 10.1177/1753193418764287] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
UNLABELLED Nail varnish is commonly removed from fingernails prior to surgical procedures. We report the results of a randomized controlled trial comparing the microbial counts in hands with and without nail varnish applied, following surgical skin preparation. Forty-three patients were randomized; three patients were lost to follow-up. Each patient had one hand painted with nail varnish and had both hands tested 1 week later. There was no significant difference in terms of positive microbial growth between the nail plates or hyponichia with or without nail varnish applied. Our results demonstrate that the presence of nail varnish does not have an effect on the microbial counts of hands following surgical skin preparation. LEVEL OF EVIDENCE I.
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Affiliation(s)
- Vinay Kulkarni
- 1 Departments of Orthopaedic Surgery, Gosford Hospital, NSW, Australia
| | - Anthony Murray
- 1 Departments of Orthopaedic Surgery, Gosford Hospital, NSW, Australia
| | - Rajat Mittal
- 1 Departments of Orthopaedic Surgery, Gosford Hospital, NSW, Australia
| | - David Spence
- 2 Infectious Diseases, Gosford Hospital, NSW, Australia
| | | | - Ian Incoll
- 1 Departments of Orthopaedic Surgery, Gosford Hospital, NSW, Australia
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Haber R, Khoury R, Kechichian E, Tomb R. Splinter hemorrhages of the nails: a systematic review of clinical features and associated conditions. Int J Dermatol 2016; 55:1304-1310. [DOI: 10.1111/ijd.13347] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/04/2016] [Accepted: 03/02/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Roger Haber
- Department of Dermatology; Hotel Dieu de France University Hospital; Beirut Lebanon
- Department of Dermatology; Faculty of Medicine; Saint Joseph University; Beirut Lebanon
| | - Rana Khoury
- Department of Dermatology; Hotel Dieu de France University Hospital; Beirut Lebanon
- Department of Dermatology; Faculty of Medicine; Saint Joseph University; Beirut Lebanon
| | - Elio Kechichian
- Department of Dermatology; Hotel Dieu de France University Hospital; Beirut Lebanon
- Department of Dermatology; Faculty of Medicine; Saint Joseph University; Beirut Lebanon
| | - Roland Tomb
- Department of Dermatology; Hotel Dieu de France University Hospital; Beirut Lebanon
- Department of Dermatology; Faculty of Medicine; Saint Joseph University; Beirut Lebanon
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6
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Gursu M, Uzun S, Topcuoğlu D, Koc LK, Yucel L, Sumnu A, Cebeci E, Ozkan O, Behlul A, Koc L, Ozturk S, Kazancioglu R. Skin disorders in peritoneal dialysis patients: An underdiagnosed subject. World J Nephrol 2016; 5:372-377. [PMID: 27458566 PMCID: PMC4936344 DOI: 10.5527/wjn.v5.i4.372] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 03/02/2016] [Accepted: 04/22/2016] [Indexed: 02/05/2023] Open
Abstract
AIM: To examine all skin changes in peritoneal dialysis (PD) patients followed up in our unit.
METHODS: Patients on PD program for at least three months without any known chronic skin disease were included in the study. Patients with already diagnosed skin disease, those who have systemic diseases that may cause skin lesions, patients with malignancies and those who did not give informed consent were excluded from the study. All patients were examined by the same predetermined dermatologist with all findings recorded. The demographic, clinical and laboratory data including measures of dialysis adequacy of patients were recorded also. Statistical Package for Social Sciences (SPSS) for Windows 16.0 standard version was used for statistical analysis.
RESULTS: Among the patients followed up in our PD unit, those without exclusion criteria who gave informed consent, 38 patients were included in the study with male/female ratio and mean age of 26/12 and 50.3 ± 13.7 years, respectively. The duration of CKD was 7.86 ± 4.16 years and the mean PD duration was 47.1 ± 29.6 mo. Primary kidney disease was diabetic nephropathy in 11, nephrosclerosis in six, uropathologies in four, chronic glomerulonephritis in three, chronic pyelonephritis in three, autosomal dominant polycystic kidney disease in three patients while cause was unknown in eight patients. All patients except for one patient had at least one skin lesion. Loss of lunula, onychomycosis and tinea pedis are the most frequent skin disorders recorded in the study group. Diabetic patients had tinea pedis more frequently (P = 0.045). No relationship of skin findings was detected with primary renal diseases, comorbidities and medications that the patients were using.
CONCLUSION: Skin abnormalities are common in in PD patients. The most frequent skin pathologies are onychomycosis and tinea pedis which must not be overlooked.
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Twigg EV, Weitz NA, Scher RK, Grossman ME. Pincer nails in a patient with systemic lupus erythematosus and lupus nephritis: A case report. JAAD Case Rep 2016; 2:233-5. [PMID: 27366786 PMCID: PMC4919281 DOI: 10.1016/j.jdcr.2016.04.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- Emily V Twigg
- Conquest Hospital, Hastings, East Sussex, United Kingdom
| | - Nicole A Weitz
- Columbia University Medical Center, Department of Dermatology, New York, New York
| | - Richard K Scher
- Weill Cornell, Department of Dermatology, New York, New York
| | - Marc E Grossman
- Dermatology Consultation Service, Columbia University Medical Center, New York, New York
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Ma Y, Xiang Z, Lin L, Zhang J, Wang H. Half-and-half nail in a case of isoniazid-induced pellagra. Postepy Dermatol Alergol 2014; 31:329-31. [PMID: 25395931 PMCID: PMC4221350 DOI: 10.5114/pdia.2014.40969] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/02/2014] [Accepted: 01/06/2014] [Indexed: 11/17/2022] Open
Affiliation(s)
- Yiping Ma
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China. Head of Department: Prof. Baoxi Wang
| | - Zhi Xiang
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China. Head of Department: Prof. Baoxi Wang
| | - Lin Lin
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China. Head of Department: Prof. Baoxi Wang
| | - Jiechen Zhang
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China. Head of Department: Prof. Baoxi Wang
| | - Hongsheng Wang
- Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing, China. Head of Department: Prof. Baoxi Wang
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Anbar T, Hay RA, Abdel-Rahman AT, Moftah NH, Al-Khayyat MA. Clinical study of nail changes in vitiligo. J Cosmet Dermatol 2013; 12:67-72. [PMID: 23438144 DOI: 10.1111/jocd.12022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2012] [Indexed: 11/30/2022]
Abstract
Both vitiligo and alopecia areata (AA) are associated together, associated with other autoimmune diseases, and autoimmunity is one of the important theories in their etiology. Nail changes are a known association with AA, thus we hypothesized that nail changes can be found in vitiligo patients. On revising the literature, only two types of nail changes were described in association with vitiligo. Our aim was to study the frequency and types of nail changes among vitiligo patients in comparison with normal healthy volunteers. This multi-centric study was carried on 91 patients with vitiligo, as well as 91 normal healthy control subjects who were age- and sex-matched. Nails were examined for changes in nail plates as regards striations, texture, curvature, dystrophy, and pigmentation. The presence or absence of the thumb lunula was also reported. Nail changes were observed in 62 patients (68.1%) and 46 (50.5%) control subjects with a statistically significant difference (P = 0.016). Longitudinal ridging and absent lunula were significantly higher in patients than in the controls (P = 0.001 and 0.037, respectively). Other reported nail abnormalities in the current study included punctate leukonychia, pitting, flag sign, and Terry's nails. Awareness of this association will widen the clinician's perspective to carefully examine the nail changes in vitiligo patients and conversely examine patients with nail changes for vitiligo.
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Affiliation(s)
- Tag Anbar
- Dermatology Department, Al-Minya University, Al-Minya, Egypt.
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Affiliation(s)
- Müzeyyen Gönül
- Second Dermatology Clinic, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Charkhchian M, Beheshti A, Zangivand AA, Sedighi A. Nail disorder among patients on maintenance hemodialysis. DERMATOL SIN 2013. [DOI: 10.1016/j.dsi.2012.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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