ABSTRACT
IMPORTANCE: Congenital malalignment of the great toenail (CMGT) is an idiopathic deviation of the nail apparatus. CMGT predisposes patients to recurrent stress forces, microtrauma, and secondary complications. The purpose of this study was to review the current published photographs to determine the relationship between variants of CMGT and the disappearing nail bed (DNB). OBSERVATIONS: A search in PubMed and Google using the terms congenital malalignment of the great toenail, disappearing nail bed, and lateral nail deviation was performed. Of the 53 photographs found in a total of 35 articles, 23 were disqualified due to low picture resolution or poor angle. The remaining 30 photographs were evaluated. Pure nail malalignment with associated dystrophy and DNB was found in 22 of 30 photographs. Four of 30 cases demonstrated pure deviation of the distal phalanx, with nail dystrophy but minimal DNB. The remaining 4 cases demonstrated a combination of toe deviation and nail unit deviation with varying degrees of DNB. CONCLUSIONS AND RELEVANCE: DNB was associated with all forms of pure CMGT. Moreover, a variant of malalignment of the distal phalanx was noted in 8 photographs. This has potential implications for further studies and treatment to correct secondary complications.
ABSTRACT
This case reminded us that not every moist, erythematous, crusting eruption is purely infectious.
Subject(s)
Cephalexin/therapeutic use , Ear Diseases/diagnosis , Ear Diseases/drug therapy , Eczema/diagnosis , Eczema/drug therapy , Erythema/diagnosis , Erythema/drug therapy , Prednisone/therapeutic use , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Child , Communicable Diseases/diagnosis , Communicable Diseases/drug therapy , Communicable Diseases/physiopathology , Ear Diseases/physiopathology , Eczema/physiopathology , Erythema/physiopathology , Humans , Male , Treatment OutcomeABSTRACT
A young man presented with blue nodules on the trunk, face, and extremities that gradually increased in number and size. His mother had similar lesions. Initially, blue rubber bleb nevus syndrome was suspected, but histological findings confirmed the diagnosis of hereditary glomuvenous malformations. Making the correct diagnosis spares the patient unnecessary evaluation for the arteriovenous malformations of the gastrointestinal tract associated with the former diagnosis.
Subject(s)
Glomus Tumor/pathology , Paraganglioma, Extra-Adrenal/pathology , Skin Neoplasms/pathology , Adolescent , Diagnosis, Differential , Gastrointestinal Neoplasms/diagnosis , Glomus Tumor/diagnosis , Humans , Male , Nevus, Blue/diagnosis , Paraganglioma, Extra-Adrenal/diagnosis , Skin Neoplasms/diagnosisABSTRACT
Beau lines, onychomadesis, and retronychia are nail dystrophies with distinctive clinical findings. Trauma has been reported as the initiating factor in each of these entities. Infections, severe medical illnesses, major surgery/anesthesia, medication side effects, and autoimmune disease can produce Beau lines and onychomadesis. This article illustrates the common underlying pathophysiological mechanism that produces each of these nail dystrophies.
Subject(s)
Nail Diseases/diagnosis , Nail Diseases/therapy , Humans , Nail Diseases/etiology , Nail Diseases/physiopathologyABSTRACT
Dermatologists often perform 2 biopsies in patients with widespread tense blisters: one for light microscopy and another for direct immunofluorescence (DIF). Biopsy techniques recommended for blistering diseases with tense blisters are discussed, and illustrations demonstrate an alternative approach utilizing a single punch biopsy. A single punch biopsy is more cost effective and provides the same diagnostic information as the standard 2-biopsy approach for subepidermal blisters plus additional salt-split skin-like diagnostic information. A limitation for bisecting the single punch biopsy specimen is a potential complete separation of the epidermis from the dermis. The single punch biopsy technique is a simple cost-effective method for obtaining necessary diagnostic information when sampling tense blisters in patients with blistering diseases.