Retronychia: report of two cases.

Retronychia is an incomplete form of nail shedding that leads to embedding of the nail into the proximal nail fold and subsequent inflammation. Patients present with persistent paronychia in the setting of disrupted nail growth. Other nail changes may be present. Simple avulsion is curative, and unlike other forms of ingrown nails, it does not tend to recur. We report 2 cases of retronychia that were associated with distal onycholysis and subungual hematoma, respectively. Both were successfully treated with nail avulsion.

Atrophoderma of Pasini and Pierini: a clinical and histopathological study.

BACKGROUND: Idiopathic atrophoderma of Pasini and Pierini (IAPP) usually manifests as one or multiple depressed and hyperpigmented patches, with a predilection to the trunk. No diagnostic changes are usually seen on histology. Elastic stains often reveal no abnormalities. OBJECTIVE: To review our cases of IAPP, describe their clinical and histological findings and compare them with the literature. METHODS: Retrospective review of IAPP cases who presented to our institution between 1994 and 2006. RESULTS: From a total of 16 patients, only 19% displayed hyperpigmented lesions, while 81% had either hypopigmented (9/16) or skin-colored (4/16) lesions. The sites predominantly affected were the lower extremities (62.5%), followed by the upper extremities and trunk. Only in one patient was IAPP co-existent with morphea. Histology revealed no diagnostic abnormalities; however, elastic stains showed a spectrum of changes ranging from normal to severe diminution and fragmentation of elastic fiber network. CONCLUSIONS: Our study shows several new aspects of IAPP. Clinically, the lesions were most commonly hypopigmented and involved predominantly the extremities. Histologically, IAPP exhibited a spectrum of alterations in elastic fibers. The most prevalent form of IAPP in our country seems to be unassociated with morphea.

Vitamins and minerals: their role in nail health and disease.

Nail health and appearance are global concerns. We investigated the use of biotin vitamin E, alpha-tocopherol, vitamin C (ascorbic acid), vitamin A, retinoids, retinol, retinal, silicon, zinc, iron, copper, selenium, and vitamin B12 (Cyanocobalamin) in nail health and disease. The evidence that we adduce in this paper suggests that: 1) proper nail care seems to help maintain nail health; 2) no evidence supports the use of vitamin supplementation with vitamin E, vitamin C (ascorbic acid), vitamin A, retinoids, retinol, retinal, silicon, zinc, iron, copper, selenium, or vitamin B12 (Cyanocobalamin) for improving the nail health of well-nourished patients or improving the appearance of nails affected by pathologic disease; and 3) brittle nail syndrome appears to abate with supplementation with a 2.5-mg dose of biotin daily or a 10-mg dose of silicon daily, a useful form of which is choline-stabilized orthosilicic acid.

Less well-defined dermatoses of pregnancy.

Over the past several decades, many specific and nonspecific dermatoses of pregnancy have been described. The lack of a well-defined clinical and histological features as well as reproducibility in some of these entities has led to confusing reports in the literature. In this review article, an account of these nonspecific dermatoses of pregnancy will be presented in an attempt to shed light on their nosology and to better categorize them in view of the recent literature findings.

Nail diseases related to nail cosmetics.

The use of nail care products and procedures to beautify and groom the nails is extremely common. Unfortunately, when improperly used, nail cosmetics can lead to nail diseases, such as paronychia, onycholysis, and brittle nails. Understanding the pathophysiology behind these conditions is an essential step toward better treatment and future prevention allowing patients to enjoy nail adornments while maintaining healthy nails.

The Role of Hair Restoration Surgery in Primary Cicatricial Alopecia.

Primary scarring alopecias are a group of inflammatory conditions in which the main target of the inflammation is the hair follicle. They represent up to 7.3% of the hair loss cases presenting to specialty hair clinics. They are poorly understood, their pathogeneses are mostly unknown and their management is guided at best by the results of small case series and expert opinions. These alopecias are frequently referred to as a trichologic emergency as their progression can be rapid and the hair loss they induce is permanent. In view of the suboptimal solutions offered by the pharmacological treatments available and the significant emotional distress caused by these conditions, it is only normal for patients with scarring alopecias and their treating physicians alike to explore the prospects of surgical correction. This review attempts to summarize what is known about hair restoration surgery in scarring alopecia.

Primary localized cutaneous amyloidosis: a sign of immune dysregulation?

The manifestations of primary localized cutaneous amyloidosis (PLCA) are usually limited to the skin. The exact etiopathogenesis of PLCA has not been clearly elucidated yet. An increasing number of reports in the literature that associate PLCA with various autoimmune/immune disorders suggest that underlying immune-mediated factors may be implicated. We report a case of sarcoidosis and a case of IgA nephropathy in association with extensive macular amyloidosis, adding these two conditions to the list of other autoimmune/immune disorders associated with PLCA. At least a subset of PLCA patients, especially those with extensive involvement, may have associated autoimmune/immune disorders raising the possibility of a common underlying immune-mediated mechanism.