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Nail Splinter Hemorrhage

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21. Nail Surgery (Treatment)

that are significantly dystrophic appear to respond better to avulsion with urea paste. The benefits of performing nonsurgical nail avulsion with urea ointment include pain relief; a low risk of infection, hemorrhage (ie, bloodless procedure), and other morbidity; a quick improvement after avulsion; and the absence of pain during and after treatment. [ ] Nail avulsion with urea is ideal for the treatment of symptomatic dystrophic nails in patients with diabetic neuropathy, vascular disease, or immunosuppression (...) Nail Surgery (Treatment) Nail Surgery Treatment & Management: Approach Considerations, Surgical Therapy, Preoperative Details Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEyNjcyNS10cmVhdG1lbnQ= processing

2014 eMedicine.com

22. Nail Surgery (Follow-up)

that are significantly dystrophic appear to respond better to avulsion with urea paste. The benefits of performing nonsurgical nail avulsion with urea ointment include pain relief; a low risk of infection, hemorrhage (ie, bloodless procedure), and other morbidity; a quick improvement after avulsion; and the absence of pain during and after treatment. [ ] Nail avulsion with urea is ideal for the treatment of symptomatic dystrophic nails in patients with diabetic neuropathy, vascular disease, or immunosuppression (...) Nail Surgery (Follow-up) Nail Surgery Treatment & Management: Approach Considerations, Surgical Therapy, Preoperative Details Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEyNjcyNS10cmVhdG1lbnQ= processing

2014 eMedicine.com

23. Psoriasis, Nails (Follow-up)

starts distally and progresses proximally, causing a traumatic uplifting of the distal nail plate. Secondary microbial colonization may occur. Nail plate crumbling Nail plate weakening due to disease of the underlying structures causes this condition. Splinter hemorrhage/dilated tortuous capillaries in the dermal papillae Splinter hemorrhages are longitudinal black lines due to minute foci of capillary hemorrhage between the nail bed and the nail plate. This is analogous to the Auspitz sign (...) . Previous Next: Histologic Findings Psoriasis can affect any part of the nail unit. Most changes occur in the nail plate. Histologic findings of nail psoriasis include mild-to-moderate hyperkeratosis, hypergranulosis, serum globules and hemorrhage in the corneum layer, papillomatous epidermal hyperplasia, and spongiosis. Previous Next: Overview of Treatment of Nail Psoriasis Many treatment options are available after the diagnosis of nail psoriasis is made. The treatments focus on improvement

2014 eMedicine.com

24. Psoriasis, Nails (Diagnosis)

starts distally and progresses proximally, causing a traumatic uplifting of the distal nail plate. Secondary microbial colonization may occur. Nail plate crumbling Nail plate weakening due to disease of the underlying structures causes this condition. Splinter hemorrhage/dilated tortuous capillaries in the dermal papillae Splinter hemorrhages are longitudinal black lines due to minute foci of capillary hemorrhage between the nail bed and the nail plate. This is analogous to the Auspitz sign (...) . Previous Next: Histologic Findings Psoriasis can affect any part of the nail unit. Most changes occur in the nail plate. Histologic findings of nail psoriasis include mild-to-moderate hyperkeratosis, hypergranulosis, serum globules and hemorrhage in the corneum layer, papillomatous epidermal hyperplasia, and spongiosis. Previous Next: Overview of Treatment of Nail Psoriasis Many treatment options are available after the diagnosis of nail psoriasis is made. The treatments focus on improvement

2014 eMedicine.com

25. Dermatoscopy of nail lichen planus. (PubMed)

in 50.63%, splinter hemorrhage in 35.44%, onycholysis in 27.85%, and subungual keratosis in 7.59%. Concerning anomalies that involved nail matrix, bed, and perionychial region altogether, there were longitudinal streaks in 82.28% and anonychia in 1.27%. Paronychia was present in 31.65% of the cases.Considering that nail lichen planus is an underdiagnosed disease with severe consequences, early diagnosis is essential. This descriptive study of dermatoscopic characteristics of nail lichen planus would (...) Dermatoscopy of nail lichen planus. Nail lichen planus affects 10% of all patients with lichen planus. It is a severe disease that may lead to destruction of the nail plate. It affects fingernails more than toenails. Early diagnosis is important due to its aggressive behavior. Histopathology should be carried out, but in many occasions it is not enough to come to a conclusive diagnosis. Dermatoscopy, a complementary tool, has proven to be useful in its diagnosis, management, and prognosis

2013 International Journal of Dermatology

26. A Study to Evaluate the Safety and Efficacy of Adalimumab in Subjects With Chronic Plaque Psoriasis and Nail Psoriasis

for psoriasis with mNAPSI, and the scores of all 10 fingernails were combined. Investigators assessed each nail abnormality for each of a participant's nails by grading 3 features or groups of features (pitting, onycholysis and oil-drop dyschromia, and crumbling) and noting the presence or absence of 4 features (leukonychia, splinter hemorrhages, hyperkeratosis, and red spots in the lunula). The range of possible scores was 0 to 130, with a score of 0 indicating absence of nail psoriasis and a score of 130 (...) A Study to Evaluate the Safety and Efficacy of Adalimumab in Subjects With Chronic Plaque Psoriasis and Nail Psoriasis A Study to Evaluate the Safety and Efficacy of Adalimumab in Subjects With Chronic Plaque Psoriasis and Nail Psoriasis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum

2013 Clinical Trials

27. Nail psoriasis: a review. (PubMed)

Nail psoriasis: a review. Nail psoriasis is common, occurring in up to half of patients with psoriasis and in 90% of patients with psoriatic arthritis. Left untreated, it may progress to debilitating nail disease, which leads to significant functional impairment. The most common clinical signs of nail psoriasis are nail plate pitting and onycholysis. Other classical signs include oil drop discoloration, subungual hyperkeratosis, and splinter hemorrhages. The modified Nail Psoriasis Severity (...) Index (mNAPSI) can be used to grade the severity of nail psoriasis, while the Nail Psoriasis Quality of Life Scale (NPQ10) is a questionnaire that evaluates the impact of nail psoriasis on the patient's functional status and quality of life. Treatment of nail psoriasis should be individualized according to the patient's preferences, severity of nail changes, and presence of skin and/or joint involvement. Both topical and intralesional therapies are safe and effective treatment modalities for nail

2012 American journal of clinical dermatology

28. Comparison of Efficacy of Intralesional Triamcinolone Injection and Clobetasol Propionate Ointment for Psoriatic Nails

, discoloration, splinter hemorrhage and subungual hyperkeratosis. The main treatment of psoriatic nails is using topical high- potent steroids however topical steroids are limited their ability to penetrate deep nail matrix or nail bed which are the main pathology. Use of such a treatment can lead to skin atrophy and report in the case of "Disappearing digits". Previous studies of steroid injection in the treatment of psoriatic nails show satisfactory results without any serious permanent adverse effects (...) disorder. The nails involvement has been reported up to 40% of psoriatic patients. Psoriatic nails can significantly affect a quality of life of patients. Psoriasis affects both nail matrix and nail bed. Pitting, leukonychia and red spots in lunula indicate a defect in the nail matrix. Psoriasis can change the nail bed as the results in onycholysis, discoloration, splinter hemorrhage and subungual hyperkeratosis. The main treatment of psoriatic nails is using topical high- potent steroids however

2012 Clinical Trials

29. Longitudinal erythronychia: individual or multiple linear red bands of the nail plate: a review of clinical features and associated conditions. (PubMed)

band), type Ib (monodactylous - bifid bands), type IIa (polydactylous - single band), and type IIb (polydactylous - multiple bands). Associated morphologic findings that can be present at the distal tip of the nail with longitudinal erythronychia include fragility, onycholysis, splinter hemorrhage, splitting, subungual keratosis, thinning, and V-shaped nick. Some patients with longitudinal erythronychia seek medical evaluation because of pain in the associated distal digit; however, the linear red (...) Longitudinal erythronychia: individual or multiple linear red bands of the nail plate: a review of clinical features and associated conditions. Longitudinal erythronychia is a linear red band on the nail plate that originates at the proximal nail fold, traverses the lunula, and extends to the free edge of the nail plate. Longitudinal erythronychia is classified based upon the number of nails affected and the number of red streaks present on each nail as follows: type Ia (monodactylous - single

2011 American journal of clinical dermatology

30. Onychomatricoma: Genome-wide analyses of a rare nail matrix tumor. (PubMed)

Onychomatricoma: Genome-wide analyses of a rare nail matrix tumor. Onychomatricoma (OM) is a rare benign tumor of the nail matrix in which genome-wide analyses have never been performed. It is clinically characterized by an increased transversal curvature of the nail plate, a longitudinal yellowish discoloration, and splinter hemorrhages. Once the nail plate has been removed, fingerlike fibrokeratogenous projections appear through the proximal nailfold. Histologically, it is a fibroepithelial

2010 Journal of American Academy of Dermatology

31. Effectiveness of Adalimumab (HUMIRA®) in the Treatment of Scalp and Nail Affection in Patients With Moderate to Severe Plaque Psoriasis in Routine Clinical Practice

(NAPSI) [ Time Frame: Baseline and Months 3, 6, 9, and 12 ] NAPSI grades nails for both nail matrix psoriasis and nail bed psoriasis. The sum of these two scores is the total score for that nail. Nail matrix psoriasis consists of any of the following: pitting, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis is the presence or absence of onycholysis, splinter hemorrhages, oil drop (salmon patch) discoloration or nail bed hyperkeratosis. Scoring for each is based (...) , and 12 ] Good clinical response on nails is defined as ≥ 50% improvement from Baseline in total NAPSI score. The NAPSI grades nails for both nail matrix psoriasis and nail bed psoriasis. The sum of these two scores is the total score for that nail. Nail matrix psoriasis consists of any of the following: pitting, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis is the presence or absence of onycholysis, splinter hemorrhages, oil drop (salmon patch) discoloration

2010 Clinical Trials

32. CRACKCast E083 – Infective Endocarditis and Valvular Disease

spots (these were described in the pre-antibiotic era). Osler nodes Tender subcutaneous violaceous nodules usually on the pads of fingers and toes. (papulopustules) Splinter hemorrhages Non-blanching, linear, reddish brown lesions under the nail beds Roth Spots Exudative, edematous hemorrhagic lesions of the retina with pale centres. 2) What are the HACEK organisms, and what is their significance in patients with IE? HACEK haemophilus, actinobacillus, cardiobacterium, eikenella, kingella (...) of infective endocarditis Clinical Features: intermittent fever Osler nodes / roth spots / rheumatoid factor Malaise, chills, anorexia non specific : weakness, myalgias, back pain, dyspnea, chest pain, cough, h/a murmur usually absent in EARLY disease present in < 30% 4) Give three examples of vascular sequelae of infective endocarditis Osler nodes Splinter hemorrhages Janeway lesions Roth spots Splenomegaly watch for stroke like symptoms and fever Can have emboli anywhere! CRAO Pneumonia MI Intestinal

2017 CandiEM

33. Why Do Toenails Grow More Slowly Than Fingernails?

, harden, and flatten. The overall size and shape of the nail varies, and is largely determined by the shape of the bone of the distal phalanx [6]. Other factors that affect the shape of the nail are health, nutrition, and use. Physicians inspect the nails during the physical exam to look for clubbing, pitting, cyanosis, splinter hemorrhages, [7]. But what affects the speed of nail growth? The growth rates of nails and claws vary both between species and within species. For example, badger claws (...) Why Do Toenails Grow More Slowly Than Fingernails? Why Do Toenails Grow More Slowly Than Fingernails? – Clinical Correlations Search Why Do Toenails Grow More Slowly Than Fingernails? November 14, 2014 4 min read By Alice Drain Peer Reviewed Warm weather heralds the arrival of flip-flops and the exposure of toes previously tucked away in socks and boots. This sudden pedal presence makes one wonder, why do toenails grow more slowly than fingernails? First, to what degree does speed of nail

2014 Clinical Correlations

34. Real-World Outcome of Psoriasis Subjects in Korea on Adalimumab

psoriasis [ Time Frame: Week 0 (baseline), Week 16, Week 24 ] NAPSI grades nails for both nail matrix psoriasis and nail bed psoriasis. The most affected fingernail was determined at Baseline and used for the analysis. Nail matrix psoriasis consists of any of the following: pitting, leukonychia, red spots in the lunula, or nail plate crumbling. Nail bed psoriasis is the presence or absence of onycholysis, splinter hemorrhages, oil drop (salmon patch) discoloration or nail bed hyperkeratosis. Scoring (...) on the degree of effect on body surface area of psoriasis and the extension of erythema (reddening), induration (plaque thickness), desquamation (scaling) of the lesions and area affected as observed on the day of examination. The score ranges from 0 (no psoriasis) to 72 (very severe psoriasis). PASI-75 responders are the participants who achieved at least a 75% reduction (improvement) from baseline in PASI score at Week 24. Change in Nail Psoriasis Severity Index (NAPSI) score in participants with nail

2017 Clinical Trials

35. Evaluation of the Efficacy and Safety of Indigo Naturalis Oil Extract on Psoriatic Nails

in that quadrant. The NAPSI score evaluates presence of signs in the nail bed (of onycholysis, splinter hemorrhages, nail bed discoloration, and subungual hyperkeratosis) and on the nail matrix (pitting, leukonychia, red spots in the lunula and nail plate crumbling) in all 10 fingernails, providing a minimal score of 0 and a maximum of 80. This study is an intra-patient side-to-side comparison, it measures nail disease on a single hand. All 5 fingers in each group were scored providing a maximum score of 40 (...) and longitudinal lines into quadrants. Each nail is given a score for nail bed psoriasis (0-4) and nail matrix psoriasis (0-4) depending on the presence of any of the features of nail psoriasis in that quadrant. The NAPSI score evaluates presence of signs in the nail bed (of onycholysis, splinter hemorrhages, nail bed discoloration, and subungual hyperkeratosis) and on the nail matrix (pitting, leukonychia, red spots in the lunula and nail plate crumbling) in all 10 fingernails, providing a minimal score of 0

2009 Clinical Trials

36. Medicine isn’t just about accuracy and efficiency

myself to do anything else. As we left, the attending was still writing his note. “What else might you look for in these cases?” he asked. “I’m not sure—” “Her nail beds! Did you look at her nail beds? Sometimes you can see splinter hemorrhages when the infection is severe.” “No,” I said again, trying to rally my thoughts. “This seems so sad to me,” I began. “She’s so young … I just want to make sure all of her comfort-care orders are in.” I wanted to say that Annie’s death was making this room

2016 KevinMD blog

38. Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants (PubMed)

Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants Onychomatricoma is a rare benign fibroepithelial filamentous tumor originating from the nail matrix. It typically presents with the clinical tetrad of xanthonychia, pachyonychia, proximal splinter hemorrhages and increased transverse overcurvature of the nail plate. The giant variant can easily confuse the clinician due to its extensive nail dystrophy that can mask the characteristic features (...) of this tumor. Benign (fibrokeratoma, ungual fibroma, onycholytic matricoma) and malignant entities (Bowen's disease, squamous cell carcinoma, onycholytic carcinoma) are mimics of the disease. Nail surgery can facilitate the diagnosis, which should always be confirmed by histology, as rare variants do exist.

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2016 Skin appendage disorders

39. Study of Secukinumab Compared to Fumaderm® in Adults With Moderate to Severe Psoriasis

nail was divided with imaginary horizontal and longitudinal lines into quadrants. Each nail was given a score of 0 - 4 for nail matrix and nail bed psoriasis 0-4 (0: for none, 1: for 1 quadrant, 2: for 2 quadrants, 3: for 3 quadrants, 4: for all 4 quadrants), based on presence of any feature of nail psoriasis in that quadrant. Nail matrix psoriasis feature includes: pitting, leukonychia red spots in lunula, crumbling. Nail bed psoriasis feature includes: onycholysis, splinter hemorrhages, subungual (...) spots in lunula, crumbling. Nail bed psoriasis feature includes: onycholysis, splinter hemorrhages, subungual hyperkeratosis, "oil drop" (salmon patch dyschroma). NPASI 75 responders were participants who achieved >=75% improvement (reduction) in NPASI score compared to baseline. Percentage of Participants Achieving Nail Psoriasis Severity Index (NAPSI) 90 Response at Week 1, 2, 3, 4, 6, 8, 12, 16, 20 and 24 [ Time Frame: Baseline, Week 1, 2, 3, 4, 6, 8, 12, 16, 20 and 24 ] NAPSI was used to assess

2015 Clinical Trials

40. Clinical, dermoscopic, and pathologic features of onychopapilloma: A review of 47 cases. (PubMed)

the last 5 years, and reviewed the published literature.The most common clinical presentation was longitudinal erythronychia (n = 25); followed by longitudinal leukonychia (n = 7); longitudinal melanonychia (n = 4); long splinter hemorrhages without erythronychia, leukonychia, or melanonychia (n = 8); and short splinter hemorrhages without erythronychia, leukonychia, or melanonychia (n = 3), with subungual mass (n = 47) and distal fissuring (n = 11). Pathology was consistent with acanthosis of the nail (...) Clinical, dermoscopic, and pathologic features of onychopapilloma: A review of 47 cases. Onychopapilloma is a benign neoplasm of the nail bed and the distal matrix. Although not uncommon in our experience, only up to 32 cases of this tumor have been reported in the literature.We sought to review the clinical, dermoscopic, and pathologic features of onychopapilloma.We retrospectively analyzed the clinical features of 47 patients with pathologically confirmed onychopapilloma diagnosed within

2015 Journal of American Academy of Dermatology

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