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Nail Splinter Hemorrhage

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41. Melanoma Accuracy Study; Phase 2

, mustache) where hair cannot be removed Lesions located on genitalia not accessible to equipment Lesions located in an area that has previously biopsied or subjected to any kind of surgical or ablative procedure Lesion with foreign matter, e.g. tattoo or splinter Lesion and/or reference located on acute sunburn Skin surface not measurable, e.g. lesion on a stalk Skin surface not accessible, e.g. inside ears, ears, under nails Skin not intact (measurement area), e.g. bleeding or with clinically

2018 Clinical Trials

42. 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 (...) , it has been noted that onchycophagia, a habit commonly [1,11]. Trauma may lead to increased blood and nutrient supply to the affected area, resulting in increased growth. The evolution of nails from claws is important to the baseline rate of growth, but the difference between fingernail and toenail growth may be equally dependent on nail use and trauma. Either way, paint them, flaunt them, and enjoy that warm weather. By Alice Drain, 3rd year medical student at NYU School of Medicine Peer reviewed

2014 Clinical Correlations

43. 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

44. A Study to Assess the Efficacy of Risankizumab Compared to FUMADERM® in Subjects With Moderate to Severe Plaque Psoriasis Who Are Naïve to and Candidates for Systemic Therapy

drop, splinter haemorrhage, subungual hyperkeratosis, onycholysis). Percentage of participants with a PASI 50 response [ Time Frame: Up to 24 weeks ] Denotes greater than or equal to 50% improvement in PASI score. PASI provides a quantitative assessment of psoriasis disease state based on the amount of body surface area that is affected and the degree of severity of erythema, induration, and scale, weighted by body part. Percentage of participants with a PASI 90 response [ Time Frame: Up to 24 (...) (sPGA) score of 0 (clear) or 1 (almost clear) [ Time Frame: Up to 24 weeks ] The sPGA is the physician's current assessment of the average thickness, erythema, and scaling of all psoriatic lesions. Scores range from 0 (clear) to 4 (severe). Change from Baseline in Clinical Severity of Nail Psoriasis (NAPPA-CLIN) [ Time Frame: Up to 24 weeks ] The NAPPA-CLIN is used to assess the severity of nail matrix psoriasis (leukonychia, red spots, dots, nail plate crumbling) and psoriasis of the nail bed (oil

2017 Clinical Trials

45. Management of chronic venous leg ulcers

vasculitis. If this is the case there will be evidence of vasculitic lesions elsewhere, eg nail fold infarcts or splinter haemorrhages. Rarely, ulceration will be due to Felty’s syndrome or pyoderma gangrenosum. Systemic vasculitis occurs as a feature of several collagen vascular diseases when leg ulcers will usually be multiple, necrotic, deep and have an atypical distribution. ? Diabetes mellitus: approximately 5% of patients will have diabetes. 3 These patients may have venous, arterial or neuropathic (...) of 0.8 Sited foot/ lateral aspect of leg Yes No Date to Redoppler: Obese Urinalysis Smoker B.P. Poor nutrition H.B.C./Hb Previous Leg Ulcer treatements: Anaemia Blood/Glucose Poor mobility L R Poor ankle movement Ankle circumference Psycho/ social factors Previous Leg Ulcers Calf circumference IV drug use PREDISPOSING MEDICAL CONDITIONS Night pain relieved when leg is dependent Calf/Thigh muscle wasting PRESENTING Loss of hair Atrophic, shiny skin Skin,cold/white/blue MEDICATION Pedal pulse absent

2010 SIGN

46. Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants Full Text available with Trip Pro

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.

2016 Skin appendage disorders

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

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

48. 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

49. Etanercept and Methotrexate in Combination or as Monotherapy in Psoriatic Arthritis

) splinter hemorrhages (0 = absent, 1 = present) In participants with fingernails involved with psoriasis, each fingernail was scored at baseline to determine the worst fingernail (ie, the fingernail with the highest mNAPSI score). This fingernail was followed for the remainder of the study. mNAPSI scores range from 0-13 where higher scores represent worse nail disease. Percentage of Participants With Clear mNAPSI at Week 24 [ Time Frame: Baseline and week 24 ] The modified NAPSI scale is a grading (...) system for nail psoriasis that incorporates the following 7 clinical features: pitting (scores 0-3, depending on the number of pits) nail plate crumbling (scores 0-3, depending on the % of nail involvement) onycholysis and oil drop dyschromia (scores 0-3, depending on the % of nail involvement) leukonychia (0 = absent, 1 = present) red spots in lunula (0 = absent, 1 = present) nail bed hyperkeratosis (0 = absent, 1 = present) splinter hemorrhages (0 = absent, 1 = present) In participants

2015 Clinical Trials

50. Dermoscopic Features of Onychomatricoma: A Study of 34 Cases. (Abstract)

were studied. In detail, 6 observers evaluated 12 clinical and 12 dermoscopical criteria as present or absent.For clinical criteria, the highest mean values were leuconychia (3.21), splinter hemorrhages (3.45), and thickening of the plate (3.0). Dermoscopical criteria were more often found present, such as longitudinal parallel white lines (4.33), parallel lesion edges (4.61), splinter hemorrhages (4.48), dark dots (3.96), free-edge nail pitting (4.5), and thickening of the free edge (5.27 (...) Dermoscopic Features of Onychomatricoma: A Study of 34 Cases. Onychomatricoma is a benign tumor of the nail matrix with a precise histopathological definition but many different clinical features and differential diagnoses.The diagnosis of onychomatricoma is based on the pathological examination of a surgical specimen. The objective of this study was to define preoperative diagnostic criteria using noninvasive investigations: observation and dermoscopy.A total of 34 cases of onychomatricoma

2015 Dermatology

51. What Kind of Buddhist was Steve Jobs, Really?

the motherboard in his head. The classic Buddhist image of this hack is that thoughts are like clouds passing through a spacious blue sky. All your life, you’ve been convinced that this succession of clouds comprises a stable, enduring identity — a “self.” But Buddhists believe this self this is an illusion that causes unnecessary suffering as you inevitably face change, loss, disease, old age, and death. One aim of practice is to reveal the gaps or discontinuities — the glimpses of blue sky — between (...) than please everyone and go along with the current. It might be painful for your clients or your audience to take the splinter out of their system, so to speak. It probably will be quite painful for them to accommodate such pressure coming from the artist’s vision. However, that should be done, and it is necessary. Otherwise, the world will go downhill, and the artist will go downhill also. Flowers at Tassajara. Photo by Perfecto Insecto. Another influence on Apple’s young founder was the book Zen

2015 PLOS Blogs Network

52. Efficacy and Safety of Namilumab (MT203) for Plaque Psoriasis

) and nail bed (onycholysis, splinter hemorrhages, subungual hyperkeratosis, oil drop [salmon patch dyschromia]). Each finger nail divided with imaginary lines into quadrants and scored for both nail matrix and nail bed psoriasis (range from 0 [absence of psoriasis] to 4 [presence of psoriasis in all 4 quadrants]). The total NAPSI score equals the sum of scores for all of the finger nails evaluated and ranges from 0 to 80. Higher scores = more severe psoriasis. Eligibility Criteria Go to Information from (...) to be 52 weeks) with open-label study medication. At Week 12, participants were assessed for primary endpoint response, which determined the course of their progression through the open-label treatment period. Participants who showed >=75% reduction of Baseline (Day 1) PASI at Week 12, "Responders", began a washout interval (for a maximum of 24 weeks) with no use of study medication: this interval continued until a partial (25%) loss of Week 12 treatment response is recorded in assessments conducted

2014 Clinical Trials

53. An Efficacy and Safety of CNTO 1959 (Guselkumab) in Participants With Moderate to Severe Plaque-type Psoriasis

Psoriasis Area and Severity Index (NAPSI) Among Participants with Nail Psoriasis at Baseline [ Time Frame: Week 16 and 48 ] The NAPSI is an index used for assessing and grading the severity of nail psoriasis. A target nail representing the worst nail psoriasis is divided into quadrants and is graded for nail matrix psoriasis (pitting, leukonychia, red spots in the lunula, and nail plate crumbling) and nail bed psoriasis (onycholysis, splinter hemorrhages, oil drop discoloration, and nail bed (...) . It is a 10-item questionnaire that in addition to evaluating overall QOL can be used to assess 6 different aspects that may affect QOL: symptoms and feelings, daily activities, leisure, work or school performance, personal relationships, and treatment. The DLQI item response options are rated by the participant from 0 (not at all/not relevant) to 3 (very much) with a total score range of 0 (best) to 30 (worst); higher scores indicate poor quality of life. Percent Improvement From Baseline in Nail

2014 Clinical Trials

54. Tetanus (Diagnosis)

of neurotransmitter containing vesicles to the cell membrane. As a result, gamma-aminobutyric acid (GABA)-containing and glycine-containing vesicles are not released, and there is a loss of inhibitory action on motor and autonomic neurons. [ ] With this loss of central inhibition, there is autonomic hyperactivity as well as uncontrolled muscle contractions (spasms) in response to normal stimuli such as noises or lights. Once the toxin becomes fixed to neurons, it cannot be neutralized with antitoxin. Recovery (...) of nerve function from tetanus toxins requires sprouting of new nerve terminals and formation of new synapses. Localized tetanus develops when only the nerves supplying the affected muscle are involved. Generalized tetanus develops when the toxin released at the wound spreads through the lymphatics and blood to multiple nerve terminals. The blood-brain barrier prevents direct entry of toxin to the CNS. Previous Next: Etiology Tetanus spores may survive for years in some environments and are resistant

2014 eMedicine.com

55. Psoriatic Arthritis (Diagnosis)

with psoriatic arthritis, may include the following: Beau lines Leukonychia Onycholysis Oil spots Subungual hyperkeratosis Splinter hemorrhages Spotted lunulae Transverse ridging Cracking of the free edge of the nail Uniform nail pitting Extra-articular features are observed less frequently in patients with psoriatic arthritis than in those with rheumatoid arthritis (RA) but may include the following: Synovitis affecting flexor tendon sheaths, with sparing of the extensor tendon sheath Subcutaneous nodules (...) at the attachment of the Achilles tendon and the plantar fascia to the calcaneus with the development of insertional spurs Dactylitis with sausage digits is seen in as many as 35% of patients Skin lesions include scaly, erythematous plaques; guttate lesions; lakes of pus; and erythroderma Psoriasis may occur in hidden sites, such as the scalp (where psoriasis frequently is mistaken for dandruff), perineum, intergluteal cleft, and umbilicus Psoriatic nail changes, which may be a solitary finding in patients

2014 eMedicine.com

56. Psoriatic Arthritis (Diagnosis)

with psoriatic arthritis, may include the following: Beau lines Leukonychia Onycholysis Oil spots Subungual hyperkeratosis Splinter hemorrhages Spotted lunulae Transverse ridging Cracking of the free edge of the nail Uniform nail pitting Extra-articular features are observed less frequently in patients with psoriatic arthritis than in those with rheumatoid arthritis (RA) but may include the following: Synovitis affecting flexor tendon sheaths, with sparing of the extensor tendon sheath Subcutaneous nodules (...) at the attachment of the Achilles tendon and the plantar fascia to the calcaneus with the development of insertional spurs Dactylitis with sausage digits is seen in as many as 35% of patients Skin lesions include scaly, erythematous plaques; guttate lesions; lakes of pus; and erythroderma Psoriasis may occur in hidden sites, such as the scalp (where psoriasis frequently is mistaken for dandruff), perineum, intergluteal cleft, and umbilicus Psoriatic nail changes, which may be a solitary finding in patients

2014 eMedicine.com

57. Psoriatic Arthritis (Diagnosis)

with psoriatic arthritis, may include the following: Beau lines Leukonychia Onycholysis Oil spots Subungual hyperkeratosis Splinter hemorrhages Spotted lunulae Transverse ridging Cracking of the free edge of the nail Uniform nail pitting Extra-articular features are observed less frequently in patients with psoriatic arthritis than in those with rheumatoid arthritis (RA) but may include the following: Synovitis affecting flexor tendon sheaths, with sparing of the extensor tendon sheath Subcutaneous nodules (...) at the attachment of the Achilles tendon and the plantar fascia to the calcaneus with the development of insertional spurs Dactylitis with sausage digits is seen in as many as 35% of patients Skin lesions include scaly, erythematous plaques; guttate lesions; lakes of pus; and erythroderma Psoriasis may occur in hidden sites, such as the scalp (where psoriasis frequently is mistaken for dandruff), perineum, intergluteal cleft, and umbilicus Psoriatic nail changes, which may be a solitary finding in patients

2014 eMedicine.com

58. Infective Endocarditis (Diagnosis)

signs of IE are found in as many as 50% of patients. They include the following: Petechiae: Common, but nonspecific, finding Subungual (splinter) hemorrhages: Dark-red, linear lesions in the nail beds Osler nodes: Tender subcutaneous nodules usually found on the distal pads of the digits Janeway lesions: Nontender maculae on the palms and soles Roth spots: Retinal hemorrhages with small, clear centers; rare Signs of neurologic disease, which occur in as many as 40% of patients, include the following (...) , septic pulmonary infarcts, mycotic aneurysm, intracranial hemorrhage, conjunctival hemorrhage, or Janeway lesions Immunologic phenomenon such as glomerulonephritis, Osler nodes, Roth spots, and rheumatoid factor Positive blood culture results not meeting major criteria or serologic evidence of active infection with an organism consistent with IE Echocardiogram results consistent with IE but not meeting major echocardiographic criteria A definitive clinical diagnosis can be made based on the following

2014 eMedicine.com

59. Psoriatic Arthritis (Overview)

with psoriatic arthritis, may include the following: Beau lines Leukonychia Onycholysis Oil spots Subungual hyperkeratosis Splinter hemorrhages Spotted lunulae Transverse ridging Cracking of the free edge of the nail Uniform nail pitting Extra-articular features are observed less frequently in patients with psoriatic arthritis than in those with rheumatoid arthritis (RA) but may include the following: Synovitis affecting flexor tendon sheaths, with sparing of the extensor tendon sheath Subcutaneous nodules (...) at the attachment of the Achilles tendon and the plantar fascia to the calcaneus with the development of insertional spurs Dactylitis with sausage digits is seen in as many as 35% of patients Skin lesions include scaly, erythematous plaques; guttate lesions; lakes of pus; and erythroderma Psoriasis may occur in hidden sites, such as the scalp (where psoriasis frequently is mistaken for dandruff), perineum, intergluteal cleft, and umbilicus Psoriatic nail changes, which may be a solitary finding in patients

2014 eMedicine.com

60. Psoriatic Arthritis (Overview)

with psoriatic arthritis, may include the following: Beau lines Leukonychia Onycholysis Oil spots Subungual hyperkeratosis Splinter hemorrhages Spotted lunulae Transverse ridging Cracking of the free edge of the nail Uniform nail pitting Extra-articular features are observed less frequently in patients with psoriatic arthritis than in those with rheumatoid arthritis (RA) but may include the following: Synovitis affecting flexor tendon sheaths, with sparing of the extensor tendon sheath Subcutaneous nodules (...) at the attachment of the Achilles tendon and the plantar fascia to the calcaneus with the development of insertional spurs Dactylitis with sausage digits is seen in as many as 35% of patients Skin lesions include scaly, erythematous plaques; guttate lesions; lakes of pus; and erythroderma Psoriasis may occur in hidden sites, such as the scalp (where psoriasis frequently is mistaken for dandruff), perineum, intergluteal cleft, and umbilicus Psoriatic nail changes, which may be a solitary finding in patients

2014 eMedicine.com

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