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Nail Splinter Hemorrhage

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81. A Study Evaluating The Efficacy And Safety oO CP-690,550 In Asian Subjects With Moderate To Severe Plaque Psoriasis

indicate poor quality of life. Percent Change From Baseline in Nail Psorasis Severity Index (NAPSI) at Week 16 in Participants With Nail Psoriasis at Baseline [ Time Frame: Baseline to Week 16 ] The NAPSI quantifies severity of nail psoriasis by evaluating the presence or absence of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) and nail bed (onycholysis, splinter hemorrhages, subungual hyperkeratosis, oil drop [salmon patch dyschromia]). Each finger (...) psoriasis by evaluating the presence or absence of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) 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

2013 Clinical Trials

82. An Open-Label, Prospective Study to Assess the Safety and Effectiveness of Adalimumab in Patients With Moderate to Severe Plaque Psoriasis in the Russian Federation

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 (salman patch) discoloration or nail bed hyperkeratosis. Scoring for each is based on the following scale: 0 = none; 1 = present in 1/4 nail quadrants; 2 = present in 2/4 nail (...) score is 0 to 30. A score of 21 to 30 means an extremely large effect on the participant's life whereas 0-1 means that the disease has no effect at all. Change from Baseline is presented as a percentage of the Baseline value: Post-baseline value - Baseline value / Baseline value * 100. A negative change from Baseline indicates improvement. Percent Change From Baseline in Nail Psoriasis Severity Index (NAPSI) [ Time Frame: Baseline and Week 24 ] NAPSI grades nails for both nail matrix psoriasis

2012 Clinical Trials

83. A One-Year Study To Evaluate The Efficacy And Safety Of CP-690,550 For Patients With Moderate To Severe Chronic Plaque Psoriasis

in Nail Psoriasis Severity Index (NAPSI) at Week 16 [ Time Frame: Baseline, Week 16 ] The NAPSI quantifies severity of nail psoriasis by evaluating the presence or absence of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) 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 (...) of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) 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

2011 Clinical Trials

84. A One-Year Study To Evaluate The Effects And Safety Of CP-690,550 In Patients With Moderate To Severe Chronic Plaque Psoriasis

, Week 16 ] The NAPSI quantifies severity of nail psoriasis by evaluating the presence or absence of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) 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 (...) Severity Index (NAPSI) Score [ Time Frame: Baseline, Week 8, 16, 20, 28, 40, 52 ] The NAPSI quantifies severity of nail psoriasis by evaluating the presence or absence of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) 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

2011 Clinical Trials

85. A Long Term Study To Evaluate The Safety, Tolerability And Efficacy Of CP-690,550 In Patients With Moderate To Severe Plaque Psoriasis And/Or Psoriatic Arthritis

). Maintenance of PGA response at Week 52 among participants achieving PGA response at Week 16 is reported. Change From Baseline in Nail Psoriasis Severity Index (NAPSI) Score [ Time Frame: Week 8, 16, 20, 28, 40, 52 ] The NAPSI quantifies severity of nail psoriasis by evaluating the presence or absence of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) and nail bed (onycholysis, splinter hemorrhages, subungual hyperkeratosis, oil drop [salmon patch (...) of psoriatic manifestations on the nail matrix (pitting, leukonychia, red spots on lulunea, crumbling) and nail bed (onycholysis, splinter hemorrhages, subungual hyperkeratosis, oil drop [salmon patch dyschromia]). Total number psoriasis affected nails (presence of psoriatic manifestations on the nail matrix/nail bed) were assessed and reported. Itch Severity Item (ISI) Score [ Time Frame: Baseline, Week 2, 4, 8, 12, 16, 20, 28, 40, 52 ] ISI assessed severity of itch (pruritus) due to psoriasis. ISI

2011 Clinical Trials

86. Microscopic Polyangiitis (MPA)

. Without prompt diagnosis and treatment, renal failure may follow rapidly. Cutaneous: About one third of patients have a purpuric rash at the time of the diagnosis. Nail bed infarcts and splinter hemorrhages may occur; digital ischemia occurs rarely. Respiratory: If the lungs are affected, may occur and may be followed by pulmonary fibrosis. Rapid-onset dyspnea and anemia, with or without hemoptysis and bilateral patchy infiltrates (seen on chest x-ray) may be due to alveolar hemorrhage, a medical (...) , MPH, Cleveland Clinic Click here for Patient Education NOTE: This is the Professional Version. CONSUMERS: Topic Resources Microscopic polyangiitis is a systemic necrotizing vasculitis without immune globulin deposition (pauci-immune) that affects mainly small vessels. It may begin as a pulmonary-renal syndrome with rapidly progressing glomerulonephritis and alveolar hemorrhage, but the pattern of disease depends on the organs affected. Diagnosis is made by clinical findings and sometimes confirmed

2013 Merck Manual (19th Edition)

87. Fever

, and tenderness (suggesting a joint infection or rheumatologic disorder). The hands and feet are inspected for signs of endocarditis, including splinter hemorrhages under the nails, painful erythematous subcutaneous nodules on the tips of digits (Osler nodes), and nontender hemorrhagic macules on the palms or soles (Janeway lesions). The spine is percussed for focal tenderness. is done to detect focal deficits. Red flags The following findings are of particular concern: Altered mental status Headache, stiff (...) localizing symptoms, a complete examination is necessary because clues to the diagnosis may be in any organ system. The patient’s general appearance, including any weakness, lethargy, confusion, cachexia, and distress, should be noted. All of the skin should be inspected for rash, particularly petechial or hemorrhagic rash and any lesions or areas of erythema or blistering suggesting skin or soft-tissue infection. Neck, axillae, and epitrochlear and inguinal areas should be examined for adenopathy

2013 Merck Manual (19th Edition)

88. Infective Endocarditis

). Cutaneous manifestations include petechiae (on the upper trunk, conjunctivae, mucous membranes, and distal extremities), painful erythematous subcutaneous nodules on the tips of digits (Osler nodes), nontender hemorrhagic macules on the palms or soles (Janeway lesions), and splinter hemorrhages under the nails. About 35% of patients have CNS effects, including , , toxic encephalopathy, and, if a mycotic CNS aneurysm ruptures, brain abscess and subarachnoid hemorrhage. Renal emboli may cause flank pain (...) on the fingers). The image on the left shows an Osler node (tender and erythematous nodule) on the thumb. The image on the right shows Janeway lesions (nontender and erythematous macules on the palm). Splinter hemorrhages are small linear hemorrhages under the fingernails. Conjunctival Hemorrhage in Infective Endocarditis This photo shows conjunctival petechiae in a patient with infective endocarditis. This photo shows conjunctival hemorrhages in a patient with infective endocarditis. The image on the left

2013 Merck Manual (19th Edition)

89. Evaluation of the Elderly Patient

findings. Nail plate fractures may occur because with aging, the nail plate thins. Black splinter hemorrhages in the middle or distal third of the fingernail are more likely to be due to trauma than to bacteremia. A thickened, yellow toenail indicates onychomycosis, a fungal infection. Toenail borders that curve in and down indicate ingrown toenail (onychocryptosis). Whitish nails that scale easily, sometimes with a pitted surface, indicate psoriasis. Unexplained bruises may indicate abuse. Head (...) includes color (normal rubor, pale, cyanotic). Examination includes a search for premalignant and malignant lesions, tissue ischemia, and pressure ulcers. In the elderly, the following should be considered: Ecchymoses may occur readily when skin is traumatized, often on the forearm, because the dermis thins with aging. Uneven tanning may be normal because melanocytes are progressively lost with aging. Longitudinal ridges on the nails and absence of the crescent-shaped lunula are normal age-related

2013 Merck Manual (19th Edition)

90. Acral lesions in tuberous sclerosis complex: Insights into pathogenesis. (PubMed)

in this study.Examination of patients for skin lesions of TSC could be improved by including inspection for longitudinal nail grooves, red comets, longitudinal leukonychia, and splinter hemorrhages in addition to ungual fibromas. The anatomic distribution of TSC ungual fibromas is not random and appears consistent with trauma-promoted tumor formation.Copyright 2009 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved. (...) more common than subungual fibromas, were more common on the feet than the hands, and showed the greatest frequency on the fifth toe. Longitudinal grooves in the nails occurred with or without a visible fibroma. Longitudinal short red streaks--lesions that we term "red comets"--were observed in 22 patients (29%). Longitudinal leukonychia was observed in 14 patients (18%). One patient had isolated digital overgrowth and one patient had pachydermodactyly.No men or children were included

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2010 Journal of American Academy of Dermatology

91. Tazarotene 0.1% gel in the treatment of fingernail psoriasis: a double-blind, randomized, vehicle-controlled study. (PubMed)

. The tazarotene treatment resulted in a significantly greater reduction in onycholysis in occluded nails (P < or = .05 at weeks 4 and 12) and a significantly greater reduction in onycholysis in nonoccluded nails (P < or = .05 at week 24). Tazarotene also resulted in a significantly greater reduction in pitting in occluded nails (P < or = .05 at week 24). There were no other significant between-group differences in pitting, subungual hyperkeratosis, leukonychia, nail plate crumbling/loss, splinter hemorrhage (...) , or nail growth rate. Tazarotene 0.1% gel was well tolerated with only 5 of the 21 tazarotene-treated patients reporting a treatment-related adverse event (all mild or moderate). In conclusion, tazarotene 0.1% gel can significantly reduce onycholysis (in occluded and nonoccluded nails) and pitting (in occluded nails) and is well tolerated in the treatment of nail psoriasis.

2001 Cutis; cutaneous medicine for the practitioner

92. Effects of Etanercept on Nail Psoriasis and Plaque Psoriasis

into quadrants and graded for nail matrix and nail bed psoriasis. Sum of scores = total score for that nail (0-8). Nail Matrix Psoriasis = pitting, leukonychia, red spots in lunula, and/or nail plate crumbling. Nail Bed Psoriasis = onycholysis, splinter hemorrhages, oil drop (salmon patch) discoloration, and/or nail bed hyperkeratosis. Range for both scores: 0 (none), 1 (present in 1/4 nail), 2 (present in 2/4 nail), 3 (present in 3/4 nail), 4 (present in 4/4 nail). Higher scores = more severe psoriasis (...) = onycholysis, splinter hemorrhages, oil drop (salmon patch) discoloration, and/or nail bed hyperkeratosis. Range for both scores: 0 (none), 1 (present 1/4 nail), 2 (present 2/4 nail), 3 (present 3/4 nail), and 4 (present 4/4 nail). Percent of Participants Who Achieved a 50% Improvement in the Nail Psoriasis Severity Index (NAPSI) Score for Target Fingernail at Week 12 and Week 24 [ Time Frame: Week 12, Week 24 ] Target fingernail (highest matrix + bed scores at baseline) divided with imaginary lines

2007 Clinical Trials

93. Nail disorders in hemodialysis patients and renal transplant recipients: a case-control study. (PubMed)

transplantation.One hundred and eighty-two hemodialysis patients and 205 renal transplant recipients were screened for the presence of nail disorders. The findings in these groups were compared with findings in 143 healthy individuals.One hundred and twenty-seven patients (69.8%) in the hemodialysis group and 116 patients (56.6%) in the renal transplant recipients had at least one type of nail pathology. Absence of lunula, splinter hemorrhage, and half-and-half nails were significantly more common (...) in the hemodialysis patients than in the renal transplant recipients. Leukonychia was significantly more frequent in the renal transplant recipients than in the hemodialysis patients and controls.Hemodialysis patients and renal transplant recipients have higher rates of nail disease than the healthy population. Renal transplantation may reduce the frequencies of splinter hemorrhage and half-and-half nails. Interestingly, leukonychia increases significantly after renal transplantation.

2004 Journal of American Academy of Dermatology

94. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. (PubMed)

, ranging from the common pitting and loosening of the nail plate to the less frequent discoloration and splinter hemorrhages seen in the nail bed. This article discusses the normal anatomy and embryology of the nail unit as well as the current understanding of the pathogenesis of the disease. It also provides an extensive review of the existing literature with respect to psoriatic nail therapy. Although there have been many recent advances in the treatment of the cutaneous form of the disease-most (...) Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. Psoriasis is a chronic skin disease that affects millions of people throughout the world. Even though cutaneous signs and symptoms are the most common clinical manifestations, the nails can be involved in up to 50% of cases, and their involvement remains an important yet often overlooked aspect of the disease. There is a broad spectrum of nail dystrophies associated with psoriasis

2007 Journal of American Academy of Dermatology

95. Subungual splinter haemorrhages: a new sign of the antiphospholipid coagulopathy? (PubMed)

Subungual splinter haemorrhages: a new sign of the antiphospholipid coagulopathy? 2339910 1990 06 21 2018 11 13 0003-4967 49 4 1990 Apr Annals of the rheumatic diseases Ann. Rheum. Dis. Subungual splinter haemorrhages: a new sign of the antiphospholipid coagulopathy? 268 Asherson R A RA eng Letter England Ann Rheum Dis 0372355 0003-4967 0 Autoantibodies 0 Phospholipids IM Autoantibodies analysis Female Hemorrhage etiology Humans Nail Diseases etiology Phospholipids immunology Pregnancy 1990 4 1

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1990 Annals of the Rheumatic Diseases

96. Idiopathic splinter hemorrhages. (PubMed)

Idiopathic splinter hemorrhages. Splinter hemorrhages are non-blanchable usually distal reddish-brown linear hemorrhages beneath the nails. Among a variety of etiologic factors reported, trauma is the most common cause. A 26-year-old Hispanic female presented with asymptomatic, extensive fingernail hemorrhages of two months duration. There was no history of physical trauma to the nails. Treatment with a topical antifungal medication for one month produced no improvement. The past medical (...) history was noncontributory. Extensive laboratory testing revealed no underlying systemic disease. Three months after the initial presentation, 6 of 10 fingernails showed signs of resolution without treatment. We conclude that idiopathic atraumatic subungual splinter hemorrhages can occur in healthy individuals. Spontaneous resolution occurred in our patient.

2004 Journal of American Academy of Dermatology

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