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Nail Telangiectasia

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1. Nail Telangiectasia

Nail Telangiectasia Nail Telangiectasia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Nail Telangiectasia Nail Telangiectasia Aka (...) : Nail Telangiectasia , Scleroderma-Associated Nailfold Telangiectasia , Lupus Erythematosus-Associated Nailfold Telangiectasia From Related Chapters II. Associated Conditions Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Nail Telangiectasia." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Telangiectasia of nailfolds (C1274274) Concepts

2018 FP Notebook

2. Nail Telangiectasia

Nail Telangiectasia Nail Telangiectasia Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Nail Telangiectasia Nail Telangiectasia Aka (...) : Nail Telangiectasia , Scleroderma-Associated Nailfold Telangiectasia , Lupus Erythematosus-Associated Nailfold Telangiectasia From Related Chapters II. Associated Conditions Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Nail Telangiectasia." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Telangiectasia of nailfolds (C1274274) Concepts

2015 FP Notebook

3. Clubbing of the Nails (Overview)

manifestations and nail changes in patients with end-stage renal disease on hemodialysis. Saudi J Kidney Dis Transpl . 2013 Jan. 24(1):36-40. . Salem A, Al Mokadem S, Attwa E, Abd El Raoof S, Ebrahim HM, Faheem KT. Nail changes in chronic renal failure patients under haemodialysis. J Eur Acad Dermatol Venereol . 2008 Nov. 22(11):1326-31. . Gefen AM, White AJ. Asymptomatic pulmonary arteriovenous malformations in children with hereditary hemorrhagic telangiectasia. Pediatr Pulmonol . 2017 Jun 13. . Rush PJ (...) Clubbing of the Nails (Overview) Clubbing of the Nails: Background, Pathophysiology, Epidemiology 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEwNTk0Ni1vdmVydmlldw== processing > Clubbing of the Nails Updated

2014 eMedicine.com

4. Clubbing of the Nails (Treatment)

, Ebrahim HM, Faheem KT. Nail changes in chronic renal failure patients under haemodialysis. J Eur Acad Dermatol Venereol . 2008 Nov. 22(11):1326-31. . Gefen AM, White AJ. Asymptomatic pulmonary arteriovenous malformations in children with hereditary hemorrhagic telangiectasia. Pediatr Pulmonol . 2017 Jun 13. . Rush PJ, Giorshev C, Shore A, Levinson H. The use of thermography in clubbing. Respir Med . 1992 May. 86(3):257-9. . Ward RW, Chin R Jr, Keyes JW Jr, Haponik EF. Digital clubbing. Demonstration (...) Clubbing of the Nails (Treatment) Clubbing of the Nails Treatment & Management: Medical Care, Surgical Care, Consultations 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEwNTk0Ni10cmVhdG1lbnQ= processing

2014 eMedicine.com

5. Clubbing of the Nails (Follow-up)

, Ebrahim HM, Faheem KT. Nail changes in chronic renal failure patients under haemodialysis. J Eur Acad Dermatol Venereol . 2008 Nov. 22(11):1326-31. . Gefen AM, White AJ. Asymptomatic pulmonary arteriovenous malformations in children with hereditary hemorrhagic telangiectasia. Pediatr Pulmonol . 2017 Jun 13. . Rush PJ, Giorshev C, Shore A, Levinson H. The use of thermography in clubbing. Respir Med . 1992 May. 86(3):257-9. . Ward RW, Chin R Jr, Keyes JW Jr, Haponik EF. Digital clubbing. Demonstration (...) Clubbing of the Nails (Follow-up) Clubbing of the Nails Treatment & Management: Medical Care, Surgical Care, Consultations 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEwNTk0Ni10cmVhdG1lbnQ= processing

2014 eMedicine.com

6. Clubbing of the Nails (Diagnosis)

manifestations and nail changes in patients with end-stage renal disease on hemodialysis. Saudi J Kidney Dis Transpl . 2013 Jan. 24(1):36-40. . Salem A, Al Mokadem S, Attwa E, Abd El Raoof S, Ebrahim HM, Faheem KT. Nail changes in chronic renal failure patients under haemodialysis. J Eur Acad Dermatol Venereol . 2008 Nov. 22(11):1326-31. . Gefen AM, White AJ. Asymptomatic pulmonary arteriovenous malformations in children with hereditary hemorrhagic telangiectasia. Pediatr Pulmonol . 2017 Jun 13. . Rush PJ (...) Clubbing of the Nails (Diagnosis) Clubbing of the Nails: Background, Pathophysiology, Epidemiology 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTEwNTk0Ni1vdmVydmlldw== processing > Clubbing of the Nails Updated

2014 eMedicine.com

7. Radiation therapy for early Dupuytren's disease

patients treated with 32 Gy of radiation within a median follow-up of 40 months. 5.11 Skin atrophy was reported in 3% (7/206) of patients in the case series of 206 patients treated with 32 Gy of radiation, in more than 4 weeks of follow-up. In the same study, telangiectasia was reported in 3% (6/206) of patients, in more Radiation therapy for early Dupuytren's disease (IPG573) © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights (...) ). Page 6 of 9than 4 weeks of follow-up. Mild skin atrophy with occasional telangiectasia was reported in 7% (14/208) of hands in the case series of 135 patients within a median follow-up of 13 years. 5.12 Alteration of heat and pain sensation was reported in 4% (8/198) of hands in the RCT of 129 patients treated with 30 Gy or 21 Gy (minimum follow-up of 1 year). Sensory affection was reported in 2% (4/206) of patients in the case series of 206 patients treated with 32 Gy of radiation, in more than 4

2017 National Institute for Health and Clinical Excellence - Interventional Procedures

8. Systemic sclerosis (scleroderma)

blood vessels, fibrosis of skin and internal organs, and production of auto-antibodies. History and exam presence of risk factors Raynaud's phenomenon digital pits or ulcers swelling of the hands and feet skin thickening loss of function of hands sclerodactyly heartburn, reflux, and dysphagia bloating faecal incontinence arthralgias and myalgias abnormal nail-fold capillaroscopy telangiectasia subcutaneous calcinosis dyspnoea dry crackles at lung bases tendon friction rub abrupt onset moderate

2018 BMJ Best Practice

9. Cirrhosis

to be irreversible in its advanced stages. [Figure caption and citation for the preceding image starts]: Laparoscopic view of a cirrhotic liver Courtesy of Dr Eugene Schiff and Dr Lennox Jeffers; used with permission [Citation ends]. History and exam presence of risk factors abdominal distension jaundice and pruritus coffee-ground vomitus and black stool (melaena) hand and nail features (e.g., leukonychia, palmar erythema, spider angiomata) facial features (e.g., telangiectasia, spider angiomata, jaundiced

2018 BMJ Best Practice

10. Topical Photodynamic therapy

of treatment in 23% of patients. 119 A comprehensive disease-specific guideline pointed to the value of PDT for all lesions in poor healing sites and for large lesions in good healing sites, supported by a recent review. 120,121 PDT is considered a fair choice for small lesions in good healing sites, multiple lesions, facial, digital, nail bed and penile lesions, in comparison with other therapeutic options. In a patient-reported outcome study, satisfaction with ALA-PDT for SCC in situ was high, with 90

2019 European Dermatology Forum

11. Bruising

as bruising on exposed areas (such as the arms or legs) after minor trauma. May be associated with menorrhagia. Hereditary haemorrhagic telangiectasia (HHT) A rare autosomal dominant genetic disorder which leads to mucocutaneous telangiectasia of the skin, mucous membranes, and organs. There may be a positive family history, recurrent nosebleeds, fatigue, nail changes, and hair loss. Ehlers-Danlos syndrome This causes joint hypermobility and skin translucency and hyperextensibility. It may present (...) vasculitis, such as . Brittle hair and nails — suggests nutritional factors, ageing, hypothyroidism, or rarely hereditary haemorrhagic telangiectasia. Examine the joints for: Abnormalities suggestive of an inflammatory arthropathy (such as rheumatoid arthritis). See the Prodigy topic on for more information. Hyperextensibility or elasticity — suggestive of . Swelling and tenderness — may indicate haemarthrosis, suggesting . Tenderness — may be seen in acute leukaemia or neuroblastoma. Examine the abdomen

2017 Prodigy

12. Primary Biliary Cholangitis

wellastheNationalInstitutesofHealthwebsite(https://livertox. nih.gov) can be helpful for assessing a patient’s risk pro?le for DILI. Previous surgery and blood transfusions should be listed. Physical examination should include screening for hepato- and splenomegaly as well as extrahepatic signs of advanced liver disease, such as icterus of sclera, skin and mucous membranes, xanthelasma, palmar and plantar erythema, nail abnormalities, or scratch lesions particularly on the arms and legs. Abdominal ultrasound is the ?rst recommended (...) Paraneoplastic (Hodgkin’s disease, renal cell carcinoma) Sepsis Total parenteral nutrition Vascular diseases (e.g. Budd-Chiari syndrome, sinusoidal obstruction syndrome, congestive hepatopathy) Viral hepatitis, cholestatic form Cholangiocellular/biliary cholestasis Primary biliary cholangitis Primary sclerosing cholangitis IgG4-associated cholangitis Secondary sclerosing cholangitis, e.g. due to cholangiolithiasis, ischemia (Shock, polytrauma, intensive care therapy), telangiectasia, vasculitis, infectious

2017 European Association for the Study of the Liver

13. Guidance on Primary Biliary Cholangitis

studies that have found associations with urinary tract infections, reproductive hormone replacement, nail polish, and past cigarette smoking. (22-24) Studies of geographic clustering have suggested environmental exposure and socioeconomic factors as well. (25-28) The interaction between genetic and environmental effects has only begun to be assessed in PBC, with several possible gene-modifying mecha- nisms being supported. (15,29) Specific environmental agents that may lead to the loss of tolerance (...) may be found in the setting of portal hypertension. If limited scleroderma coexists, the examination may show sclerodoactyly or telangiectasias. Special Cases a Ma-N egati Ve pBC The term AMA-negative PBC refers to those who lack serum AMA but whose clinical presentation, liver histology, and natural history are nearly identical to patients with typical AMA-positive PBC. The impre- cise terms “autoimmune cholangiopathy” or “autoim- mune cholangitis” should not be used interchangeably with AMA

2018 American Association for the Study of Liver Diseases

14. CRACKCast E120 – Dermatologic presentations

Measles Dengue Acute meningococcemia Meningococcal disease may manifest as one of three syndromes: meningitis, bacteremia, or bacteremic pneumonia. Drug induced Chemotherapy drug: Acral erythema (e.g. due to doxorubicin) Hand-foot skin reaction Erythema multiforme [4] Describe the various presentations of tinea and their treatment Tinea refers to superficial dermatophytic infection of the skin, hair, and/or nails, usually by the Trichophyton organism. Tinea Corporis Tinea refers to superficial (...) dermatophytic infection of the skin, hair, and/or nails, usually by the Trichophyton organism. Infections of the body, groin, and extremities usually respond to topical antifungal agents. A number of effective topical antifungal agents are available, including clotrimazole, haloprogin, miconazole, tolnaftate, terbinafine, naftifine, and others. Two or three daily applications of the cream form of any of these preparations result in healing of most superficial lesions in 1 to 3 weeks. Tinea Capitis Tinea

2017 CandiEM

15. European Society of Endocrinology Clinical practice guidelines for the care of girls and women with Turner syndrome

posterior hairline 40 Broad short-appearing neck 40 Pterygium colli (webbed neck) 25 Thorax Broad chest (shield chest) 30 Inverted nipples 5 Skin, nails, and hair Increased skin ridge count 30 Lymphedema of hands and feet 25 Multiple pigmented naevi 25 Nail hypoplasia/dystrophy 10 Vitiligo 5 Alopecia 5 Skeleton Bone age delay 85 Decreased bone mineral content 50–80 Cubitus valgus 50 Short fourth metacarpal 35 Genu valgum 35 Congenital hip luxation 20 Scoliosis 10 Madelung deformity 5 Heart Bicuspid (...) with unexplained growth failure or pubertal delay, with or without the constellation of the lymphedema sequence (edema of the hands or feet, nuchal fold, neck webbing, low hairline and hyperconvex or hypoplastic nails); characteristic facial features such as epicanthal folds, downslanting palpebral fissures, low-set ears and micrognathia; left-sided cardiac anomalies, especially coarctation of the aorta, bicuspid aortic valve and aortic stenosis; markedly elevated follicle-stimulating hormone (FSH); cubitus

2017 European Society of Endocrinology

16. Clinical practice guidelines for the care of girls and women with Turner syndrome: proceedings from the 2016 Cincinnati International Turner Syndrome Meeting Full Text available with Trip Pro

posterior hairline 40 Broad short-appearing neck 40 Pterygium colli (webbed neck) 25 Thorax Broad chest (shield chest) 30 Inverted nipples 5 Skin, nails, and hair Increased skin ridge count 30 Lymphedema of hands and feet 25 Multiple pigmented naevi 25 Nail hypoplasia/dystrophy 10 Vitiligo 5 Alopecia 5 Skeleton Bone age delay 85 Decreased bone mineral content 50–80 Cubitus valgus 50 Short fourth metacarpal 35 Genu valgum 35 Congenital hip luxation 20 Scoliosis 10 Madelung deformity 5 Heart Bicuspid (...) with unexplained growth failure or pubertal delay, with or without the constellation of the lymphedema sequence (edema of the hands or feet, nuchal fold, neck webbing, low hairline and hyperconvex or hypoplastic nails); characteristic facial features such as epicanthal folds, downslanting palpebral fissures, low-set ears and micrognathia; left-sided cardiac anomalies, especially coarctation of the aorta, bicuspid aortic valve and aortic stenosis; markedly elevated follicle-stimulating hormone (FSH); cubitus

2016 European Society of Human Reproduction and Embryology

17. Genetics of Skin Cancer (PDQ®): Health Professional Version

hereditary infundibulocystic BCC AD [ ] Unknown Unknown Multiple BCC (infundibulocystic type) Schopf-Schultz-Passarge syndrome AR > AD Unknown Unknown Ectodermal dysplasia (hypotrichosis, hypodontia, and nail dystrophy [anonychia and trachyonychia]), hidrocystomas of eyelids, palmoplantar keratosis and hyperhidrosis, and BCC [ ] AD = autosomal dominant; AR = ; XD = X-linked dominant. (Refer to the section in the section of this summary for more information about Brooke-Spiegler syndrome.) Interventions

2018 PDQ - NCI's Comprehensive Cancer Database

18. Balanitis

or plaques on the glans penis and foreskin, possible telangiectasia, haemorrhagic vesicles, blisters, erosions, or ulceration. Repeated chronic inflammation causes white, firm scarring of the foreskin tip which may lead to inability to retract the foreskin (phimosis), meatal stenosis, and urethral stricture. Lichen planus — this is an inflammatory disorder which can affect the skin, genital, and oral mucous membranes. This typically presents with purplish, well-demarcated plaques on the glans penis (...) for treatment of mycotic infections of the skin and nails. Advise the person to apply topical miconazole to the affected area twice daily. Treatment should be continued for 10 days after lesions have healed. Topical econazole 1% is licensed for the treatment of mycotic balanitis. Advise the person to apply topical econazole to the affected area twice daily for at least two weeks. Topical ketoconazole 2% is licensed for the treatment of fungal infections of the skin. Advise the person to apply topical

2018 NICE Clinical Knowledge Summaries

19. Anaemia - iron deficiency

, or increased requirements. Symptoms commonly include fatigue, dyspnoea, and headache. Symptoms of iron deficiency may occur without anaemia. Common signs of iron deficiency anaemia include pallor and atrophic glossitis. Less common signs include: tachycardia, nail changes, and angular cheilosis. There may be an absence of signs, even if the person has severe anaemia. Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum (...) is severe, ask about specific cardiac symptoms (for example angina, palpitations, and ankle swelling). Diet (to identify poor iron intake). Drug history (for example the use of aspirin, nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, clopidogrel, or corticosteroids). A family history of: Iron deficiency anaemia (which may indicate inherited disorders of iron absorption). Bleeding disorders and telangiectasia. Colorectal carcinoma. Haematological disorders (for example

2018 NICE Clinical Knowledge Summaries

20. Psoriasis

Psoriasis Psoriasis - NICE CKS Share Psoriasis: Summary Psoriasis is a systemic, immune-mediated, inflammatory skin disease which typically has a chronic relapsing-remitting course, and may have nail and joint (psoriatic arthritis) involvement. Chronic plaque psoriasis (including scalp psoriasis, flexural psoriasis, and facial psoriasis) is the most common form, affecting 80–90% of people with psoriasis. The second most common form is localized pustular psoriasis of the palms and soles. Other (...) forms of psoriasis include: Guttate psoriasis. Nail psoriasis. Erythrodermic and generalized pustular psoriasis (rare medical emergencies, may be life-threatening). Psoriasis is common, with about 1.3–2.2% of the UK population affected. Several factors are associated with the onset or exacerbation of psoriasis, including infection, drugs (including corticosteroid withdrawal), ultraviolet light exposure, trauma, hormonal changes, stress, smoking, and alcohol. Psoriasis may be associated with other

2018 NICE Clinical Knowledge Summaries

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