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Book Details
Abstract
Get a quick, expert overview of nail diseases and procedures with this concise, practical resource. Dr. Antonella Tosti covers high-interest clinical topics including anatomy and physiology of the nail, benefits and side effects of nail cosmetics, nail diseases in children and the elderly, and much more.
- Covers key topics such as nail psoriasis, nail lichen planus, onychomycosis, traumatic toenail disorders, self-induced nail disorders, the nail in systemic disorders, nail disorders in patients of color, and more.
- Includes basic nail procedures useful to students, residents, fellows, and practitioners.
- Consolidates today’s available information and experience in this important area into one convenient resource.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Nail Disorders | i | ||
| Nail Disorders | iii | ||
| Copyright | iv | ||
| List of Contributors | v | ||
| Nails: Some New Perspective | vii | ||
| Contents | ix | ||
| 1 - Anatomy and Physiology of the Nail | 1 | ||
| INTRODUCTION | 1 | ||
| ANATOMY | 1 | ||
| Nail Matrix | 1 | ||
| Nail Bed | 1 | ||
| HISTOLOGY (FIG. 1.5) | 4 | ||
| NAIL COMPONENTS | 5 | ||
| Nonkeratin Immunohistochemistry | 6 | ||
| EMBRYOLOGY AND DEVELOPMENT | 7 | ||
| VASCULAR SUPPLY (FIGS. 1.6 AND 1.7) | 7 | ||
| NAIL DERMIS AND LIGAMENTS | 8 | ||
| GLOMUS BODIES | 8 | ||
| NERVES (FIG. 1.8) | 8 | ||
| IMMUNE SYSTEM | 9 | ||
| PHYSIOLOGY | 9 | ||
| Nail production | 9 | ||
| Physical properties | 9 | ||
| SUMMARY FOR THE CLINICIAN | 9 | ||
| REFERENCES | 10 | ||
| 2 - Nail Psoriasis | 13 | ||
| INTRODUCTION | 13 | ||
| EPIDEMIOLOGY | 13 | ||
| CLINICAL FEATURES | 14 | ||
| Nail Matrix Signs | 14 | ||
| Nail Bed Signs | 15 | ||
| DIAGNOSTIC CLUES | 17 | ||
| TREATMENT | 18 | ||
| Steroids | 18 | ||
| Vitamin D Analogues (Calcipotriol-Tacalcitol) | 18 | ||
| Tazarotene | 18 | ||
| Tacrolimus | 20 | ||
| Combination Treatment | 20 | ||
| Systemic Treatment | 20 | ||
| Biologics | 20 | ||
| Head on Comparison Studies With Biologics | 20 | ||
| Alefacept | 21 | ||
| Etanercept | 21 | ||
| Adalimumab | 21 | ||
| Infliximab | 21 | ||
| Ustekinumab | 21 | ||
| Secukinumab | 21 | ||
| Ixekizumab | 22 | ||
| Apremilast | 22 | ||
| Tofacitinib | 22 | ||
| SUMMARY FOR THE CLINICIAN | 22 | ||
| REFERENCES | 22 | ||
| 3 - Nail Lichen Planus | 27 | ||
| INTRODUCTION | 27 | ||
| EPIDEMIOLOGY | 27 | ||
| CLINICAL FEATURES | 27 | ||
| DIAGNOSTIC CLUES | 29 | ||
| SUMMARY FOR THE CLINICIAN | 30 | ||
| REFERENCES | 30 | ||
| 4 - Onychomycosis | 31 | ||
| EPIDEMIOLOGY | 31 | ||
| CLINICAL FEATURES | 31 | ||
| DIAGNOSIS | 32 | ||
| Dermoscopic Findings | 32 | ||
| Mycological Study | 33 | ||
| Histopathologic Features | 33 | ||
| Molecular Biology | 33 | ||
| TREATMENT | 33 | ||
| SUMMARY FOR THE CLINICIAN | 34 | ||
| REFERENCES | 34 | ||
| 5 - Nail Disease in Children | 37 | ||
| INTRODUCTION | 37 | ||
| EPIDEMIOLOGY | 37 | ||
| CLINICAL FEATURES | 37 | ||
| Physiologic Aspects of the Nail in Pediatric Population | 38 | ||
| Ectodermal dysplasias | 38 | ||
| Epidermolysis bullosa | 38 | ||
| Pachyonychia congenita | 39 | ||
| Dyskeratosis congenita | 39 | ||
| Nail Changes Usually Seen in Toddlers and Preschoolers (1–5 Years) | 39 | ||
| Beau’s lines and onychomadesis | 39 | ||
| Finger sucking and nail biting | 39 | ||
| Blistering distal dactylitis25 | 40 | ||
| Herpes simplex infection | 40 | ||
| Paronychia | 40 | ||
| Ungual warts | 40 | ||
| Nail Changes Usually Seen in School Children (6–12 Years): Inflammatory Nail Diseases | 40 | ||
| Nail psoriasis | 40 | ||
| Parakeratosis pustulosa | 41 | ||
| Nail lichen planus | 41 | ||
| Nail lichen striatus | 41 | ||
| Trachyonychia | 42 | ||
| Nail Changes Usually Seen in Teenagers (>12–18 Years): Onychomycosis, Ingrowing Toenails, and Benign Tumors | 42 | ||
| Onychomycosis | 42 | ||
| Fibrokeratoma | 43 | ||
| Subungual exostosis | 43 | ||
| Ingrowing nail in children | 44 | ||
| Melanonychia in children | 44 | ||
| DIAGNOSTIC CLUES | 45 | ||
| SUMMARY FOR THE CLINICIAN | 46 | ||
| REFERENCES | 46 | ||
| 6 - Nail Diseases in the Elderly | 49 | ||
| INTRODUCTION | 49 | ||
| EPIDEMIOLOGY | 49 | ||
| CLINICAL FEATURES | 49 | ||
| Senile Changes | 49 | ||
| Alteration in chemical composition | 49 | ||
| Alteration in histology | 49 | ||
| Alteration in nail growth | 50 | ||
| Alteration in nail color | 50 | ||
| Alteration in contour | 50 | ||
| Alteration in surface texture | 50 | ||
| Alteration in thickness | 50 | ||
| Infective nail diseases | 51 | ||
| Toenail disorders related to local traumas | 51 | ||
| Onychogryphosis | 52 | ||
| Onychophosis | 52 | ||
| Onychoclavus (subungual heloma/corn) | 52 | ||
| Onychocryptosis (ingrown toenail) | 52 | ||
| Subungual hematomas | 53 | ||
| Subungual exostosis | 53 | ||
| DIAGNOSTIC CLUES | 53 | ||
| SUMMARY FOR THE CLINICIAN | 54 | ||
| REFERENCES | 54 | ||
| 7 - Traumatic Toenail Disorders | 55 | ||
| INTRODUCTION | 55 | ||
| DIAGNOSTIC CLUES | 55 | ||
| Evaluating the Toenails From a Biomechanical Perspective | 55 | ||
| CLINICAL FEATURES: TRAUMATIC TOENAIL ISSUES | 56 | ||
| Toenail Onychomycosis | 56 | ||
| General Toenail Onychodystrophy | 57 | ||
| Trauma-Induced Onychodystrophy | 58 | ||
| Ambulation disorders/biomechanical problems | 59 | ||
| Asymmetrical Gait Nail Unit Syndrome | 59 | ||
| Other Nail Pathologies Caused by Biomechanical Issues | 60 | ||
| SUMMARY FOR THE CLINICIAN | 60 | ||
| REFERENCES | 60 | ||
| 8 - Self-induced Nail Disorders | 63 | ||
| INTRODUCTION | 63 | ||
| EPIDEMIOLOGY | 63 | ||
| CLINICAL FEATURES | 64 | ||
| DIAGNOSTIC CLUES | 66 | ||
| TREATMENTS | 67 | ||
| SUMMARY FOR THE CLINICIAN | 67 | ||
| REFERENCES | 67 | ||
| 9 - Nail Cosmetics: Benefits and Side Effects | 69 | ||
| INTRODUCTION | 69 | ||
| THE MANICURE/PEDICURE TECHNIQUE | 69 | ||
| NAIL DAMAGE DUE TO MANICURE/PEDICURE | 70 | ||
| NAIL DAMAGE DUE TO NAIL POLISH | 70 | ||
| NAIL DAMAGE DUE TO ACRYLIC NAILS AND NAIL POLISH MANICURE | 70 | ||
| NAIL DAMAGE DUE TO NAIL HARDENERS | 72 | ||
| CONTACT DERMATITIS | 72 | ||
| OCCUPATIONAL EXPOSURE | 72 | ||
| HEALTH CONCERNS | 72 | ||
| SUMMARY FOR THE CLINICIAN | 73 | ||
| REFERENCES | 73 | ||
| 10 - Nails in Systemic Disorders | 75 | ||
| INTRODUCTION | 75 | ||
| CLINICAL FEATURES | 75 | ||
| Nail Abnormalities Less Associated With Systemic Disease Splinter Hemorrhages18,19 | 78 | ||
| Beau’s lines20–23 | 78 | ||
| Onychomadesis20–23 | 78 | ||
| Onycholysis24–26 | 78 | ||
| Nail size variability27,28 | 79 | ||
| Koilonychia29,30 | 79 | ||
| Pitting31,32 | 79 | ||
| Brachyonychia1–7,33 | 79 | ||
| Acrocyanosis1–7,34 | 79 | ||
| Melanonychia35–38 | 79 | ||
| Red lunula1–7,39,40 | 79 | ||
| Pterygium1–7,41,42 | 80 | ||
| Pulmonary disease1–7,44,45 | 80 | ||
| Gastrointestinal disease1–7,46 | 80 | ||
| Cardiovascular system1–7,47 | 80 | ||
| Hematologic system1–7,48 | 81 | ||
| Endocrine system1–7,49,50 | 81 | ||
| Infectious disease1–7 | 81 | ||
| Central nervous system1–7 | 81 | ||
| Nail changes in psychological disorders1–7,51 | 81 | ||
| Autoimmune disorders1–7,52,53 | 81 | ||
| Nail Abnormalities Associated With Specific Syndromes or Genetic Disorders1–7,54,55 | 81 | ||
| SUMMARY FOR THE CLINICIAN | 82 | ||
| REFERENCES | 82 | ||
| 11 - Melanonychias | 85 | ||
| INTRODUCTION | 85 | ||
| EPIDEMIOLOGY | 85 | ||
| CLINICAL FEATURES | 86 | ||
| Melanocytic Activation: Hypermelanosis | 86 | ||
| Melanocytic Hyperplasia: Lentigo Simplex and Nevus | 87 | ||
| Nail Apparatus Melanoma: In Situ or Invasive | 87 | ||
| Melanonychia in Children | 88 | ||
| DIAGNOSTIC CLUES | 89 | ||
| Dermoscopy | 89 | ||
| Nail plate surface | 89 | ||
| Free edge of the nail plate | 89 | ||
| Periungual region | 90 | ||
| Nail bed and nail matrix | 90 | ||
| Biopsy/Histology | 91 | ||
| SUMMARY FOR THE CLINICIAN | 91 | ||
| REFERENCES | 94 | ||
| 12 - Nonmelanocytic Nail Tumors | 97 | ||
| INTRODUCTION | 97 | ||
| EPITHELIAL TUMORS | 97 | ||
| Distal digital keratoacanthoma | 97 | ||
| Keratin cysts/subungual epidermoid inclusions | 99 | ||
| Onychomatricoma | 99 | ||
| Squamous cell carcinoma of the nail apparatus | 102 | ||
| SOFT TISSUE TUMORS | 103 | ||
| Acquired ungual fibrokeratoma | 103 | ||
| Subungual filamentous tumor | 104 | ||
| Fibrous dermatofibromas or “true” fibromas | 104 | ||
| Keloid | 105 | ||
| Malignant vascular tumors | 107 | ||
| Osteochondroma | 107 | ||
| PSEUDOTUMORS | 108 | ||
| Warts | 108 | ||
| Myxoid Pseudocysts of the Digits | 109 | ||
| METASTATIC PROCESSES | 110 | ||
| SUMMARY FOR THE CLINICIAN | 111 | ||
| REFERENCES | 111 | ||
| 13 - Nail Fragility | 113 | ||
| INTRODUCTION | 113 | ||
| Definitions | 113 | ||
| NAIL STRUCTURE | 113 | ||
| EPIDEMIOLOGY | 115 | ||
| ETIOPATHOGENESIS | 115 | ||
| Dermatologic Disease3 | 117 | ||
| Systemic Diseases3 | 118 | ||
| Nutritional Deficiencies10 | 118 | ||
| Drugs | 119 | ||
| Trauma | 119 | ||
| Environmental Factors | 119 | ||
| Occupational Factors | 120 | ||
| CLINICAL FEATURES | 120 | ||
| CLINICAL TYPES | 124 | ||
| Secondary Nail Brittleness | 124 | ||
| Idiopathic Nail Brittleness | 124 | ||
| MANAGEMENT | 124 | ||
| General Measures | 124 | ||
| Treating the Cause (If Secondary Type of Nail Fragility) | 124 | ||
| Supplements (for Idiopathic Nail Fragility) | 125 | ||
| Moisturizers | 125 | ||
| Cosmetic Measures | 126 | ||
| SUMMARY FOR THE CLINICIAN | 126 | ||
| REFERENCES | 127 | ||
| 14 - Dermoscopy of Nail Disorders | 129 | ||
| TECHNIQUE | 129 | ||
| INFLAMMATORY NAIL DISORDERS | 129 | ||
| Nail Psoriasis | 129 | ||
| Nail Lichen Planus | 129 | ||
| Alopecia Areata | 130 | ||
| TRAUMATIC NAIL DISORDERS | 130 | ||
| Hematoma | 130 | ||
| Onycholysis | 131 | ||
| Traumatic Leukonychia | 131 | ||
| Onychotillomania | 131 | ||
| INFECTIONS | 131 | ||
| Onychomycosis | 131 | ||
| Warts | 131 | ||
| NAIL PIGMENTATION | 131 | ||
| Melanonychia | 131 | ||
| Pseudo-Hutchinson’s sign | 134 | ||
| Hutchinson’s sign of the hyponychium | 134 | ||
| Amelanotic/Hypomelanotic Melanoma | 134 | ||
| NONMELANOCYTIC TUMORS | 135 | ||
| Squamous Cell Carcinoma and Bowen’s Disease | 135 | ||
| Onychomatricoma | 135 | ||
| Onychopapilloma | 136 | ||
| Periungual and Subungual Pyogenic Granuloma | 136 | ||
| Glomus Tumor | 136 | ||
| Digital Mucous Cysts | 136 | ||
| SUMMARY FOR THE CLINICIAN | 137 | ||
| REFERENCES | 137 | ||
| 15 - Common Nail Procedures | 139 | ||
| INTRODUCTION | 139 | ||
| INSTRUMENTATION, ANESTHESIA, AND GENERAL CONSIDERATIONS | 139 | ||
| PROCEDURES ON THE NAIL PLATE | 140 | ||
| Evaluation of Onychomycosis | 140 | ||
| Trephination for Subungual Hematoma | 140 | ||
| Nail Avulsion | 141 | ||
| PROCEDURES ON THE NAIL BED | 142 | ||
| Repair of Nail Bed Lacerations | 142 | ||
| Biopsy and Excision of Local Tumors | 142 | ||
| PROCEDURES ON THE PROXIMAL NAIL FOLD AND NAIL MATRIX | 143 | ||
| Surgical Management of Paronychia | 143 | ||
| Nail Matrix Biopsy | 143 | ||
| Matricectomy | 144 | ||
| MANAGEMENT OF COMMON NAIL TUMORS | 144 | ||
| Verruca Vulgaris | 144 | ||
| Digital Myxoid Pseudocysts | 144 | ||
| Periungual and Subungual Fibromas | 145 | ||
| POSTPROCEDURAL WOUND CARE | 145 | ||
| SUMMARY AND RECOMMENDATIONS | 145 | ||
| REFERENCES | 145 | ||
| 16 - Ingrowing Toenails | 147 | ||
| INTRODUCTION | 147 | ||
| EPIDEMIOLOGY | 147 | ||
| PATHOGENESIS | 147 | ||
| RISK FACTORS | 148 | ||
| CLINICAL FEATURES | 148 | ||
| STAGING (SEVERITY INDEX) | 149 | ||
| DIAGNOSTIC CLUES | 149 | ||
| TREATMENT | 149 | ||
| PREOPERATIVE CONSULTATION | 150 | ||
| CONSERVATIVE TREATMENT | 150 | ||
| SURGICAL TREATMENT | 150 | ||
| Avulsion | 151 | ||
| Wedge Excision | 151 | ||
| Debulking of Soft Periungueal Tissue—Resection of the Soft Tissues | 152 | ||
| Howard-Dubois procedure | 153 | ||
| Super U and Vandenbos procedures | 153 | ||
| SUMMARY FOR THE CLINICIAN | 153 | ||
| REFERENCES | 155 | ||
| Index | 157 | ||
| A | 157 | ||
| B | 157 | ||
| C | 157 | ||
| D | 157 | ||
| E | 158 | ||
| F | 158 | ||
| G | 158 | ||
| H | 158 | ||
| I | 158 | ||
| K | 159 | ||
| L | 159 | ||
| M | 159 | ||
| N | 159 | ||
| O | 161 | ||
| P | 161 | ||
| R | 161 | ||
| S | 161 | ||
| T | 162 | ||
| U | 162 | ||
| V | 162 | ||
| W | 162 | ||
| X | 162 | ||
| Y | 162 |