RESUMEN
OBJECTIVES: Cutaneous involvement is an extra-articular manifestation of rheumatoid arthritis (RA). This includes nail abnormalities, which are often overlooked. We described nail findings in RA patients currently attending an early arthritis cohort (n=145), and associated them with disease activity and/or damage, as well as patient-reported outcomes. METHODS: A standardised nail examination was performed in 122 patients (84.1% of the cohort), concomitant to the rheumatic assessment. Disability, quality of life and perceived nail-related health were also assessed. Nail findings and their location were recorded and classified according to standardised definitions. Logistic and linear regression models were used to investigate predictors of nail findings and to identify the impact of toenail findings on disability, which was evaluated with the HAQ. Patients consented to participate. RESULTS: Patients were primarily middle-aged females, with median follow-up of 9 years, and had disease under control. Most patients (62.3%) had at least one nail finding and these patients scored lower their nail-related health. The median (IQR) of findings/abnormalities per patient was 3 (2-5) and the number of nails affected per patient was 10 (2-12). Age (OR: 1.04, 95%CI: 1.007-1.074) and erosive disease (OR: 2.26, 95%CI: 1.1-5.1) were associated with nail findings. Toenail involvement was consistently associated with HAQ score out of normal range (OR=3.4, 95%CI=1.24-9.35, p=0.02). There was a linear association between the number of toenails affected and the HAQ score. CONCLUSIONS: Nail abnormalities are common and heterogeneous findings in RA patients; they are associated with erosive damage and impact disability.
Asunto(s)
Artritis Reumatoide , Uñas Malformadas , Artritis Reumatoide/diagnóstico por imagen , Artritis Reumatoide/epidemiología , Estudios Transversales , Evaluación de la Discapacidad , Femenino , Humanos , Persona de Mediana Edad , Uñas/diagnóstico por imagen , Uñas Malformadas/diagnóstico por imagen , Uñas Malformadas/epidemiología , Uñas Malformadas/etiología , Calidad de Vida , Índice de Severidad de la EnfermedadAsunto(s)
Dermoscopía , Enfermedades de la Uña/patología , Nevo Pigmentado/patología , Neoplasias Cutáneas/patología , Adolescente , Niño , Preescolar , Colombia/epidemiología , Humanos , Lactante , Recién Nacido , Enfermedades de la Uña/congénito , Enfermedades de la Uña/epidemiología , Uñas Malformadas/congénito , Uñas Malformadas/epidemiología , Uñas Malformadas/patología , Nevo Pigmentado/congénito , Nevo Pigmentado/epidemiología , Estudios Retrospectivos , Neoplasias Cutáneas/congénito , Neoplasias Cutáneas/epidemiologíaRESUMEN
BACKGROUND: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. OBJECTIVE: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. METHODS: This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. RESULTS: Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). CONCLUSIONS: Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study.
Asunto(s)
Uñas Malformadas/epidemiología , Vitíligo/epidemiología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Hipopigmentación/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades de la Uña/congénito , Enfermedades de la Uña/epidemiología , Uñas Malformadas/etiología , Uñas Malformadas/patología , Prevalencia , Estadísticas no Paramétricas , Turquía/epidemiología , Vitíligo/complicaciones , Vitíligo/patología , Adulto JovenRESUMEN
Abstract: Background: Vitiligo is an acquired pigmentary skin disorder affecting 0.1-4% of the general population. The nails may be affected in patients with an autoimmune disease such as psoriasis, and in those with alopecia areata. It has been suggested that nail abnormalities should be apparent in vitiligo patients. Objective: We sought to document the frequency and clinical presentation of nail abnormalities in vitiligo patients compared to healthy volunteers. We also examined the correlations between nail abnormalities and various clinical parameters. Methods: This study included 100 vitiligo patients and 100 healthy subjects. Full medical histories were collected from the subjects, who underwent thorough general and nail examinations. All nail changes were noted. In the event of clinical suspicion of a fungal infection, additional mycological investigations were performed. Results: Nail abnormalities were more prevalent in the patients (78%) than in the controls (55%) (p=0.001). Longitudinal ridging was the most common finding (42%), followed by (in descending order): leukonychia, an absent lunula, onycholysis, nail bed pallor, onychomycosis, splinter hemorrhage and nail plate thinning. The frequency of longitudinal ridging was significantly higher in patients than in controls (p<0.001). Conclusions: Nail abnormalities were more prevalent in vitiligo patients than in controls. Systematic examination of the nails in such patients is useful because nail abnormalities are frequent. However, the causes of such abnormalities require further study. Longitudinal ridging and leukonychia were the most common abnormalities observed in this study.
Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Adulto Joven , Vitíligo/epidemiología , Uñas Malformadas/epidemiología , Turquía/epidemiología , Vitíligo/complicaciones , Vitíligo/patología , Estudios de Casos y Controles , Prevalencia , Hipopigmentación/epidemiología , Estadísticas no Paramétricas , Enfermedades de la Uña/congénito , Enfermedades de la Uña/epidemiología , Uñas Malformadas/etiología , Uñas Malformadas/patologíaRESUMEN
Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects.
Asunto(s)
Úlcera de la Pierna/epidemiología , Uñas Malformadas/epidemiología , Onicomicosis/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Arthrodermataceae/aislamiento & purificación , Enfermedad Crónica , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Onicomicosis/etiología , Portugal/epidemiología , Prevalencia , Estadísticas no ParamétricasRESUMEN
A unha em raquete do polegar, uma forma de braquioníquia, resulta da anormalidade congênita do dedo polegar que apresenta a falange terminal mais curta e mais larga. É transmitida por herança autossômica dominante. A literatura médica consigna que a incidência feminina é o dobro da masculina e que a ocorrência bilateral é o dobro da unilateral, sendo uma entidade clínica incomum. Julgando que a anomalia possa ocorrer com mais freqüência, porém despercebida procuramos observar sistematicamente as extremidades digitais em todos aqueles que nos procuram. Foram examinadas 2.000 pessoas , 1.000 de cada sexo. Foram encontrados 19 casos da URO, o que dá uma freqüência de 0,95%, sendo que 12 casos feminino, 10 bilaterais e 11 com ocorrência familiar. O resultado obtido confirmou a nossa suposiçäo inicial de que näo é rara a ocorrência da URP e veio contribuir para melhorar a literatura existene que é bastante reduzida
Asunto(s)
Humanos , Masculino , Femenino , Uñas Malformadas/epidemiología , Brasil , MuestreoRESUMEN
Pterygium inversum unguis (PIU) is a digital anomaly characterized by adherence of the subungueal tissue to the ventral surface of the distal nail plates. Universal medical literature in ten years reported 24 cases. The foresight that this anomaly could be more frequent, although unnoticed, led us to perform a survey through a systematic digital checking of all patients who were examined by us, in a 8 month period. In this period 2,000 clients were examined, 1,000 being of the female sex and 1,000 of the male sex. Eight cases of PIU of hands, with no familiar trait were diagnosed, 6 of them in females and 2 in males. From the cases in males, 1 was of the idiopathic congenital type and the other was of the secondary type (post-traumatic). From the cases identified in females, 5 were of the idiopathic type (4 acquired and 1 congenital) and 1 was of the secondary type (dermatomyositis). PIU was diagnosed in 8 of the 2,000 adult patients examined by us, reaching 0.4% in frequency. The final result was in accordance with our previous opinion that is not uncommon the incidence of the PIU allowing us to assemble in a short period of time a number of cases larger than any other survey found in medical literature.