nail diseases


Summary: Diseases of the nail plate and tissues surrounding it. The concept is limited to primates.

Top Publications

  1. Rich P, Scher R. Nail Psoriasis Severity Index: a useful tool for evaluation of nail psoriasis. J Am Acad Dermatol. 2003;49:206-12 pubmed
    ..The NAPSI will be useful during clinical trials for evaluating response to treatment of psoriatic nails. The scale is reproducible, and because there are few data points, statistical analysis is simplified. ..
  2. Zuo Y, Ma D, Jin H, Liu Y, Wang H, Sun Q. Treatment of Laugier-Hunziker syndrome with the Q-switched alexandrite laser in 22 Chinese patients. Arch Dermatol Res. 2010;302:125-30 pubmed publisher
    ..Our study has also demonstrated QSAL to be highly effective and safe in the treatment of LHS. ..
  3. Phan A, Dalle S, Touzet S, Ronger Savle S, Balme B, Thomas L. Dermoscopic features of acral lentiginous melanoma in a large series of 110 cases in a white population. Br J Dermatol. 2010;162:765-71 pubmed publisher
    ..Amelanotic ALM either in volar skin or in nail apparatus is characterized by remnants of pigmentation and a polymorphic vascular pattern. ..
  4. Bilemjian A, Pineiro Maceira J, Barcaui C, Pereira F. Melanonychia: the importance of dermatoscopic examination and of nail matrix / bed observation. An Bras Dermatol. 2009;84:185-9 pubmed
    ..It may have different causes, including subungueal melanoma, making early etiologic diagnosis very important. ..
  5. Alkhalifah A, Alsantali A, Wang E, McElwee K, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62:177-88, quiz 189-90 pubmed publisher
    ..Part one of this two-part series on AA describes the clinical presentation and the associated histopathologic picture. It also proposes a hypothesis for AA development based on the most recent knowledge of disease pathogenesis...
  6. Koga H, Saida T, Uhara H. Key point in dermoscopic differentiation between early nail apparatus melanoma and benign longitudinal melanonychia. J Dermatol. 2011;38:45-52 pubmed publisher
    ..Diagnosis of amelanotic or hypomelanotic melanoma affecting the nail apparatus is also challenging, but melanoma should be highly suspected if remnants of melanin granules are detected dermoscopically. ..
  7. Hirata S, Yamada S, Enokihara M, Di Chiacchio N, de Almeida F, Enokihara M, et al. Patterns of nail matrix and bed of longitudinal melanonychia by intraoperative dermatoscopy. J Am Acad Dermatol. 2011;65:297-303 pubmed publisher
    ..The patterns described present high sensitivity and specificity for intraoperative differential diagnosis of pigmented nail lesions. ..
  8. Duarte A, Correia O, Barros A, Azevedo R, Haneke E. Nail matrix melanoma in situ: conservative surgical management. Dermatology. 2010;220:173-5 pubmed publisher
    ..Full-thickness skin grafting after total nail unit excision is a simple procedure providing a good functional and cosmetic outcome. ..
  9. Redondo Granado M, Torres Hinojal M, Izquierdo López B. [Post viral onychomadesis outbreak in Valladolid]. An Pediatr (Barc). 2009;71:436-9 pubmed publisher
    ..Perhaps the diagnosis is underestimated due to ignorance of the disease and the long interval between the acute viral process and nail shedding. ..

More Information


  1. Di Chiacchio N, Hirata S, Enokihara M, Michalany N, Fabbrocini G, Tosti A. Dermatologists' accuracy in early diagnosis of melanoma of the nail matrix. Arch Dermatol. 2010;146:382-7 pubmed publisher
    ..The level of expertise did not statistically influence the correct diagnosis. ..
  2. Davia J, Bel P, Ninet V, Bracho M, Gonzalez Candelas F, Salazar A, et al. Onychomadesis outbreak in Valencia, Spain associated with hand, foot, and mouth disease caused by enteroviruses. Pediatr Dermatol. 2011;28:1-5 pubmed publisher
    ..The 2008 onychomadesis outbreak in the metropolitan area of Valencia was associated with an outbreak of hand, foot, and mouth disease primarily caused by coxsackievirus A10. ..
  3. Cabrerizo M, de Miguel T, Armada A, Martínez Risco R, Pousa A, Trallero G. Onychomadesis after a hand, foot, and mouth disease outbreak in Spain, 2009. Epidemiol Infect. 2010;138:1775-8 pubmed publisher
    ..The epidemiological results of this study confirm onychomadesis as a complication in HFMD. In future outbreaks, molecular characterization of enterovirus from appropriate clinical samples should be studied. ..
  4. Holzberg M. Common nail disorders. Dermatol Clin. 2006;24:349-54 pubmed
    ..There is considerable overlap in the nail findings in these cutaneous conditions, but nail changes distinct to each do exist. ..
  5. Wasner G, Hilpert F, Schattschneider J, Binder A, Pfisterer J, Baron R. Docetaxel-induced nail changes--a neurogenic mechanism: a case report. J Neurooncol. 2002;58:167-74 pubmed
    ..In accordance with this hypothesis, a cyclooxygenase-2 inhibitor improved nail alterations of the non-paretic limbs. ..
  6. Minisini A, Tosti A, Sobrero A, Mansutti M, Piraccini B, Sacco C, et al. Taxane-induced nail changes: incidence, clinical presentation and outcome. Ann Oncol. 2003;14:333-7 pubmed
    ..They include nail pigmentation, subungual hematoma, Beau's lines and onycholysis and subungual suppuration. The incidence of such changes (ranging from 0% to 44%) is reviewed from a Medline search of the literature. ..
  7. Scotte F, Tourani J, Banu E, Peyromaure M, Levy E, Marsan S, et al. Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand. J Clin Oncol. 2005;23:4424-9 pubmed
    ..FG significantly reduces the nail and skin toxicity associated with docetaxel and provides a new tool in supportive care management to improve a patient's quality of life. ..
  8. Hirata S, Yamada S, Almeida F, Enokihara M, Rosa I, Enokihara M, et al. Dermoscopic examination of the nail bed and matrix. Int J Dermatol. 2006;45:28-30 pubmed
    ..Conclusions This procedure enables visualization of dermascopic features not seen in the nail plate, making the diagnosis of melanocytic lesions easier. ..
  9. Braun R, Baran R, Saurat J, Thomas L. Surgical Pearl: Dermoscopy of the free edge of the nail to determine the level of nail plate pigmentation and the location of its probable origin in the proximal or distal nail matrix. J Am Acad Dermatol. 2006;55:512-3 pubmed
  10. Yago K, Tanaka Y, Asanami S. Laugier-Hunziker-Baran syndrome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:e20-5 pubmed publisher
    ..Oral scientists and clinicians must be familiar with Laugier-Hunziker-Baran syndrome, because this syndrome is probably more common than is generally recognized. ..
  11. Rafi L, Friedrich M, Tilgen W, Reichrath J. Severe nail changes due to Docetaxel treatment. Eur J Dermatol. 2003;13:610-1 pubmed
    ..We report a case of severe nail changes which occurred in a patient under docetaxel treatment for metastatic breast cancer. ..
  12. Sabesan T, Ramchandani P, Peters W. Laugier-Hunziker syndrome: a rare cause of mucocutaneous pigmentation. Br J Oral Maxillofac Surg. 2006;44:320-1 pubmed
    ..An 80-year-old white woman presented with brown pigmentation on both sides of the buccal mucosa and lower lip and patchy freckling in her nails, which was diagnosed as Laugier-Hunziker syndrome. ..
  13. Gencoglan G, Gerceker Turk B, Kilinc Karaarslan I, Akalin T, Ozdemir F. Dermoscopic findings in Laugier-Hunziker syndrome. Arch Dermatol. 2007;143:631-3 pubmed
    ..Future reports highlighting the dermoscopic features of this syndrome may simplify the diagnosis of LHS, which is thought to be underdiagnosed. ..
  14. Imakado S, Sato H, Hamada K. Two cases of subungual melanoma in situ. J Dermatol. 2008;35:754-8 pubmed publisher
    ..Judging from previously reported cases, it is unlikely that patients with malignant melanoma have an increased risk of carcinoma of the uterine cervix or of the stomach. ..
  15. Bernier V, Labreze C, Bury F, Taieb A. Nail matrix arrest in the course of hand, foot and mouth disease. Eur J Pediatr. 2001;160:649-51 pubmed
    ..We present four patients in whom the same benign viral condition in childhood appeared as a stressful event preceding onychomadesis. In each case, spontaneous complete healing of the nails was achieved within a few weeks...
  16. Siponen M, Salo T. Idiopathic lenticular mucocutaneous pigmentation (Laugier-Hunziker syndrome): a report of a case. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:288-92 pubmed
    ..Here we report the first case of the Laugier-Hunziker syndrome in Scandinavia. Other conditions causing diffuse or multifocal pigmented oral lesions are discussed. ..
  17. Nicolopoulos J, Howard A. Docetaxel-induced nail dystrophy. Australas J Dermatol. 2002;43:293-6 pubmed
    ..Docetaxel-induced nail changes are a common adverse effect, occurring in 30-40% of patients. Mild changes do not usually warrant the discontinuation of treatment. ..
  18. Pavithran K, Doval D. Nail changes due to docetaxel. Br J Dermatol. 2002;146:709-10 pubmed
  19. Rigopoulos D, Gregoriou S, Stratigos A, Larios G, Korfitis C, Papaioannou D, et al. Evaluation of the efficacy and safety of infliximab on psoriatic nails: an unblinded, nonrandomized, open-label study. Br J Dermatol. 2008;159:453-6 pubmed publisher
    ..3 at baseline to 19.1 at week 38. Alphalthough there is no control group, this data suggests that infliximab is effective for psoriatic nail disease in the context of severe skin and joint involvement. ..
  20. Haas N, Henz B. Pitfall in pigmentation: pseudopods in the nail plate. Dermatol Surg. 2002;28:966-7 pubmed
    ..Pseudopods of the nail resulted from erythrocytes entrapped between the layers of the nail plate. Pseudopod formation of the nail may represent a diagnostic criterion to distinguish hemorrhage and melanoma of the nail apparatus. ..
  21. Wortsman X, Jemec G. Ultrasound imaging of nails. Dermatol Clin. 2006;24:323-8 pubmed
    ..Characteristic ultrasound pictures can be seen in psoriasis, cysts, vascular abnormalities,and other nail diseases. Ultrasound examination can visualize and quantify morphologic and functional aspects of nail biology.
  22. Ronger S, Touzet S, Ligeron C, Balme B, Viallard A, Barrut D, et al. Dermoscopic examination of nail pigmentation. Arch Dermatol. 2002;138:1327-33 pubmed
  23. Ghetti E, Piraccini B, Tosti A. Onycholysis and subungual haemorrhages secondary to systemic chemotherapy (paclitaxel). J Eur Acad Dermatol Venereol. 2003;17:459-60 pubmed
    ..Hemorrhagic onycholysis and subungual abscesses are a possible side effect of taxane treatment that should be early recognized to prevent serious complications. ..
  24. Haneke E, Baran R. Longitudinal melanonychia. Dermatol Surg. 2001;27:580-4 pubmed
    ..Treatment is as conservative as possible in order to keep the tip of the digit; once the melanoma is completely removed, amputations have not been shown to prolong the disease-free survival time. ..
  25. Kawabata Y, Ohara K, Hino H, Tamaki K. Two kinds of Hutchinson's sign, benign and malignant. J Am Acad Dermatol. 2001;44:305-7 pubmed
    ..However, there was a wide difference in their dermatoscopic features. We believe that observation of pigmentation on the hyponychium with the use of a dermatoscope contributes to the precise diagnosis of subungual melanoma. ..
  26. Covello S, Smith F, Sillevis Smitt J, Paller A, Munro C, Jonkman M, et al. Keratin 17 mutations cause either steatocystoma multiplex or pachyonychia congenita type 2. Br J Dermatol. 1998;139:475-80 pubmed
    ..These results demonstrate that K17 mutations commonly underlie both PC-2 and steatocystoma multiplex and that the alternate phenotypes which arise from these genetic lesions in K17 are independent of the specific mutation involved. ..
  27. Smith F, Jonkman M, van Goor H, Coleman C, Covello S, Uitto J, et al. A mutation in human keratin K6b produces a phenocopy of the K17 disorder pachyonychia congenita type 2. Hum Mol Genet. 1998;7:1143-8 pubmed
    ..Co-expression of these genes was confirmed by in situ hybridization and immunohistochemical staining. These results reveal the hitherto unknown role of the K6b isoform in epithelial biology, as well as genetic heterogeneity in PC-2. ..
  28. Aytekin S, Alp S. Laugier-Hunziker syndrome associated with actinic lichen planus. J Eur Acad Dermatol Venereol. 2004;18:221-3 pubmed
  29. Antonovich D, Grin C, Grant Kels J. Childhood subungual melanoma in situ in diffuse nail melanosis beginning as expanding longitudinal melanonychia. Pediatr Dermatol. 2005;22:210-2 pubmed
  30. Braun R, Baran R, Le Gal F, Dalle S, Ronger S, Pandolfi R, et al. Diagnosis and management of nail pigmentations. J Am Acad Dermatol. 2007;56:835-47 pubmed
    ..In this article, we will review the management, including diagnosis as well as differential diagnosis of nail pigmentations and propose a new algorithm for the non invasive diagnosis of nail pigmentation. ..
  31. Wang J, Zhao L, Ma N, Che J, Li H, Cao B. Cronkhite-Canada syndrome associated with colon cancer metastatic to liver: A case report. Medicine (Baltimore). 2017;96:e7466 pubmed publisher
    ..Although malignant colon and gastric cancer have been reported in CCS, reports of distant metastasis have been rare in CCS...
  32. Larsen C, Bygum A. Idiopathic 20-nail dystrophy. BMJ Case Rep. 2016;2016: pubmed publisher
    ..girl with a 3-year history of 20-nail dystrophy and no associated diseases or family history of skin or nail diseases. She was followed and treated conservatively and, after 6?years of follow-up, we found a marked improvement ..
  33. de Berker D. Management of psoriatic nail disease. Semin Cutan Med Surg. 2009;28:39-43 pubmed publisher
    ..Biological therapy usually is indicated for widespread psoriasis, but studies show that therapy directed at nail symptoms can be effective in the treatment of coincident nail disease. ..
  34. Baswan S, Li S, LaCount T, Kasting G. Size and Charge Dependence of Ion Transport in Human Nail Plate. J Pharm Sci. 2016;105:1201-8 pubmed publisher of human nail plate are poorly characterized yet are a key determinate of the potential to treat nail diseases, such as onychomycosis, using iontophoresis...
  35. Sugandhan S, Gupta S, Khandpur S, Khanna N, Mehta M, Inna P. 'Munchausen syndrome by proxy' presenting as battered child syndrome: a report of two cases. Int J Dermatol. 2010;49:679-83 pubmed publisher
    ..A multidisciplinary team effort is essential in evaluating such cases, and dermatologists should be aware and be well informed about this condition that can be potentially lethal but easily overlooked. ..
  36. Pahwa M, Pahwa P, Kathuria S. Glomus tumour of the nail bed treated with the 'trap door' technique: a report of two patients. J Dermatolog Treat. 2010;21:298-300 pubmed publisher
    ..We have treated two patients of this rare presentation with a nail plate-conserving surgical method called the 'trap door' technique with excellent results. We hereby present a step-by-step pictorial guide to the method. ..
  37. Lencastre A, Lamas A, Sa D, Tosti A. Onychoscopy. Clin Dermatol. 2013;31:587-93 pubmed publisher
    ..can be used to evaluate the nail apparatus (ie, onychoscopy), and it is helpful for the diagnosis of numerous nail diseases and tumors...
  38. Stewart C, Rubin A. Update: nail unit dermatopathology. Dermatol Ther. 2012;25:551-68 pubmed publisher
  39. Yap F. Psoriasis among Sarawakian natives in a tertiary skin centre in Sarawak. Australas J Dermatol. 2010;51:210-1 pubmed publisher
    ..2% had chronic stable plaque psoriasis, 86.9% had a body surface area involvement of less than 10%, 60.9% had nail disease, 22.5% had joint disease and 55.1% had minimal effects to their quality of life because of their psoriasis. ..
  40. Haneke E. Non-infectious inflammatory disorders of the nail apparatus. J Dtsch Dermatol Ges. 2009;7:787-97 pubmed publisher
    ..Eczemas and various autoimmune dermatoses may also affect the nails but the changes are not clinically specific. ..
  41. Hasselmann D, Meier T, Amann Vesti B, Thalhammer C. [Electric blue finger nail]. Praxis (Bern 1994). 2012;101:545-7 pubmed publisher
    ..Glomus tumors are benign tumors and are most often localized acral. They usually are diagnosed non-invasively by patient's history, clinical examination, duplex ultrasound and MRI-angiography. Need for intervention depends on the symptoms. ..
  42. Mir H, Khan S, Arif M, Ali G, Wali A, Ansar M, et al. Mutations in the gene phospholipase C, delta-1 (PLCD1) underlying hereditary leukonychia. Eur J Dermatol. 2012;22:736-9 pubmed publisher
    ..2. Sequence analysis of the gene detected one novel (p.Ser740ArgfsX19) and one previously reported mutation (p.Arg437X). This study expands spectrum of the mutations in the gene PLCD1 causing hereditary leukonychia. ..
  43. Wang W, Wang X, Duan N, Jiang H, Huang X. Laugier-Hunziker syndrome: a report of three cases and literature review. Int J Oral Sci. 2012;4:226-30 pubmed publisher
    ..We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature. ..
  44. Maehara L, Ohe E, Enokihara M, Michalany N, Yamada S, Hirata S. Diagnosis of glomus tumor by nail bed and matrix dermoscopy. An Bras Dermatol. 2010;85:236-8 pubmed
    ..It is a simple and low-cost procedure that does not involve additional risks to the patient who will undergo surgery. ..
  45. Lai W, Tang W, Loo S, Chan Y. Clinical characteristics and treatment outcomes of patients undergoing nail avulsion surgery for dystrophic nails. Hong Kong Med J. 2011;17:127-31 pubmed
    ..Retrospective study. Two dermatology centres in Hong Kong. A total of 32 patients with nail diseases who underwent 33 nail avulsion procedures were reviewed from case records...
  46. Carreño A, Nakajima S, Pennini S, Candido Junior R, Schettini A. Nail apparatus melanoma: a diagnostic opportunity. An Bras Dermatol. 2013;88:268-71 pubmed publisher
    ..The incidental diagnosis of nail melanoma in situ in our case significantly impacted the patient's survival. ..
  47. Reich A, Szepietowski J. Health-related quality of life in patients with nail disorders. Am J Clin Dermatol. 2011;12:313-20 pubmed publisher
    ..Based on literature data and our own experience we conclude that nail diseases cause a marked decrease in health-related quality of life in a substantial percentage of patients...
  48. Wollstein A, Wollstein R. Subungual glomangiomyoma - a case report. Hand Surg. 2012;17:271-3 pubmed
    ..This may suggest that the histological type may be more important in predicting the clinical presentation than the anatomical location of the glomus tumor. ..
  49. Husein El Ahmed H, Garrido Pareja F, Ruiz Carrascosa J, Naranjo Sintes R. Vessel resistance to blood flow in the nailfold in patients with psoriasis: a prospective case-control echo Doppler-based study. Br J Dermatol. 2012;166:54-8 pubmed publisher
    ..Psoriasis decreases the blood flow in nails, suggesting that this skin disease confers an independent risk for microvascular changes. This outcome may be associated with greater risk of nail-related signs. ..
  50. Vaka S, Murthy S, O Haver J, Repka M. A platform for predicting and enhancing model drug delivery across the human nail plate. Drug Dev Ind Pharm. 2011;37:72-9 pubmed publisher
    ..This study demonstrated that pretreatment of the nail plate with PA (1% or 10%, w/w) for a short duration could be a potential method of improving the efficiency of topical monotherapy treatment for nail diseases.
  51. Tully A, Trayes K, Studdiford J. Evaluation of nail abnormalities. Am Fam Physician. 2012;85:779-87 pubmed
    ..A pincer nail deformity is inherited or acquired and can be associated with beta-blocker use, psoriasis, onychomycosis, tumors of the nail apparatus, systemic lupus erythematosus, Kawasaki disease, and malignancy. ..
  52. Ameen M. The impact of human immunodeficiency virus-related diseases on pigmented skin types. Br J Dermatol. 2013;169 Suppl 3:11-8 pubmed publisher
    ..In addition, the clinical presentation will vary in pigmented skin types. The aim of this article is to describe disease variation in pigmented skin types. ..
  53. Mertens F, Möller E, Mandahl N, Picci P, Perez Atayde A, Samson I, et al. The t(X;6) in subungual exostosis results in transcriptional deregulation of the gene for insulin receptor substrate 4. Int J Cancer. 2011;128:487-91 pubmed publisher