2018, Number 2
<< Back Next >>
Med Cutan Iber Lat Am 2018; 46 (2)
Clinical and dermatoscopical characterization of patients with diagnosis of nail fragility syndrome not secondary to dermatological pathology
Gaviria BME, Gómez VLM, Cuesta CDP
Language: Spanish
References: 28
Page: 98-103
PDF size: 286.29 Kb.
ABSTRACT
Objective: To describe the clinical and dermatoscopical characteristics of patients with a diagnosis of nail fragility syndrome (NFS) not secondary to dermatological disease in two specialized Colombian centers.
Material and methods: Cross sectional descriptive study. Patients older than 18 years with NFS who were evaluated at either in Clinica Universitaria Bolivariana dermatology service or a private practice dermatology center ranging from October 2015 to February 2017 were prospectively enrolled. Demographic data, comorbidities, signs, symptoms, clinical and dermatoscopic examination of four nails were evaluated and the presence or absence of affectation in the toenails was determined as well. The perception of quality of life was inquired.
Results: 62 patients and 248 nails with NFS in the hands were evaluated; 91.9% were women and the median age was 53 years (RIQ: 31-61). At least one comorbidity was reported in 20.9%. The reported ungular symptoms were 96.8% rupture, 93.5% weak nails, 67.7% lack of growth and 25.8% pain; 67.7% of patients perceived impairment of quality of life and median duration of symptoms was 12 months (RIQ: 6-24); 22.6% reported toenail involvement. Clinical signs and dermatoscopic findings were respectively: 76.2-84.7% onicorrexis, 64.9-79.8% onychosis, 9.7-10.1% lateral border rupture and 5.2-8.5% longitudinal divisions.
REFERENCES
Gaviria-Barrera ME, Gómez-Vargas LM. Síndrome de uñas frágiles. Med Cutan Iber Lat Am. 2016; 44 (2): 79-88.
Shemer A, Daniel CR 3rd. Common nail disorders. Clin Dermatol. 2013; 31 (5): 578-586.
Iorizzo M, Pazzaglia M, Piraccini B, Tullo S, Tosti A. Brittle nails. J Cosmet Dermatol. 2004; 3 (3): 138-144.
van de Kerkhof PC, Pasch MC, Scher RK, Kerscher M, Gieler U, Haneke E et al. Brittle nail syndrome: a pathogenesis-based approach with a proposed grading system. J Am Acad Dermatol. 2005; 53 (4): 644-651.
Baran R, Schoon D. Nail fragility syndrome and its treatment. J Cosmet Dermatol. 2004; 3 (3): 131-137.
Stern DK, Diamantis S, Smith E, Wei H, Gordon M, Muigai W et al. Water content and other aspects of brittle versus normal fingernails. J Am Acad Dermatol. 2007; 57 (1): 31-36.
Kechijian P. Brittle fingernails. Dermatol Clin. 1985; 3 (3): 421-429.
Lubach D, Cohrs W, Wurzinger R. Incidence of brittle nails. Dermatologica. 1986; 172 (3): 144-147.
Colombo VE, Gerber F, Bronhofer M, Floersheim GL. Treatment of brittle fingernails and onychoschizia with biotin: scanning electron microscopy. J Am Acad Dermatol. 1990; 23 (6 Pt 1): 1127-1132.
Gequelim GC, Kubota CY, Sanches S, Dranka D, Mejia MM, Sumiya FM et al. Perception of brittle nails in dermatologic patients: a cross-sectional study. An Bras Dermatol. 2013; 88 (6): 1022-1025.
Shelley WB, Shelley ED. Onychoschizia: scanning electron microscopy. J Am Acad Dermatol. 1984; 10 (4): 623-627.
Rowland-Payne CM. Brittle nails, fragile nails. J Cosmet Dermatol. 2004; 3 (3): 119-121.
Helmdach M, Thielitz A, Röpke EM, Gollnick H. Age and sex variation in lipid composition of human fingernail plates. Skin Pharmacol Appl Skin Physiol. 2000; 13 (2): 111-119.
Singh G, Haneef NS, Uday A. Nail changes and disorders among the elderly. Indian J Dermatol Venereol Leprol. 2005; 71 (6): 386-392.
Lubach D, Beckers P. Wet working conditions increase brittleness of nails, but do not cause it. Dermatology. 1992; 185 (2): 120-122.
Dimitris R, Ralph D. Management of simple brittle nails. Dermatol Ther. 2012; 25 (6): 569-573.
Duarte AF, Correia O, Baran R. Nail plate cohesion seems to be water independent. Int J Dermatol. 2009; 48 (2): 193-195.
Rycroft RJG, Baran R. Occupational abnormalities and contact dermatitis. In: Baran R, Dawber RPR, editors. Diseases of the nails and their management. 3rd ed. Oxford: Blackwell; 2001. pp. 330-357.
Wallis MS, Bowen WR, Guin JD. Pathogenesis of onychoschizia (lamellar dystrophy). J Am Acad Dermatol. 1991; 24 (1): 44-48.
Geyer AS, Onumah N, Uyttendaele H, Scher RK. Modulation of linear nail growth to treat diseases of the nail. J Am Acad Dermatol. 2004; 50 (2): 229-234.
Razi A, Golforoushan F, Nejad AB, Goldust M. Evaluation of dermal symptoms in hypothyroidism and hyperthyroidism. Pak J Biol Sci. 2013; 16 (11): 541-544.
de Jong EM, Seegers BA, Gulinck MK, Boezeman JB, van de Kerkhof PC. Psoriasis of the nails associated with disability in a large number of patients: results of a recent interview with 1,728 patients. Dermatology. 1996; 193 (4): 300-303.
Drake LA, Patrick DL, Fleckman P, Andr J, Baran R, Haneke E et al. The impact of onychomycosis on quality of life: development of an international onychomycosis-specific questionnaire to measure patient quality of life. J Am Acad Dermatol. 1999; 41 (2 Pt 1): 189-196.
Elewski BE. The effect of toenail onychomycosis on patient quality of life. Int J Dermatol. 1997; 36 (10): 754-756.
Sparavigna A, Caserini M, Tenconi B, De Ponti I, Palmieri R. Effects of a novel nail lacquer based on hydroxypropyl-chitosan (HPCH) in subjects with fingernail onychoschizia. J Dermatolog Clin Res. 2014; 2 (2): 1013.
Lencastre A, Lamas A, Sá D, Tosti A. Onychoscopy. Clin Dermatol. 2013; 31 (5): 587-593.
Haenssle HA, Blum A, Hofmann-Wellenhof R, Kreusch J, Stolz W, Argenziano G et al. When all you have is a dermatoscope- start looking at the nails. Dermatol Pract Concept. 2014; 4 (4): 11-20.
Piraccini BM, Bruni F, Starace M. Dermoscopy of non-skin cancer nail disorders. Dermatol Ther. 2012; 25 (6): 594-602.