Trachyonychia in a child with concomitant alopecia areata and lichen planus

<p>Trachyonychia of nails has been found to be associated with dermatoses such as lichen planus, psoriasis, alopecia areata etc. When involving all the finger and toe nails bilaterally, it is referred to as ‘twenty nail dystrophies. We, hereby, report a case of trachyonychia in an 8-year-old boy, with concomitant lichen planus and alopecia areata. He was successfully treated with biweekly pulse systemic corticosteroid therapy for duration of 6 months. Significant response was noted at the end of 6 months in terms of hair re-growth; improvement of nail texture, thickness and subungual hyperkeratosis; and resolution of skin lesions.</p>

Familial median canaliform dystrophy of heller affecting multiple nails: a rare clinical entity

<p class="abstract">Median canaliform dystrophy (MCD); first described by Heller in 1928 is characterized by a midline or paramedian split in the nail plate. Mostly idiopathic, some identifiable causes include habitual picking of the nails, oral isotretinoin use and positive family history. The familial occurrence of MCD has rarely been described. Till date, no therapy has proven to be consistently successful in effectively managing the condition. Commonly utilized treatments have been intralesional triamcinolone acetonide injections into the dystrophic nail, topical 0.1% tacrolimus ointment and topical tazarotene 0.05% ointment. Despite available treatment options, the condition has a tendency to recur. Here; we report a case of a 14‑year‑old male presenting with familial MCD affecting multiple finger and toe nails.</p>

Coincidence of psoriasis and onychomycosis

In a three year period, authors observed 16 cases whith plaque psoriasis accompanied with nail symptoms characteristic for typical psoriasis. Microscopy examinations were positive in cases of 7 in fingernails, and in 3 cases of toe nails. In cultures, pathogenic agents were grown in 4 cases from finger nails, in 2 cases from toe nails. Considering the 16 psoriasis cases out of the 1087 mycotic tests carried out in the 3 years period, onychomycosis occurred only in 1,5% of the cases. Therefore further studies are needed for the assessment of onychomycosis in psoriatic cases.

Prevalence of Tinea unguium (Onychomycosis) in Toe Nails of boot wearing group (The Footballers) in Owerri, Imo State. Nigeria

Foot mycoses are a frequent disease that represents a public health problem worldwide. This study aims to evaluate the epidemiology of foot mycoses among footballers in Owerri, Imo State, in order to determine the fungal etiological agents and to identify possible risk factors. To investigate the treatment and preventive measures for the susceptible groups. A total of 485 samples were collected; tinea unguium were confirmed in 88.2% of cases. A prospective study of fifty footballers was undertaken during one year (2018-2019). A complete mycological diagnosis was carried out on all footballers. The results obtained showed that out of the 50 toe nails samples of footballers examined, 28(56.0%) had positive cases of the infection on direct microscopy which served as the screening test. The causative pathogens of Onychomycosis isolated from fungal culture are dermatophytes , and the most frequent pathogen was Trichophyton rubrum 15(30.0%), yeast Candida albicans 9(18.0%). Non-dermatophyte molds were observed in 8(16.0%) cases and Fusarium sp. was the frequent genus 14(28.0%)and Aspergillus sp. 4(8.0%). The main predisposing factors of fungal foot infections were practicing ritual washing (56.6%) and frequentation of communal showers (50.5%). Confirmatory test such as germ-tube test was done on the Candida albicans isolate for proper identification. The age group 31- 35 years had the highest prevalence of onychomycosis 12(92.31%) and age group 16-20 years presented the lowest prevalence of onychomycosis 4(28.57%). Proper care of toe nails and boots is necessary to prevent the increasing rate of this infection.

Comparative evaluation of KOH mount, fungal culture and PAS staining in onychomycosis

<p class="abstract"><strong>Background:</strong> Onychomycosis is a common ailment associated with significant physical and psychological morbidity. Increased prevalence in the recent years has attributed to enhanced longitivity, co morbid conditions like diabetes, avid spots participation and emergence of HIV. The objective of the study was to evaluate KOH mount, fungal culture and PAS staining of affected nail plate in diagnosis of onychomycosis.</p><p class="abstract"><strong>Methods:</strong> The present study was carried out in OPD of Dermatology, PESIMSR, Kuppam, Andhra Pradesh during the period of October 2010 to October 2012 including all patients showing classical clinical features of onychomycosis.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of patients were from 21-40 years age group i.e. 46%. 56% of finger nails were commonly involved than 36% toe nails. DLSO is the most common clinical variant accounting for 80%. Most common isolated species as <em>Trichophyton rubrum </em>(31.6%) followed by <em>T. mentagrophytes</em> and <em>Aspergillus niger</em> 15.8% each. The sensitivity of KOH (81.82%), PAS (84.56%) and culture 57%. Both PAS and KOH were more sensitive than culture (p&lt;0.001). PAS was also more sensitive than KOH. The specificity of KOH 92.86%, culture 92.86% and PAS 57.14%.</p><p class="abstract"><strong>Conclusions:</strong> Fungal culture though is the gold standard for the identification of pathogens but it takes minimum 2-3 weeks. Histopathological examination of nail clippings with PAS stain is simple, highly sensitive screening test.</p>

Mutation in Phospholipase C, δ1 (PLCD1) gene underlies hereditary leukonychia in a Pashtun family and review of the literature

Human hereditary leukonychia is a rare nail disorder characterized by nail plates whitening on all finger and toe nails. Inheritance pattern is both autosomal dominant and recessive. To date, the only gene, phospholipase C, δ1 (PLCD1), on chromosome 3p22.2 has been reported to be involved in hereditary leukonychia. In the present study, a family of Pakhtun ethnicity, carrying leukonychia phenotype was investigated. The family inherited the phenotype in an autosomal dominant fashion. Affected individuals exhibited characteristic features of hereditary leukonychia with involvement of nails on both the hands and feet. Sequence analysis of DNA detected a p.Cys209Arg mutation, reported for the first time in a Pakistani Pashtun family.

Clinico-mycological profile of onychomycosis in Assam, India

Background: Onychomycosis (OM) is a common nail disorder caused by dermatophytes, non-dermatophyte moulds and yeasts. The increased prevalence of OM along with the wide range of associated fungi necessitates the accurate labora­tory isolation and identification of the causative fungus for optimal management strategies. The aim of the study was to evaluate clinical, epidemiological and mycological characteristics of OM in a tertiary care hospital in Assam.Methods: It was a prospective hospital-based study. Hundred consecutive patients clinically diagnosed as OM were subjected to detailed history, clinical examination and investigations. Nail clipping and subungual debris of OM patients were subjected to KOH preparation and culture. Isolates were identified by colony characters, pigment production, microscopic morphology and biochemical tests.Results: The maximum number of OM cases belonged to the age group 21-30 years with a male preponderance (M:F=1.7:1). The commonest clinical type of OM was distal lateral subungual onychomycosis (DLSO) (51%). Toe nails OM was the most common presentation (54%). Trauma (35%) was the most common predisposing factor. Farmers (agro industry labourers) (23%) were found to be the most commonly affected group. Non-dermatophyte moulds (NDM) accounted for 38(47.5%) of OM cases followed by yeast 27(33.8%) and dermatophytes 15(18.8%).Conclusions: Early diagnosis and treatment is important to prevent distortion of the nails which can prevent loss of working efficiency of the commonly affected population of this region.