Onychomatricoma with misleading features

Onychomatricoma is a rare tumour of the nail matrix with peculiar clinical and histological features and electron microscopic findings. We report on 5 cases with appearances which were misleading. Three presented as longitudinal melanonychia, a previously unreported observation. One case had the appearance of a cutaneous horn. In 3 of the 5 cases the tumour was associated with an onychomycosis and this may thus have been a predisposing factor in the secondary fungal infestation. Onychomatricoma appears as a multi-faceted tumour which can be mimicked by longitudinal melanonychia and/or onychomycosis.     

Symptomatic vulvar demodicosis: A case report and review of the literature

Demodex folliculorum is a mite that commonly inhabits the pilosebaceous units of facial skin, particularly in a perioral and periorbital distribution. While typically an incidental and asymptomatic parasite, Demodex spp. are proposed to contribute to the pathogenesis of facial folliculitis, chronic blepharitis and papulopustular rosacea. Reports of demodicosis in anatomic locations other than the face are exceedingly rare. Here we report a 36-year-old woman with symptomatic Demodex spp. infestation of Fordyce spots of the labia minora. She was referred to dermatology after a 9-month history of tender red bumps on the vulva that would arise and drain over a 24 to 72 hours period, several times per week. Physical examination revealed erythema of the labia minora and introitus with a 4 mm, pink, dome-shaped soft papule on the left labium minus. Wet mount, microbiologic cultures and sexually transmitted infection (STI) screenings were unremarkable. Histopathologic examination revealed a well-circumscribed nodule of suppurative granulomatous inflammation arising in a background of mucosa with Fordyce spots, the majority of which were infiltrated by Demodex spp. Treatment with oral ivermectin and topical metronidazole cream resulted in a symptom-free period of 22 months. This case represents an unusual presentation of symptomatic Demodex infestation.     

Pseudo-delusory syndrome caused by Limothrips cerealium

BACKGROUND: Limothrips cerealium (or "grain thrips") is an insect of the phylum Arthropoda, known as parasite of plants of the family Gramineae; human infestation is not frequently described in literature. MATERIALS AND METHODS: We report the case of a 59-year-old female farmer, come to observation because of intense itching and sensation of "walking insects" on her head, with no objective cutaneous signs except lesions due to scratching. After repeated visits, in which negative results of clinical and laboratory tests suggested the diagnosis of "delusory syndrome" (Ekbom's syndrome), we finally isolated on her head some insects, identified by stereomicroscopy as L. cerealium. Careful inspection of the house of our patient allowed us to identify, as possible source of parasites, a wheat field and a deposit of grains used for animal feeding. Temporarily removing the patient from her usual environment resulted in complete clinical resolution. RESULTS: Peculiarity of symptoms caused by this parasite and consequent problems for a correct diagnosis are discussed, as well as possible solutions.     

Hookworm‐related cutaneous larva migrans of the penis successfully treated with topical ivermectin

Hookworm‐related cutaneous larva migrans is an infestation of the skin caused by nematodes. Involvement of genitals is extremely rare. We report the case of a child with this infestation on the penis who cleared rapidly with topical ivermectin.     

Hyperkeratotic (Norwegian) scabies and onychomycosis in an immunosuppressed patient

Hyperkeratotic scabies and onychomycosis were associated in an immunosuppressed patient. Onychomycosis healed spontaneously after treatment of scabies. A possible interrelationship between Sarcoptes scabiei infestation of the hyponychium and dermatophytes infestation of the nail plate could be responsible for this peculiar evolution.     

A case of nodular subungual melanoma without Hutchinson's nail sign

An early and accurate diagnosis is critical for the optimal management of subungual melanoma; the absence of Hutchinson's nail sign makes an accurate diagnosis extremely difficult. Previous publications show that most subungual melanomas have Hutchinson's nail sign. In this report, we present a rare case of a subungual melanoma without Hutchinson's nail sign and discuss the importance of cautious evaluations of Hutchinson's nail sign by dermoscopy.     

Two hundred ninety-six cases of onychomycosis in children and teenagers: a 10-year laboratory survey

There is still little data available about the epidemiology of childhood onychomycosis. Looking at our laboratory figures over a 10-year period provided us with some useful information. Nail keratin samples were taken by dermatologists from 21,557 patients with nail conditions, mainly in the Brussels region. The specimens were examined by direct microscopy and/or histology, and cultured on Sabouraud medium agar. Only patients less than 17 years of age were considered as children. Clinical information was gathered about age, sex, and the location of the infected nail. Nine hundred sixty-three of the samples were from children, and 296 of those children had proven onychomycosis. More than three-fourths of the cases were found in children more than 6 years old, and boys were more frequently affected than girls. Toenails were the predominant location of infection. Trichophyton rubrum was the main pathogen, followed by Candida spp. and Trichophyton interdigitale. One case was caused by Scopulariopsis spp. As in adults, onychomycosis is probably the main nail disease in children. After the age of 6 years, the presentation is very similar to that in adults: toenails are mostly involved, and T. rubrum, the main pathogen, is responsible for distal and lateral subungual onychomycosis.     

Onychomatricoma: report of three cases, including the first recognized in a colored man

Onychomatricoma is an uncommon benign tumor of the nail matrix with typical clinical features. We report here 3 cases of onychomatricoma, including the first case in a black patient. In all three patients a presumptive diagnosis of onychomatricoma was made by clinical examination. The affected nails were thickened and showed a marked overcurvature of the nail plate. Frontal view of the nail revealed the presence of small woodworm-like cavities within the nail plate. In all cases the pathology showed multiple fibroepithelial projections that extended into the thickened nail plate. The tumor epithelium was identical to that of the normal nail matrix and keratinized without a granular layer.     

Scalp Infestation by Phthirus pubis in a 6-Week-Old Infant

This case report describes a 6-week-old infant with a Phthirus pubis infestation of the scalp. It is believed this patient is the first reported case in this age group. Treatment is discussed, as are the family dynamics that put this infant at risk. The authors address the possible association between infestation and child abuse.     

Unusual manifestation of the yellow nail syndrome - Case report

The yellow nail syndrome is a rare disorder characterized by the classic triad of yellow and dystrophic nails, lymphedema and pleural effusion. We report in this paper a case of yellow nail syndrome, presenting the classic triad of the disease, associated with an unusual lymph accumulation in the abdomen region.     

Unilateral onychodystrophy secondary to nail biting

Whether or not nail biting is a sign of underlying psychiatric disorders is the subject of controversy. We report here a case of nail biting that was unusual in its pattern and severity, and occurred in a patient with previously diagnosed psychiatric disease. The literature regarding psychiatric disease associated with self-inflicted nail disease is reviewed.     

Yellow-nail syndrome from d-penicillamine

The yellow nail syndrom consists of the triad of scleronychia (yellow nails), lymphedema and respiratory tract involvement. The nail changes include symmetrical involvement of finger and toe nails with regression of the nail sheath, paling of the half-moon, arrest of longitudinal growth, thickening, yellow coloration, increased transverse convexity, ridging and partial separation of the nail. This report describes a case of drug-induced yellow nail syndrom due to penicillamin.     

脉冲染料激光联合卡泊三醇倍他米松乳膏治疗甲银屑病一例并文献复习

甲银屑病的局部药物和物理治疗是目前治疗轻、中度甲银屑病研究的方向。本文报道595nm脉冲染料激光(Pulsed dye laser, PDL)联合卡泊三醇倍他米松乳膏治疗甲银屑病1例,并对PDL治疗甲银屑病的相关文献进行复习。     

Lichen nitidus associated with distinctive nail changes

We report a case of lichen nitidus with nail changes, occurring in a young girt. The relationship between lichen nitidus and lichen planus is discussed, with particular regard to the associated nail changes.     

Median canaliform nail dystrophy in a 2-year-old boy: Case report and review of the literature

Median canaliform nail dystrophy (MCD) is a rare nail abnormality with an unknown etiology. We report the case of MCD of both great toenails in a 2-year-old boy presenting with a fir tree nail pattern and longitudinal splits. MCD was treated with topical marigold therapy (Tagetes sp.). By 15 weeks, the proximal 50% of the MCD had normalized. The report highlights a potential new treatment of marigold therapy for MCD.     

Unilateral subungual hyperkeratosis following a cerebrovascular incident in a patient with psoriasis

The prevalence of nail abnormalities in psoriasis is reported to be between 50 and 90% of affected adults. These include pitting, nail discoloration, onycholysis and subungual hyperkeratosis. Although nail changes may be associated with neurological disease, there are no previous reports of psoriatic nail changes following cerebrovascular events. We report the first case to our knowledge of unilateral subungual hyperkeratosis in a psoriatic patient which developed following a cerebrovascular event.     

The yellow nail syndrome associated with sinusitis, bronchiectasis and transitory lymphoedema in a Nigerian patient

Recurrent primary lymphoedema associated with irregularities of the nail plate should suggest the Yellow Nail Syndrome (Samman & White, 1964). We report a case of sinusitis, bronchiectasis, transitory lymphoedema and nail changes in a female Nigerian patient.     

Pregnancy‐associated acquired arteriovenous malformation of the nail unit: a novel cause of localized erythronychia

Localized longitudinal erythronychia describes a solitary red streak limited to a single nail unit. Localized longitudinal erythronychia can be caused by both benign and malignant entities. Most commonly, the cause is a benign process, such as an onychopapilloma. We report a case of an acquired subungual arteriovenous malformation that presented as localized longitudinal erythronychia during pregnancy. To our knowledge, this is the first report of localized longitudinal erythronychia arising from a pregnancy‐associated arteriovenous malformation of the nail unit.     

Congenital Yellow Nail Syndrome: A Case Report and Its Relationship to Nonimmune Fetal Hydrops

Abstract: Yellow nail syndrome (YNS) is an uncommon disorder characterized by a triad of nail dystrophy, lymphedema, and pleural effusion. It is rare in children and congenital occurrence of YNS has been very rarely described. We report a 2‐year‐old Arab boy having congenital yellow nail syndrome with mild facial dysmorphism and bilateral conjunctival pigmentation born to consanguineous parents. One of his older siblings had died of nonimmune fetal hydrops (NIFH). The case supports the genetic basis of yellow nail syndrome with a possible relationship to nonimmune fetal hydrops.     

Atypical malignant melanoma of the nail apparatus

Malignant melanoma of the nail is a serious disease with a five year survival rate of between 21% (Booher & Pack, 1957) and 50% (Graham, 1973). The diagnosis of atypical cases ultimately depends on interpreting histological material. We report here a case in which two initial biopsies of the affected nail failed to show malignant melanoma. The diagnosis was eventually made by formal longitudinal nail biopsy including matrix tissue proximal to the dystrophic area, and examination of sections cut at several levels.