Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.
-
Upload
earl-glenn -
Category
Documents
-
view
221 -
download
2
Transcript of Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.
![Page 1: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/1.jpg)
Nail Diseases 03-2009Nail Diseases 03-2009
Tom Paige MDTom Paige MD
Department of DermatologyDepartment of Dermatology
CCRMCCCRMC
![Page 2: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/2.jpg)
![Page 3: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/3.jpg)
![Page 4: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/4.jpg)
![Page 5: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/5.jpg)
![Page 6: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/6.jpg)
![Page 7: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/7.jpg)
![Page 8: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/8.jpg)
![Page 9: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/9.jpg)
![Page 10: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/10.jpg)
![Page 11: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/11.jpg)
![Page 12: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/12.jpg)
![Page 13: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/13.jpg)
![Page 14: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/14.jpg)
![Page 15: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/15.jpg)
![Page 16: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/16.jpg)
How To Approach Nail DiseasesHow To Approach Nail Diseases
Abnormalities of the nail plate surface
Nail discoloration
Abnormalities of the cuticle and nail fold
Abnormalities of nail shape
Loss of nails
Lesions around nails
![Page 17: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/17.jpg)
Nail ApparatusNail Apparatus
![Page 18: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/18.jpg)
![Page 19: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/19.jpg)
![Page 20: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/20.jpg)
![Page 21: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/21.jpg)
![Page 22: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/22.jpg)
![Page 23: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/23.jpg)
Abnormalities of the nail plate surface
Pitting seen in– *Psoriasis– Eczema– Alopecia areata
Beau’s lines– *Trauma– Dermatologic diseases– Systemic conditions
Median nail dystrophy– *Trauma– Familial– Drugs
Onychogryphosis– *Elderly neglect– *Trauma– Peripheral vascular
disease
![Page 24: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/24.jpg)
![Page 25: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/25.jpg)
Nail discoloration
Darier’s disease– Hereditary disease
Yellow nails– Y N Syndrome
associated w/ lymphedema and respiratory tract disease
Green nails– Infection w/
Pseudomonas aeruginosa
Salmon patches or “oil drop sign”– Psoriasis
![Page 26: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/26.jpg)
![Page 27: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/27.jpg)
Abnormalities of the cuticle and nail fold
Paronychia– Acute
BacterialViral
– ChronicExposure to irritants and/or allergens
Nailfold telangiectasias– Dermatomyositis
Ragged cuticleEnlarged capillaries
– SclerodermaCapillary changes like DM
– SLESee wandering glomeruloid loopsNo skip areas
![Page 28: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/28.jpg)
![Page 29: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/29.jpg)
Abnormalities of nail shape
Enlarged nail– Osteoid osteoma
(bone tumor)
Clubbing of nails– Hereditary– Acquired
Koilonychia– Physiologic in children– Iron deficiency in
adults
Pachyonychia congenita– Hereditary– Autosomal dominant
![Page 30: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/30.jpg)
![Page 31: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/31.jpg)
Loss of nails
Onychophagia – Compulsive habit– Up to 30% of kids bite
their nails by some studies
Lichen planus– 10% of patients w/ LP
have nail changesNail thinning and fissuring most commonly seen
Possible cicatricial outcome (dorsal pterygium formation and/or anonychia)
![Page 32: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/32.jpg)
![Page 33: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/33.jpg)
Lesions around nails
Paronychial warts– HPV types 1, 2 ,and 4
Squamous cell carcinoma in situ– Verrucous lesion– Onycholysis– Melanonychia– Inflammation and
crusting
Purple toe syndrome– Many causes
Subungal tumor– Osteoma
![Page 34: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/34.jpg)
![Page 35: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/35.jpg)
![Page 36: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/36.jpg)
![Page 37: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/37.jpg)
![Page 38: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/38.jpg)
![Page 39: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/39.jpg)
![Page 40: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/40.jpg)
![Page 41: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/41.jpg)
![Page 42: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/42.jpg)
![Page 43: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/43.jpg)
Assosciated Assosciated conditionsconditions– Diabetes mellitusDiabetes mellitus– Iron deficiency anemiaIron deficiency anemia– TraumaTrauma– End stage renal End stage renal
diseasedisease– None of the above None of the above
![Page 44: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/44.jpg)
![Page 45: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/45.jpg)
This entity is seen inThis entity is seen in– Warfarin intakeWarfarin intake– Cholesterol emboliCholesterol emboli– SmokingSmoking– Mercury poisoningMercury poisoning– None of the aboveNone of the above
![Page 46: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/46.jpg)
![Page 47: Nail Diseases 03-2009 Tom Paige MD Department of Dermatology CCRMC.](https://reader036.fdocuments.us/reader036/viewer/2022062320/56649d195503460f949ee2f9/html5/thumbnails/47.jpg)