RESUMO
BACKGROUND/OBJECTIVES: Most studies about Papillon-Lefèvre syndrome (PLS) are limited to case reports and patients of the same nationality. This study aimed to determine the self-reported prevalence of signs, symptoms and treatment effectiveness in PLS patients from five Latin American countries. METHODS: An online survey was conducted among adult and paediatric patients from Mexico, Argentina, Colombia and Brazil. Data were collected using multiple-choice, open-ended and image-chooser questions on demographics, signs and symptoms, perceived treatment effectiveness and quality of life. RESULTS: Seventeen patients (10 males and 7 females) aged 4-47 years were surveyed. All had palmoplantar hyperkeratosis. Other affected sites were the feet and hand dorsum (82.35%), Achilles tendon (88.24%), forearms (58.82%), legs (29.41%) and glutes (23.53%). They frequently presented hyperhidrosis and nail pitting. Four had a history of delayed umbilical cord separation. All used topical treatments, with moderate effectiveness; half used oral retinoids, perceived as highly effective. Most reported decreased quality of life and walking difficulties. CONCLUSIONS: The study's results align with prior research on PLS, but reveal new insights, including the impact on patients' quality of life and a history of delayed umbilical cord separation. These findings warrant consideration in future research and patient care.
Assuntos
Doença de Papillon-Lefevre , Qualidade de Vida , Autorrelato , Humanos , Masculino , Feminino , Adulto , Estudos Transversais , Adolescente , Criança , Pessoa de Meia-Idade , Adulto Jovem , Pré-Escolar , Brasil , Colômbia , Resultado do Tratamento , México , Argentina , Retinoides/uso terapêutico , Hiperidrose/terapia , Doenças da Unha/terapiaRESUMO
Because several nail disorders share similar clinical features, their diagnosis and management can be challenging to clinicians. The physical examination may disclose localized abnormalities or point to an underlying systemic disease, requiring additional workup. Furthermore, cosmetic distress and nail-related symptoms (e.g., tingling, stinging, numbness, and pain) are common factors that influence the patient's search for medical assistance. Nail pain (i.e., onychalgia) can accompany both localized and systemic pathology. Onychalgia can be acute or chronic according to the time of evolution; patients may describe it as intermittent or constant, and as a throbbing, burning, sharp, or shooting sensation denoting the nature of the pain. It may be exacerbated by colder temperatures, touch, and increased activity (e.g., manipulating objects, walking). We present four main groups of conditions that might cause nail pain: nail tumors, nail deformities, inflammatory or infectious diseases, and external or traumatic agents. Our article includes an overview of the clinical features, as well as diagnosis and management pearls for each entity. Physicians (dermatologists and nondermatologists) should be aware that abnormalities of the ungual and subungual space are not exclusive of dermatological disorders but may also be present in noncutaneous contexts.
Assuntos
Doenças da Unha , Unhas Malformadas , Neoplasias , Humanos , Doenças da Unha/diagnóstico , Doenças da Unha/terapia , Unhas , Unhas Malformadas/diagnóstico , Unhas Malformadas/terapia , Dor/diagnóstico , Dor/etiologiaRESUMO
Abstract: Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. It is suspected when there is persistent paronychia, particularly in the setting of trauma. This disease is probably underdiagnosed due to limited knowledge among dermatologists and the presence of incomplete clinical forms. Nail plate avulsion is the diagnostic and curative procedure of choice, despite reports of relapse.
Assuntos
Humanos , Doenças da Unha/diagnóstico , Paroniquia/etiologia , Onicólise/complicações , Doenças da Unha/terapia , Unhas Encravadas/complicaçõesRESUMO
Retronychia is a recently described disorder caused by ingrowth of the proximal nail plate into the proximal nail fold. It is suspected when there is persistent paronychia, particularly in the setting of trauma. This disease is probably underdiagnosed due to limited knowledge among dermatologists and the presence of incomplete clinical forms. Nail plate avulsion is the diagnostic and curative procedure of choice, despite reports of relapse.
Assuntos
Doenças da Unha/diagnóstico , Humanos , Doenças da Unha/terapia , Unhas Encravadas/complicações , Onicólise/complicações , Paroniquia/etiologiaRESUMO
La artritis psoriática es una patología inflamatoria crónica que puede afectar a articulaciones periféricas y/o axiales, las que pertenecen al espectro psoriático. Es una enfermedad subdiagnosticada y subtratada, que puede traer consecuencias funcionales, laborales y de calidad de vida en los individuos que la padecen. Se estima que el 30 por ciento de los pacientes con psoriasis presentan compromiso articular. Entre los factores de riesgo para desarrollarla se encuentran; psoriasis cutáneas severas, evolución prolongada de más de 10 años, obesidad y psoriasis ungueal. Esta última puede presentar alteraciones de la matriz y/o del lecho ungueal, las que se pueden manifestar aisladamente o en conjunto. El diagnóstico de la artritis psoriática y de la psoriasis ungueal puede representar un verdadero desafío. Es de gran relevancia el diagnóstico temprano y el tratamiento correcto, ya que permiten preservar una mejor funcionalidad y calidad de vida de los pacientes.
Psoriatic arthritis is a chronic inflammatory pathology that can affect both axial and peripheral joints, belonging to the psoriatic spectrum. It is an underdiagnosed and undertreated condition, which can bring functional, labor and quality of life consequences in individuals suffering from it. About 30 percent of patients with psoriasis also have joint involvement. Risk factors for developing the disease include severe cutaneous psoriasis of more than 10 years, obese patients and nail psoriasis. Within the nail psoriasis, there are manifestations of the nail matrix and the nail bed, which can be manifested in isolation or in conjunction. However, the differential diagnosis of these lesions and psoriatic arthritis itself can be a real challenge. Early diagnosis and correct treatment depend to a large extent on our patients having better functionality and quality of life.
Assuntos
Humanos , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , Doenças da Unha/diagnóstico , Doenças da Unha/terapiaRESUMO
Skin manifestations associated with chronic kidney disease are very common. Most of these conditions present in the end stages and may affect the patient's quality of life. Knowledge of these entities can contribute to establishing an accurate diagnosis and prognosis. Severe renal pruritus is associated with increased mortality and a poor prognosis. Nail exploration can provide clues about albumin and urea levels. Nephrogenic systemic fibrosis is a preventable disease associated with gadolinium contrast. Comorbidities, such as diabetes mellitus and secondary hyperparathyroidism, can lead to acquired perforating dermatosis and calciphylaxis, respectively. Effective and innovative treatments are available for all of these conditions.
Assuntos
Insuficiência Renal Crônica/patologia , Dermatopatias/etiologia , Pele/patologia , Calciofilaxia/etiologia , Calciofilaxia/terapia , Comorbidade , Doenças do Cabelo/etiologia , Doenças do Cabelo/patologia , Doenças do Cabelo/terapia , Humanos , Doenças da Unha/etiologia , Doenças da Unha/patologia , Doenças da Unha/terapia , Dermopatia Fibrosante Nefrogênica/etiologia , Dermopatia Fibrosante Nefrogênica/terapia , Porfiria Cutânea Tardia/etiologia , Porfiria Cutânea Tardia/terapia , Prognóstico , Prurido/etiologia , Prurido/terapia , Insuficiência Renal Crônica/complicações , Dermatopatias/diagnóstico , Dermatopatias/patologia , Dermatopatias/terapia , Terapias em EstudoRESUMO
Os onicomatricomas são tumores benignos raros que se originam a partir da matriz ungueal e do estroma subjacente. São geralmente assintomáticos e de crescimento lento. Acometem igualmente homens e mulheres de meia idade, comprometendo com maior frequência os dígitos das mãos. As características clínicas fundamentais para o diagnóstico são: faixa longitudinal amarelada de espessura variável, estilhaços hemorrágicos, estrias longitudinais associadas à hipercurvatura transversal e projeções digitiformes emergentes da matriz ungueal. Os autores relatam três casos desse tumor acometendo pododáctilos, enfatizando seus principais aspectos clínicos, achados dermatoscópicos e tratamento cirúrgico.
Onychomatricomas are rare benign tumors originating from the nail matrix and underlying stroma. They are usually asymptomatic and slow growing, affecting both middle-aged men and women, and more frequently involve the digits of the hands. Key clinical features for diagnosis are: yellowish longitudinal band of variable width, splinter hemorrhages, longitudinal grooves associated with the transverse overcurvature and fingerlike projections emerging from the nail matrix. The authors report three cases of this tumor affecting toes, emphasizing main clinical aspects, dermoscopic findings, and surgical treatment.