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When all you have is a dermatoscope- start looking at the nails.

Haenssle HA, Blum A, Hofmann-Wellenhof R, Kreusch J, Stolz W, Argenziano G, Zalaudek I, Brehmer F - Dermatol Pract Concept (2014)

Bottom Line: The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma).Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis.Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany ; Department of Dermatology, Venereology and Allergology, University Medical Center Heidelberg, Heidelberg, Germany.

ABSTRACT
Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.

No MeSH data available.


Related in: MedlinePlus

Capillaroscopy with a dermatoscope. Dilated capillaries of the proximal nail fold and small hemorrhages of the cuticula (Ehring’s rhexis bleeding) in a young woman with mild sclerodactyly and suspected CREST syndrome. (A) Overview. (B) Dermatoscopy. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)
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f24-dp0404a02: Capillaroscopy with a dermatoscope. Dilated capillaries of the proximal nail fold and small hemorrhages of the cuticula (Ehring’s rhexis bleeding) in a young woman with mild sclerodactyly and suspected CREST syndrome. (A) Overview. (B) Dermatoscopy. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)

Mentions: Another useful indication for dermatoscopy of nails is the examination of the nail fold capillaries in patients with connective tissue diseases like systemic sclerosis (Figure 24A–B) [30]. In patients suffering from sclerodactyly, the evaluation of nail fold capillaries should include the degree of dilated capillaries, the extent of nail fold hemorrhage as well as avascular areas. The dermatoscopic documentation of dilated capillaries and/or nail fold hemorrhage is a sensitive and specific strategy for the diagnosis of systemic sclerosis [30].


When all you have is a dermatoscope- start looking at the nails.

Haenssle HA, Blum A, Hofmann-Wellenhof R, Kreusch J, Stolz W, Argenziano G, Zalaudek I, Brehmer F - Dermatol Pract Concept (2014)

Capillaroscopy with a dermatoscope. Dilated capillaries of the proximal nail fold and small hemorrhages of the cuticula (Ehring’s rhexis bleeding) in a young woman with mild sclerodactyly and suspected CREST syndrome. (A) Overview. (B) Dermatoscopy. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4230252&req=5

f24-dp0404a02: Capillaroscopy with a dermatoscope. Dilated capillaries of the proximal nail fold and small hemorrhages of the cuticula (Ehring’s rhexis bleeding) in a young woman with mild sclerodactyly and suspected CREST syndrome. (A) Overview. (B) Dermatoscopy. (Copyright: ©2014 Haenssle et al.; first published in Der Hautarzt, 2014, 65(4):301–11.)
Mentions: Another useful indication for dermatoscopy of nails is the examination of the nail fold capillaries in patients with connective tissue diseases like systemic sclerosis (Figure 24A–B) [30]. In patients suffering from sclerodactyly, the evaluation of nail fold capillaries should include the degree of dilated capillaries, the extent of nail fold hemorrhage as well as avascular areas. The dermatoscopic documentation of dilated capillaries and/or nail fold hemorrhage is a sensitive and specific strategy for the diagnosis of systemic sclerosis [30].

Bottom Line: The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma).Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis.Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany ; Department of Dermatology, Venereology and Allergology, University Medical Center Heidelberg, Heidelberg, Germany.

ABSTRACT
Pigmented and non-pigmented nail alterations are a frequent challenge for dermatologists. A profound knowledge of clinical and dermatoscopic features of nail disorders is crucial because a range of differential diagnoses and even potentially life-threatening diseases are possible underlying causes. Nail matrix melanocytes of unaffected individuals are in a dormant state, and, therefore, fingernails and toenails physiologically are non-pigmented. The formation of continuous, longitudinal pigmented streaks (longitudinal melanonychia) may either be caused by a benign activation of matrix melanocytes (e.g., as a result of trauma, inflammation, or adverse drug reactions) or by a true melanocytic proliferation (e.g., in a nevus or melanoma). In general, non-continuous nail alterations, affecting only limited parts of the nail apparatus, are most frequently of non-melanocytic origin. Important and common differential diagnoses in these cases are subungual hemorrhage or onychomycosis. In addition, foreign bodies, bacterial infections, traumatic injuries, or artificial discolorations of the nail unit may less frequently cause non-continuous nail alterations. Many systemic diseases that may also show involvement of the nails (e.g., psoriasis, atopic dermatitis, lichen planus, alopecia areata) tend to induce alterations in numerous if not all nails of the hands and feet. A similar extensive and generalized alteration of nails has been reported after treatment with a number of systemic drugs, especially antibiotics and cytostatics. Benign or malignant neoplasms that may also affect the nail unit include glomus tumor, Bowen's disease, squamous cell carcinoma, and rare collision tumors. This review aims to assist clinicians in correctly evaluating and diagnosing nail disorders with the help of dermatoscopy.

No MeSH data available.


Related in: MedlinePlus