Baran and Dawber's Diseases of the Nails and their Management E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 2504

Veröffentlichungsjahr: 2018

Beschreibung

The definitive guide to the science, diagnosis and treatment of all known nail diseases The fifth edition of Baran & Dawber's Diseases of the Nails and their Management continues to offer an encyclopedic account of the human nail that is unparalleled in its detail and scope. With contributions from some of the world s leading dermatologists, the book's exhaustive coverage encompasses the cosmetic and therapeutic management of every form of nail disease. High-quality images and diagrams illustrate and enhance this essential reference guide, while easy-to-navigate sub-chapters help you to find the information you need quickly and accurately. This book: * Is edited by Professor Robert Baran, the world's leading expert on the human nail, together with a team of world-renowned experts from across Europe and North America * Provides clinical information on all nail diseases * Aids differential diagnosis by color, shape, and location * Contains over 1,500 images * Includes access to a companion website featuring downloadable images and videos of nail procedures Whether they are new to the field or have been practicing for years, dermatologists, podiatrists, and all of those managing patients with nail diseases should have a copy of Baran & Dawber's Diseases of the Nails and their Management at their disposal.

Leseprobe

Table of Contents

Cover

List of Contributors

List of Abbreviations

Foreword

Preface

About the Companion Website

Part I: The Normal Nail and Nail Signs

Chapter 1: Science of the Nail Apparatus

Gross anatomy and terminology

Embryology

Regional anatomy

Vascular supply

Nerve supply

Comparative anatomy and function

Physiology

Physical properties of nails

References

Chapter 2: Physical Signs

Modification in the configuration of the nail unit

Modification of the nail surface

Modification of the nail plate and soft tissue attachments

Modification in perionychial tissues

Modification in the consistency of the nail

Modification in color: nail dyschromia, or discoloration, or chromonychia (see Appendix)

References

Part II: Imaging of the Nail Unit

Chapter 3: Nail Photography

Introduction

Why do we need dermatological photography?

When: respect and consent form

Which camera? Technical aspects

Photographing nails

Picture format

Photographic measuring scale

Post processing/computer‐aided analysis

Where and how to store images: medical imaging software

Legal aspects

References

Chapter 4: Dermoscopy

Introduction

Equipment/technical aspects

Basic dermoscopic semiology on nails [3, 7, 11]

Advanced dermoscopy techniques

Dermoscopy‐based differential diagnoses

References

Chapter 5: Ultrasound and Other Imaging Methods

ULTRASOUND IMAGING OF THE NAIL

Introduction

Ultrasound techniques

Normal sonographic anatomy of the nail

Benign pathology

Malignant pathology

Conclusion

OPTICAL COHERENCE TOMOGRAPHY

Introduction

Technology

Normal nail anatomy

Nail pathology

HIGH‐RESOLUTION PERIPHERAL QUANTITATIVE COMPUTED TOMOGRAPHY (HR‐pQCT)

References

Chapter 6: Magnetic Resonance Imaging

Introduction

Constraints on magnetic resonance imaging of the nail apparatus

Imaging sequences

Normal magnetic resonance appearance of the nail apparatus

Tumors of the nail apparatus

Conclusion

References

Chapter 7: Nail Fold Capillary Microscopy or Capillaroscopy

Introduction

Technology

Normal nail fold microvasculature

Capillary pathology

References

Chapter 8: Confocal Microscopy

Introduction

Equipment and technical aspects

Areas of interest

References

Part III: Nail Disorders Occurring Principally in Childhood

Chapter 9: Hereditary and Congenital Nail Disorders

CONGENITAL AND HEREDITARY DISORDERS INVOLVING THE NAILS

Introduction

Nail embryology

Anonychia

Ectodermal dysplasias

Disease loci and chromosome anomalies (Fig. 9.20)

Nail change in syndromes with predominantly skeletal anomalies

Isolated congenital nail dysplasia

Koilonychia (spoon nails) (MIM *149300)

Curved nail of the fourth toe (MIM 219070)

Overcurvature of the nails

Ectopic nails, onychoheterotopia (Figs 9.29–9.31)

Congenital malformations caused by drugs or infections (see also Chapter 16)

Nail discoloration

Epidermolysis bullosa (Figs 9.32–9.42)

Secondary nail changes and some miscellaneous nail conditions

MOSAIC DISORDERS INVOLVING THE NAIL REGION

Introduction

Hamartomas

Nail disorders reflecting functional X‐chromosome mosaicism

Other mosaic disorders involving the nail region

Porokeratotic eccrine nevus

References

Chapter 10: Nail Disorders in Childhood

Introduction

Composition and morphology of the nail in childhood

Nail morphology

Nail plate changes

Soft tissue features

Bacterial infections

Fungal infections

Dermatological diseases

Systemic diseases

Drug‐induced nail disorders

Benign tumors

Melanonychia and melanoma

Other malignant tumors

Trauma, finger sucking, and nail biting

Nail degloving

Infantile ingrown toenails

References

Part IV: Nail Disorders in the Elderly

Chapter 11: The Aging Nail and Related Disorders

Introduction

Modifications of the morphology and composition of the nail

Fungal infection of the nail

Iatrogenic nail changes

Benign tumors

Malignant tumors

Trauma from footwear and pedal deformities

Nail dystrophy from inadequate nail care

References

Part V: Nail Infections

Chapter 12: Fungal (Onychomycosis) and Other Infections Involving the Nail Apparatus

Introduction

ONYCHOMYCOSIS

Distal and lateral subungual onychomycosis

Superficial onychomycosis

Endonyx onychomycosis

Proximal subungual onychomycosis

Total dystrophic onychomycosis

Mixed pattern onychomycosis

Secondary onychomycosis

Paronychia

Diagnostic investigations

TREATMENT

Topical therapies

Systemic therapies

Non‐surgical devices for the treatment of onychomycosis

Surgical treatments

Management of special situations in onychomycosis

Other fungal infections

Infection in other chapters

References

Chapter 13: Bacterial, Viral, and Other Infections

Introduction

Viral infections

Bacterial infections

Mycobacterial infections

Infestations

Parasitic infections

References

Part VI: The Nail in Dermatological Conditions

Chapter 14: Dermatological Disorders

NON‐PSORIATIC DISORDERS

Pityriasis rubra pilaris

Pityriasis rosea

Pityriasis lichenoides acuta

Parakeratosis pustulosa

Lichen planus

Lichen striatus

Lichen nitidus

Lichen aureus

Keratosis lichenoides chronica

Eczema

Discoid lupus erythematosus

Bullous pemphigoid

Pemphigus

Darier disease

Stevens–Johnson syndrome and erythema multiforme

Toxic epidermal necrolysis

Alopecia areata

Porokeratosis

Acroosteolysis

Acrokeratoelastoidosis

Focal acral hyperkeratosis

Palmoplantar keratoderma

Granuloma annulare

Juvenile xanthogranuloma

Erythema elevatum diutinum

Pyoderma gangrenosum

Vitiligo

Nail degloving

PSORIASIS

Introduction/epidemiology/pathogenesis

Clinical features

Considerations in the diagnosis of nail psoriasis

Variants of nail psoriasis

Differential diagnosis

Associations

Imaging techniques

Quality of life

Severity scales

Management of nail psoriasis

Nail psoriasis and psoriatic arthritis

Psoriasis associated with other diseases

References

Part VII: The Nail in Systemic Conditions

Chapter 15: The Nail in Systemic Disease

Cardiac disorders

Circulatory disorders

Respiratory disorders

Gastrointestinal disorders

Hepatic disorders

Renal disorders

Reproductive system disorders

Endocrine disorders

Nervous system disorders

Psychological and psychiatric disorders

Musculoskeletal disorders

Hematological and lymphatic disorders

Connective tissue diseases

Immunological disorders

Infections

Nutritional disorders

Metabolic disorders

Nail changes associated with solid malignancies

Metastases to the nail unit

References

Chapter 16: Drug‐induced Nail Disorders

Introduction

Antimicrobial agents

Antiretroviral drugs

Antifungal drugs

Antimalarial agents

Drugs acting on the central nervous system

Antiinflammatory agents

Cardiovascular drugs

Anticoagulant drugs

Hormones

Cancer chemotherapeutic agents

Miscellaneous

Intoxicants

Heavy metal intoxications

References

Chapter 17: Anticancer Therapies

Chemotherapy and targeted therapies

Nail changes induced by chemotherapy

Nail changes induced by targeted therapies (Table 17.2)

Cancer immunotherapy

References

Part VIII: The Nail in Occupational, Podiatric, and Cosmetic Conditions

Chapter 18: Occupational Abnormalities and Contact Dermatitis

Definition

Diagnosis of occupational nail disorders

Etiology

Handicap, impairment, and disability

Clinical reaction patterns

Occupational nail hazards

Physical hazards

Non‐occupational nail hazards

Nail protection at work

Nail cosmetic hazards at work

References

Chapter 19: Cosmetics: the Care and Adornment of the Nail

The art of nail care

Basic manicure

Special products and procedures

Cure versus proper cure and allergic potential

Latest innovations in nail coatings

Medical issues related to artificial nail coatings

Conclusion

References

Chapter 20: Trauma from Footwear and Pedal Deformities

Introduction

Foot function

Constraints from footwear

Resulting clinical features

Foot shape and added orthopedic deformities

Management

References

Part IX: Nail Tumors and Surgery

Chapter 21: Tumors of the Nail Apparatus and Adjacent Tissues

Introduction

Epithelial tumors

Soft tissue tumors

Vascular tumors

Osteocartilaginous tumors

Synovial tumors

Lipomatous and myxomatous tumors

Sarcomas

Pseudotumors

Histiocytic, lymphomatous, and metastatic processes

Melanocytic lesions

References

Chapter 22: Nail Surgery

Introduction

Surgical anatomy

Preoperative measures and preparation of the patient

Instrumentation

Anesthesia

Nail avulsion

Biopsy of the nail area

Closures of defects at the nail apparatus

Microscopically controlled surgery

Ingrown toenails

Pincer nail

Retronychia

Non‐scalpel techniques

Trauma

Surgery for congenital abnormalities

Complications in nail surgery

Postoperative pain management

Dressings

References

Appendix

Index

End User License Agreement

List of Tables

Chapter 1

Table 1.1 Clinical appearance of distal zones of the nail bed.

Table 1.2 Keratins and their former designations (www.interfil.org/proteinsTy...

Table 1.3 Number of melanocytes found per millimeter of matrix in normal and ...

Table 1.4 Keratins in the nail unit.

Table 1.5 Analysis of the nail unit basement membrane zone using monoclonal a...

Table 1.6 Proportion of diagnoses of dogs with disorders of the claws from a stu...

Table 1.7 Mineral content (expressed as mg/kg, standard error in parentheses).

Table 1.8 Factors determining rate of nail growth.

Table 1.9 Nail constituents and means of nail analysis.

Chapter 3

Table 3.1 Digital camera types.

Chapter 9

Table 9.1 Non‐syndromic congenital nail disorders.

Table 9.2 Hereditary ectodermal dysplasia (ED) with nail changes.

Table 9.3 Ectodermal dysplasias (EDs) with nail and teeth changes: hair and s...

Table 9.4 Ectodermal dysplasia (ED) with hair and/or skin changes but without...

Table 9.5 Atrophic or hypoplastic nails with skeletal anomalies.

Table 9.6 Hereditary forms of clubbed fingernails.

Table 9.7 Hereditary forms of broad nails and some also with pseudoclubbing. ...

Table 9.8 Conditions with congenital and/or hereditary discoloration of nails...

Table 9.9 Nails in patients with epidermolysis bullosa (EB).

Table 9.10 Hereditary disorders with secondary nail changes.

Table 9.11 Various hereditary, familial or congenital disorders with nail inv...

Chapter 10

Table 10.1 Features of fingernails and toenails in infants.

Chapter 12

Table 12.1 Causes of clinical patterns of onychomycosis.

Table 12.2 Subtypes of chronic mucocutaneous candidosis (CMC).

*

Table 12.3 Comparative efficacies of antifungal agents for onychomycosis.

Chapter 14

Table 14.1 Available treatments for nail psoriasis [343].

Table 14.2 Management of exacerbating factors in nail psoriasis.

Chapter 17

Table 17.1 Proposed algorithm for taxane‐related onycholysis.

Table 17.2 Main nail toxic effects induced by targeted anticancer therapies. ...

Chapter 18

Table 18.1 Nail plate color alterations.

Table 18.2 Clubbing and pseudoclubbing.

Table 18.3 General guidance on glove materials.

*

Chapter 19

Table 19.1 Implements used to manicure the natural nail.

Table 19.2 Overview of nail wraps.

Table 19.3 Overview of the so‐called “liquid and powder” type of artificial n...

Table 19.4 Overview of ultraviolet gels.

Chapter 21

Table 21.1 Difference between keratoacanthoma (KA) on the skin and under the ...

Table 21.2 Differentiation between subungual keratoacanthoma (KA) and squamou...

Table 21.3 Hallmark clinical and dermoscopic signs of onychomatricoma [215].

Table 21.4 Differential diagnostic features of fibrokeratoma and subungual fi...

Table 21.5 Drugs associated with development of ungual pyogenic granuloma and...

Table 21.6 Differential diagnosis of subungual exostosis and osteochondroma.

Table 21.7 Differential features of exostosis, osteochondroma, enchondroma, ...

Table 21.8 Differentiation between osteoid osteoma and benign osteoblastoma.

Table 21.9 Pigmented nail associated with non‐melanoma Hutchinson’s sign.

Table 21.10 Correspondence between clinical warning signs of subungual and cutane...

Table 21.11 Modalities of treatment of subungual melanoma [1203].

Chapter 22

Table 22.1 Different types of ingrowing nails.

Table 22.2 Causes of acquired pincer nails.

List of Illustrations

Chapter 1

Figure 1.1 (a,b) Longitudinal section of a digit showing the dorsal nail appa...

Figure 1.4 Distal nail matrix and nail bed in longitudinal excision. (a,b) Lo...

Figure 1.5 (a) Onychodermal band. (b) Diagrammatic representation of the morp...

Figure 1.6 Distal nail unit in longitudinal excision. Onychodermal band (A) a...

Figure 1.7 Embryogenesis of the nail apparatus. 10 weeks, The primary nail fi...

Figure 1.8 Use of nail template for nail biopsy specimen submission. (a) Befo...

Figure 1.9 Use of nail softeners in tissue processing. (a) Nail plate and pun...

Figure 1.10 Longitudinal nail biopsy of Zaias. (a) Before biopsy; (b) 5 weeks...

Figure 1.11 A granular layer is absent from the germinal matrix (lower part) ...

Figure 1.12 Keratin stain of the nail apparatus delineating the epithelial st...

Figure 1.13 Pertinax bodies can be seen as the nuclear remnants within the na...

Figure 1.14 Normal nail matrix melanocytic density in punch biopsy. (a) Melan...

Figure 1.15 The epidermis of the nail bed has longitudinal ridges visible aft...

Figure 1.16 The undersurface of the nail plate shows longitudinal ridging tha...

Figure 1.17 The appearance of splinter hemorrhages. Heme from longitudinal na...

Figure 1.18 The undersurface of the nail has dark‐stained blood in the longit...

Figure 1.19 Sweat pores in the distal nail bed.

Figure 1.20 Comparison of keratin expression in the human and mouse nail unit...

Figure 1.21 The histochemistry of the human nail plate (after Jarrett and Spe...

Figure 1.22 Nail plate association with soft tissue and bone in the finger an...

Figure 1.23 Scanning electron micrograph of the nail bed demonstrating longit...

Figure 1.24 Shaded areas represent 7‐day periods of nail growth, separated by...

Figure 1.25 Fungal spores and hyphae can be seen in the stained section of a ...

Figure 1.26 (a) Upper part of the nail plate showing ampullar dilatations (A)...

Figure 1.27 (a,b) Upper part of the nail plate as shown in Fig. 1.26, in grea...

Figure 1.28 (a) Transmission electron micrograph of the upper part of the nai...

Figure 1.29 Corneocytes of the lowest part of the nail plate (Lp) sending out...

Figure 1.30 Intercellular junctions of the three parts of the nail: 1, upper ...

Figure 1.31 Arterial supply of the distal finger.

Figure 1.32 Capillary loops visible in the proximal nail fold.

Figure 1.33 Dermoscopy of normal nail fold vessels (×10).

Figure 1.34 Nail unit dermis in punch biopsy. (a) Low magnification of nail u...

Figure 1.35 Sensory supply of the hand.

Figure 1.36 Models of hair follicle/nail unit homology.

Figure 1.37 Localization of immunoreactivity of the hard keratin Ha‐1 in (a) ...

Figure 1.38 Comparison of hoof, nail, and claw and their matrix (red) origins...

Figure 1.39 Macroanatomy of the human nail and mouse unit. Dorsal view of the...

Figure 1.40 Light microscopy of the nail unit. The human nail unit (a–f). (a)...

Figure 1.41 Keratin expression in the mouse nail unit. Longitudinal sections ...

Figure 1.42 Theories of nail plate origin. PNF, proximal nail fold.

Figure 1.43 Vestigial solenhorn seen as focal subungual hyperkeratosis.

Figure 1.44 Change in shape and direction of the cells within the skin epider...

Figure 1.45 Why do nails grow out instead of up? (a) Four physical forces act...

Figure 1.46 Relationship of lunula to nail tip shape.

Figure 1.47 (a–d) Regrowth of the fingernail following traumatic avulsion. Th...

Figure 1.48 T‐shaped mark etched on nail for nail growth measurement.

Figure 1.49 Methods of nail growth measurement. (a) Reference point, cuticle....

Figure 1.50 Side view of a nail with Beau’s line, indicating the change in na...

Figure 1.51 Effect of therapy on nail growth in psoriasis.

Chapter 2

Figure 2.1 Clubbing. Lovibond’s “profile” sign: the angle is normally less th...

Figure 2.4 (a) Clubbing in pachydermoperiostosis. (b) Pachydermoperiostosis, ...

Figure 2.5 Koilonychia.

Figure 2.6 Koilonychia in trichoonychotic hidrotic ectodermal dysplasia.

Figure 2.7 Transverse overcurvature showing the three subtypes.(a) Pincer or ...

Figure 2.8 Pincer nail deformity.

Figure 2.9 The unilateral variety may have a lateral pincer or a plicated lat...

Figure 2.10 Brachyonychia. (a) Unilateral right thumb (

left of image

). (b) Ra...

Figure 2.11 Parrot beak nail: different degrees between (a) and (b). (c) Curv...

Figure 2.12 Macronychia associated with megadactyly.

Figure 2.13 (a) Duplication of the nail. . (b) Duplication of the nail: diagr...

Figure 2.14 (a) Shiny, “worn down” nails. (b) Triangular defect involving the...

Figure 2.15 Scleroatrophy associated with lichen planus.

Figure 2.16 (a) Anonychia of all the digits. (b) Severe anonychia involving t...

Figure 2.17 Severe anonychia with bone defect.

Figure 2.18 Pachyonychia congenita (Jadassohn–Lewandowsky syndrome).

Figure 2.19 (a) Onychogryphosis. (b) Onychogryphosis following peripheral ner...

Figure 2.20 Onychogryphosis due to psoriasis. (a) Dorsal aspect. (b) Ventral ...

Figure 2.21 Median canaliform (Heller) dystrophy: (a) early; (b) later; (c) i...

Figure 2.22 Longitudinal ridging with a “beaded” appearance.

Figure 2.23 Beau’s lines.

Figure 2.25 Latent onychomadesis.

Figure 2.26 Multiple transverse grooves of thumbs: a “habit–tic” deformity.

Figure 2.27 Pitting of the nails due to psoriasis. Irregular sized pits can b...

Figure 2.28 (a) Rippled lines of pits. (b) Pitting: (i) regular; (ii) rippled...

Figure 2.29 Trachyonychia: a sandpapered appearance.

Figure 2.30 Trachyonychia: shiny but fine stippled opalescent, longitudinal r...

Figure 2.31 Onychoschizia lamellina (lamellar splitting).

Figure 2.32 Elkonyxis. (a) Late; (b) early.

Figure 2.33 (a) Congenital dorsal pterygium. (b) Dorsal pterygium in lichen p...

Figure 2.34 Ventral pterygium (pterygium inversum unguis).

Figure 2.35 (a) Ventral pterygium. (b) Ventral pterygium associated with lent...

Figure 2.36 (a) Lyell syndrome periungual bullae. (b) Lyell syndrome onych...

Figure 2.37 (a) Onychomadesis, “retronychia” type. (b) Retronychia. Multiple ...

Figure 2.38 Onycholysis:

Candida

associated with

Pseudomonas

.

Figure 2.39 Onycholysis, with rolling or coiling of the nail plate (psoriasis...

Figure 2.40 Huge subungual keratosis lifting up the normal nail plate.

Figure 2.41 (a) Subungual hyperkeratosis of “keratosis cristarum” type. (b) H...

Figure 2.42 (a) Painful dorsolateral distal fissures. (b) Psoriatic type.

Figure 2.43 (a) Onychorrhexis: shallow parallel furrow in the superficial nai...

Figure 2.44 Transverse splitting of the lateral edges.

Figure 2.45 (a) Friability of the nail surface, here caused by nail cosmetic ...

Figure 2.46 (a) Discoloration following the shape of the proximal nail fold t...

Figure 2.47 Pseudoleukonychia due to

Scopulariopsis brevicaulis

.

Figure 2.48 (a) Total leukonychia. (b) Transverse leukonychia due to repeated...

Figure 2.49 Isolated longitudinal leukonychia.

Figure 2.50 Apparent leukonychia: Terry’s type, associated with cirrhosis.

Figure 2.51 Uremic “half‐and‐half” nail.

Figure 2.52 Apparent leukonychia: Muehrcke’s paired narrow white bands.

Figure 2.53 Red lunulae with longitudinal erythronychia.

Figure 2.54 Ethnic pigmentation.

Figure 2.55 Trichrome vitiligo. (a) First stage. (b) Final stage.

Figure 2.56 Nail bed pigmentation.

Chapter 3

Figure 3.1 Ashique and Kaliyadin’s proposed hand position, in which all eight...

Figure 3.2 Gupta and Gupta’s proposed hand position: both hands are kept flat...

Figure 3.3 Inamadar and Palit’s all‐inclusive nail position.

Figure 3.4 Suggested position for the feet.

Figure 3.5 One of the proposed positions of the subject in relation to the ph...

Figure 3.6 (a) Polarized and (b) non‐polarized photographs of a patient with ...

Chapter 4

Figure 4.1 Immersion contact dermoscopy.

Figure 4.2 Polarized light non‐contact dermoscopy.

Figure 4.3 Photodermoscopy with an immersion contact non‐polarized optical sy...

Figure 4.4 Dermoscopy of the free edge of the nail plate (a) and free edge de...

Figure 4.5 Intraoperative non‐contact polarized light photodermoscopy of the ...

Figure 4.6 Digital dermoscopy of the nail unit (a). Significant changes are o...

Figure 4.7 Blood spots have a sharp round proximal edge and a somewhat filame...

Figure 4.8 Blood spots of different ages in a repetitive trauma‐induced subun...

Figure 4.9 Invasive squamous cell carcinoma of the left thumbnail revealed by...

Figure 4.10 Brown background of the longitudinal band indicates that signific...

Figure 4.12 Dark brown background color in a benign nail matrix nevus in a Fi...

Figure 4.13 Pigmented Bowen disease (in situ squamous cell carcinoma) of the ...

Figure 4.14 Bowen disease (in situ squamous cell carcinoma) of periungual ski...

Figure 4.15 Dermoscopic gray color of the band indicates that no prominent me...

Figure 4.16 Ethnic‐type pigmentation in a Fitzpatrick’s type V patient. Note ...

Figure 4.17 Regular pattern of dermoscopic longitudinal pigmented microlines:...

Figure 4.18 Benign melanocytic nevus of the nail matrix of the fifth toenail ...

Figure 4.19 Irregular pattern of dermoscopic longitudinal microlines: lines a...

Figure 4.20 Nail matrix acral lentiginous in situ melanoma of the second fing...

Figure 4.21 Micro‐Hutchinson’s sign: presence of subtle true pigmentation of ...

Figure 4.22 Micro‐Hutchinson’s sign: presence of subtle true pigmentation of ...

Figure 4.23 Atypical Hutchinson’s sign defined by the presence of at least on...

Figure 4.24 Atypical Hutchinson’s sign: parallel ridge pattern recognized by ...

Figure 4.25 Longitudinal xantholeukonychia: it may be only white or only yell...

Figure 4.26 Longitudinal xantholeukonychia with the combination of both color...

Figure 4.27 Band‐shaped multiple splinter hemorrhages.

Figure 4.28 Band‐shaped multiple longitudinal splinter hemorrhages in a nail ...

Figure 4.29 Longitudinal erythronychia with an enlarged (club‐like) proximal ...

Figure 4.30 Longitudinal erythronychia with an enlarged proximal end in a sub...

Figure 4.31 Distal triangular nail plate erosion (a) and localized subungual ...

Figure 4.32 Onychopapilloma: note the longitudinal erythronychia is not clubb...

Figure 4.33 Polychromia defined by the presence of four or more colors among ...

Figure 4.34 Dermoscopic polychromia (red, white, gray, light brown) in a nail...

Figure 4.35 Atypical pattern of the vessels is dermoscopically defined by at ...

Figure 4.36 Atypical pattern of the vessels (dots, linear, and comma‐like ves...

Figure 4.37 Blue (or purple), red, and yellow spots.

Figure 4.38 Yellow spot in a subungual exostosis.

Figure 4.39 Red spot in an area of plate erosion in a nail matrix Clark’s lev...

Figure 4.40 (a,b) Purple spot in a subungual glomus cell tumor. Note that der...

Figure 4.41 Squamous cell carcinoma (invasive) of the nail matrix on the left...

Figure 4.43 Invasive squamous cell carcinoma of the left thumbnail. Note the ...

Figure 4.44 Examination of the free edge of the nail plate to estimate locati...

Figure 4.45 Nevus of the nail matrix in an 18‐year‐old male patient (a). Imme...

Figure 4.46 Nail matrix in situ melanoma in a 24‐year‐old male patient (a). I...

Figure 4.47 Nail bed and nail matrix squamous cell carcinoma (a). Immersion d...

Figure 4.48 Onychomatricoma: preoperative view of the tumor (a) and non‐conta...

Figure 4.49 Lentigo of the nail matrix in a 59‐year‐old female patient (a). D...

Figure 4.50 Dermoscopic views of melanonychia striata of the fourth left toen...

Figure 4.51 Clinical (a) and dermoscopic (b) views of melanonychia striata of...

Figure 4.52 Clark’s level II acral lentiginous melanoma of the left great toe...

Figure 4.53 Clark’s level II acral lentiginous melanoma of the nail matrix of...

Figure 4.54 Clark’s level III acral lentiginous melanoma of the right thumbna...

Figure 4.55 Acral lentiginous in situ melanoma with a simultaneous subungual ...

Figure 4.56 Ulcerated Clark’s level IV acral lentiginous amelanotic melanoma ...

Figure 4.57 Ulcerated Clark’s level V acral lentiginous amelanotic melanoma o...

Figure 4.58 Congenital nevus on the first left toenail in a 1‐year‐old male p...

Figure 4.59 Congenital nevus of the right thumbnail in a 3‐month‐old female p...

Figure 4.60 Congenital nevus of the left thumbnail in a 5‐day‐old female pati...

Figure 4.61 Congenital nevus on the second right toenail in a 2‐year‐old fema...

Figure 4.62 Congenital nevus on the third right toenail in a 1‐year‐old skin ...

Figure 4.63 Congenital nevus on the fourth right toenail in a 3‐year‐old fema...

Figure 4.64 Evolution after 3 years in the patient shown in Fig. 4.60. Note t...

Figure 4.65 Evolution after 7 years of the patient shown in Figs 4.60 and 4.6...

Figure 4.66 Laugier–Hunziker lentiginoses involving the mucous membranes and ...

Figure 4.67 Chronic (repetitive) trauma‐induced pigmentation of the right sec...

Figure 4.68 Drug‐induced pigmentation by bleomycin. Note the gray coloration ...

Figure 4.69 Onychomatricoma of the third right finger. Note the longitudinal ...

Figure 4.70 Blue nevus of the nail matrix. Note the presence of a somewhat sh...

Figure 4.71 Double glomus cell tumor in a patient with a past history of trau...

Chapter 5

Figure 5.1 Normal sonographic anatomy of the nail. (a) Ultrasound in longitud...

Figure 5.2 Congenital hypertrophic lip of the hallux. (a) Clinical photograph...

Figure 5.3 Congenital autosomal recessive ichthyosis. (a) Clinical photograph...

Figure 5.4 Alopecia areata. (a) Clinical photograph. (b) Ultrasound (longitud...

Figure 5.5 Ingrowing toenail – onychocryptosis. (a) Clinical photograph. (b) ...

Figure 5.6 Onychomadesis. (a) Ultrasound (longitudinal view) shows two fragme...

Figure 5.7 Retronychia. (a) Clinical photograph of the left great toe. (b) Ri...

Figure 5.8 Psoriasis. (a) Ultrasound (grayscale; longitudinal view) shows thi...

Figure 5.9 Psoriatic onychopathy monitoring of activity. (a) Power Doppler ul...

Figure 5.10 Scleroderma. (a) Clinical photograph. (b) Ultrasound (longitudina...

Figure 5.11 Calcinosis cutis secondary to dermatomyositis. (a) Clinical photo...

Figure 5.12 Lupus erythematous. (a) Clinical photograph. (b) Color Doppler ul...

Figure 5.13 Lupus. (a) Clinical photograph. (b) Ultrasound (longitudinal view...

Figure 5.14 Rheumatoid arthritis. (a) Color Doppler ultrasound (longitudinal ...

Figure 5.15 Subungual abscess. (a) Clinical photograph. (b) Ultrasound (longi...

Figure 5.16 Subungual abscess with air. (a) Clinical photograph. (b) Ultrasou...

Figure 5.17 Periungual fistula. (a) Clinical photograph. (b) Ultrasound (long...

Figure 5.18 Subungual foreign body. (a) Clinical photograph of a patient pres...

Figure 5.19 Median canalicular nail dystrophy. (a) Clinical photograph. (b) U...

Figure 5.20 Acrylic nail. (a) Clinical photograph. (b) Ultrasound (longitudin...

Figure 5.21 Glomus tumor proximally located. (a) Clinical photograph. (b) Ult...

Figure 5.22 Glomus tumor distally located. (a) Ultrasound (longitudinal view)...

Figure 5.23 Angiofibroma. (a) Clinical photograph. (b) Ultrasound (longitudin...

Figure 5.24 Fibroma. (a) Clinical photograph. (b) Ultrasound (transverse view...

Figure 5.25 Onychomatricoma. (a) Clinical photograph. (b) Color Doppler ultra...

Figure 5.26 Perineurioma. (a) Ultrasound (longitudinal view) shows a hypoecho...

Figure 5.27 Subungual keratoacanthoma. (a) Ultrasound (grayscale, longitudina...

Figure 5.28 Subungual granuloma. (a) Ultrasound (longitudinal view) shows the...

Figure 5.29 Telangiectatic granuloma. (a) Clinical photograph. (b) Color Dopp...

Figure 5.30 Subungual warts. (a) Ultrasound (longitudinal view) shows a hypoe...

Figure 5.31 Mucous cyst. (a) Clinical photograph. (b) Color Doppler ultrasoun...

Figure 5.32 Subungual exostosis. Two exostosis cases affecting the left great...

Figure 5.33 Periungual pyogenic (telangiectatic) granuloma. (a) Clinical phot...

Figure 5.34 Periungual fibroma. (a) Clinical photograph. (b) Ultrasound (long...

Figure 5.35 Myxoid (synovial) cyst. Two cases showing myxoid cysts. (a) Clini...

Figure 5.36 Melanoma in situ. (a) Clinical photograph. (b) Ultrasound (longit...

Figure 5.37 Melanoma. (a) Clinical photograph of the lesion on the left thumb...

Figure 5.38 Squamous carcinoma. (a) Clinical photograph of the lesion at the ...

Figure 5.39 Conventional optical coherence tomography of a normal human nail....

Figure 5.40 Dynamic optical coherence tomography image of a normal nail. (a) ...

Figure 5.41 Assessment of the distal digital compartment. (a) Example of one ...

Chapter 6

Figure 6.1 Sagittal three‐dimensional 1‐mm‐thick T2‐weighted image. 1, proxim...

Figure 6.2 Axial T1‐weighted spin echo image at the level of the interphalang...

Figure 6.3 (a) Axial 1‐mm‐thick three‐dimensional T2‐weighted gradient echo i...

Figure 6.4 Axial 1‐mm‐thick three‐dimensional T2‐weighted gradient echo image...

Figure 6.5 Magnetic resonance angiography (mainly arterial phase). Coronal ma...

Figure 6.6 Mucoid pseudocyst. (a) Lateral radiograph shows thickening of the ...

Figure 6.7 Mucoid pseudocyst of the posterior nail fold. Sagittal ultrasonogr...

Figure 6.8 Mucoid pseudocyst of the posterior nail fold and the subungual are...

Figure 6.9 Mucoid pseudocyst of the posterior nail fold. Sagittal (a) and axi...

Figure 6.10 Painful subungual mucoid pseudocyst. Axial T1‐weighted spin echo ...

Figure 6.11 Subungual mucoid pseudocyst. Sagittal T2‐weighted three‐dimension...

Figure 6.12 Subungual mucoid pseudocyst. (a) Sagittal T2‐weighted three‐dimen...

Figure 6.13 Periungual wart. Axial three‐dimensional gradient echo image at t...

Figure 6.14 Keratoacanthoma (arrows). Magnetic resonance sagittal gradient ec...

Figure 6.15 Subungual keratin cyst. Well‐defined bone erosion of the dorsal c...

Figure 6.16 Calcifying keratin cyst. The calcifications are in the area invol...

Figure 6.17 Subungual keratin cyst. (a) Sagittal T2‐weighted gradient echo: w...

Figure 6.18 Subungual keratin cyst. (a) Coronal power Doppler image shows the...

Figure 6.19 Keratin cyst. Axial postenhanced fat saturation T1‐weighted image...

Figure 6.20 Onychomatricoma of the thumb. Sagittal (a) and axial (b) gradient...

Figure 6.21 Onychomatricoma of the third finger. Axial T2‐weighted image at t...

Figure 6.22 Onychomatricoma of the left great toe. Parasagittal T1‐weighted s...

Figure 6.23 Acquired fibrokeratoma: deep implantation on the distal matrix. (...

Figure 6.24 Subungual fibroma (arrows). Axial postenhanced T1‐weighted spin e...

Figure 6.25 Glomus tumor with intraosseous extension. Lateral radiograph (a) ...

Figure 6.26 Glomus tumor. (a) Sagittal ultrasonography imaging: submatrical i...

Figure 6.27 Glomus tumor, common vascular type. (a) Axial ultrasonography (US...

Figure 6.28 Glomus tumor, vascular type. (a) Axial postenhanced gradient echo...

Figure 6.29 Glomus tumor. Magnetic resonance angiography at the arterial phas...

Figure 6.30 Glomus tumor, solid type. Axial postenhanced gradient echo image....

Figure 6.31 Glomus tumor, mixed type. Axial postenhanced gradient echo magnet...

Figure 6.32 Multiple glomus tumors. (a) Coronal magnetic resonance angiograph...

Figure 6.33 Recurrent glomus tumor 3 years after surgery. Axial postenhanced ...

Figure 6.34 Lateral glomus tumor. Axial T1‐weighted spin echo image before (a...

Figure 6.35 Cavernous hemangioma. Lateral radiograph with a volar mass in the...

Figure 6.36 Low‐flow malformation of the lateral nail fold. High signal of th...

Figure 6.37 High‐flow vascular malformation of the lateral nail fold and the ...

Figure 6.38 Lobular capillary hemangioma. Axial postenhanced gradient echo im...

Figure 6.39 Posttraumatic neuroma (arrow). Axial postenhanced T1‐weighted spi...

Figure 6.40 Neurofibroma of the nail bed (arrows). (a) Axial proton density‐w...

Figure 6.41 Giant cell tumor of the flexor tendon sheath. Sagittal ultrasonog...

Figure 6.42 Giant cell tumor of the tendon sheath. (a) Sagittal short time in...

Figure 6.43 Subungual exostosis. Posteroanterior radiograph.

Figure 6.44 Subungual exostosis with a high‐signal hyaline cartilage cap (arr...

Figure 6.45 Subungual exostosis with a 1‐mm‐thick fibrocartilage cap (arrows)...

Figure 6.46 Subungual exostosis with immature bone. (a) Sagittal three‐dimens...

Figure 6.47 Enchondroma of the distal phalanx. (a) Posteroanterior radiograph...

Figure 6.48 Ollier disease. Multiple exenterate chondromas (arrows) involving...

Figure 6.49 Extraosseous chondroma. Axial T2‐weighted spin echo image: high‐s...

Figure 6.50 Osteoid osteoma of the distal phalanx. (a) Posteroanterior radiog...

Figure 6.51 Osteoid osteoma of the distal phalanx. (a) Lateral radiograph: os...

Figure 6.52 Osteoid osteoma of the distal phalanx. Non‐specific osteosclerosi...

Figure 6.53 Osteoid osteoma of the distal phalanx. Sagittal postenhanced grad...

Figure 6.54 Osteoid osteoma of the distal phalanx. (a) Sagittal T2‐weighted s...

Figure 6.55 Giant cell bone tumor of the distal phalanx. (a) Posteroanterior ...

Figure 6.56 Subungual malignant melanoma. Sagittal T2‐weighted gradient echo ...

Figure 6.57 Grade 2 chondrosarcoma of the distal phalanx with invasion of the...

Chapter 7

Figure 7.1 (a) Clinical photograph taken with an ordinary dermoscope. (b) Ima...

Figure 7.2 Normal capillaroscopic features. The distal row has 9–13 evenly sp...

Figure 7.3 Basic abnormal capillaroscopic features. Capillaries may differ in...

Chapter 8

Figure 8.1 (a) Onychomycosis. (b) In vivo reflectance confocal microscopy thr...

Figure 8.2 (a) Acral lentiginous melanoma of the nail matrix, Clark’s level I...

Figure 8.3 (a) Onychomatricoma. Dermoscopy (b), dermoscopy of the free edge (...

Figure 8.4 (a) Squamous cell carcinoma of the nail bed. Dermoscopy (b), surgi...

Figure 8.5 (a) Subungual glomus cell tumor of the nail bed. The lesion was al...

Figure 8.6 (a) Subungual neuroma. (b) Extemporaneous ex vivo fluorescence con...

Chapter 9

Figure 9.1 Anonychia/hyponychia.

Figure 9.2 Anonychia/hyponychia in deafness, onychoosteodystrophy, and mental...

Figure 9.3 Syndactyly.

Figure 9.4 Syndactyly: radiographic changes in the digits of the patient in F...

Figure 9.5 Anonychia: pseudoamputee appearance.

Figure 9.6 Coffin–Siris syndrome: absence of the fifth finger.

Figure 9.7 Nail–patella syndrome: hypoplastic lunula.

Figure 9.8 Nail–patella syndrome: triangular, pointed lunula.

Figure 9.9 Nail–patella syndrome: radiograph showing aplastic patellae.

Figure 9.10 Nail–patella syndrome: radiograph showing bilateral posterior ili...

Figure 9.11 Hypohidrotic ectodermal dysplasia: nail dystrophy.

Figure 9.15 Poikiloderma acrokeratotica. Weary syndrome (see Table 9.2).

Figure 9.16 (a,b) Pachyonychia congenita.

Figure 9.17 Pachyonychia congenita.

Figure 9.18 (a,b) Dyskeratosis congenita.

Figure 9.19 Trichothiodystrophy (thin nails and slight koilonychia).

Figure 9.20 Turner syndrome (Table 9.6). Narrow hypoplastic nails associated ...

Figure 9.21 Fused digits and nails.

Figure 9.22 Radiograph of digits in Fig. 9.21 showing that only the terminal ...

Figure 9.23 Types of micronychia and other dystrophies seen particularly in c...

Figure 9.25 Congenital onychodystrophy of the index fingers (COIF) syndrome: ...

Figure 9.26 Congenital onychodystrophy of the index fingers (COIF) syndrome: ...

Figure 9.27 Congenital “onycholysis.”

Figure 9.28 Congenital onychogryphosis.

Figure 9.29 Ectopic nail.

Figure 9.31 Ectopic nail on the palmar surface of the fingertip.

Figure 9.32 Recessive dystrophic epidermolysis bullosa dystrophica, generaliz...

Figure 9.42 Junctional epidermolysis bullosa, localized: 27‐year‐old woman wi...

Figure 9.43 Keratotic papule in a patient with Cowden syndrome. (a) Clinical ...

Figure 9.44 Acral lesions of eccrine angiomatous hamartoma, causing destructi...

Figure 9.45 CHILD (congenital hemidysplasia with ichthyosiform nevus and limb...

Figure 9.46 Pathognomonic strawberry‐like acral hamartoma, originating from t...

Figure 9.47 Strawberry‐like acral hamartoma in an 8‐year‐old girl with CHILD ...

Figure 9.48 Painful nail changes as a clue to recognize incontinentia pigment...

Figure 9.49 V‐shaped notches in the distal free margin of the nail plate in a...

Figure 9.50 Asymmetrical anomalies in females with Börjeson–Forssman–Lehmann ...

Figure 9.51 Superimposed linear lichen nitidus involving the thumb nail in a ...

Figure 9.52 Unilateral systematized linear porokeratosis causing onychodystro...

Chapter 10

Figure 10.1 (a) Koilonychia of the great toenails. (b) Lamellar splitting of ...

Figure 10.2 (a) Herringbone nail. (b) Temporary, oblique ridges of early chil...

Figure 10.3 Transverse depressions.

Figure 10.4 Transverse lines in great toenail malalignment.

Figure 10.5 Acute paronychia.

Figure 10.6 (a) Impetigo involving the proximal nail fold with subsequent ony...

Figure 10.7 Blistering distal dactylitis.

Figure 10.8 Subungual

Veillonella

infection.

Figure 10.9 Leiner disease.

Figure 10.10 Nail pitting in childhood. Psoriasis pits are irregular in size ...

Figure 10.11 Pitting of a few digits in childhood psoriasis.

Figure 10.12 Mild nail pitting associated with splinter hemorrhages and onych...

Figure 10.13 Nail psoriasis in children: onycholysis and subungual hyperkerat...

Figure 10.14 Thickening of the toenails due to psoriasis in a child.

Figure 10.15 Psoriatic trachyonychia in a 15‐year‐old boy.

Figure 10.16 Childhood nail psoriasis with fingernail and toenail involvement...

Figure 10.17 Childhood nail psoriasis presenting with severe subungual hyperk...

Figure 10.18 Nail psoriasis in a child who bites the nail: subungual hyperker...

Figure 10.19 Psoriasis of the thumb associated with psoriatic arthritis of th...

Figure 10.20 Hallopeau’s acrodermatitis continua in a 12‐year‐old girl: onych...

Figure 10.21 Parakeratosis pustulosa: eczematous changes of the distal pulp a...

Figure 10.22 Parakeratosis pustulosa. (a) Clinical features. (b,c) Histology....

Figure 10.23 Parakeratosis pustulosa: pitting and nail plate surface abnormal...

Figure 10.24 Parakeratosis pustulosa: eczematous changes of the distal pulp a...

Figure 10.25 Nail lichen planus in children, longitudinal fissures and nail t...

Figure 10.26 Nail lichen striatus: lichenoid nail changes associated with red...

Figure 10.27 Nail lichen striatus: longitudinal fissures and distal nail spli...

Figure 10.28 Nail lichen striatus: longitudinal fissures, distal nail splitti...

Figure 10.29 Nail lichen striatus of the great toenail (a). Spontaneous regre...

Figure 10.30 Opaque trachyonychia: the nails are opaque and vertically striat...

Figure 10.33 Opaque trachyonychia involving all 20 nails.

Figure 10.34 Shiny trachyonychia: multiple small pits oriented longitudinally...

Figure 10.35 Shiny trachyonychia: multiple small pits oriented longitudinally...

Figure 10.36 Trachyonychia: some nails show the shiny variety and some the op...

Figure 10.37 Chronic paronychia.

Figure 10.38 Atopic dermatitis involving the fingers.

Figure 10.39 Half‐and‐half nails in a uremic child.

Figure 10.40 Capillaroscopy of systemic lupus erythematosus.

Figure 10.41 Juvenile dermatomyositis: periungual and cuticle telangiectases ...

Figure 10.42 Juvenile dermatomyositis: Gottron’s papules on the interphalange...

Figure 10.43 Graft‐versus‐host disease: dorsal pterygia of several nails.

Figure 10.44 Nail lentigo in a child. (a) Clinical: Narrow darkly pigmented b...

Figure 10.45 Nail nevus in a child. (a) Clinical: Light brown narrow band wit...

Figure 10.46 Atypical nevus and Spitz nevus in children. (a) Clinical: Narrow...

Figure 10.47 Melanoma in situ. (a) Clinical: Near complete melanonychia with ...

Figure 10.48 (a) Longitudinal melanonychia in a 4‐year‐old baby. (b) Nine mon...

Figure 10.49 Hutchinson’s sign.

Figure 10.50 Benign histology in childhood has become melanoma in adulthood....

Figure 10.51 (a) Structure of the cutaneous basement membrane zone (BMZ). (b)...

Figure 10.52 Epidermolysis bullosa simplex.

Figure 10.53 Thumb sucking associated with nail biting (subungual hemorrhage)...

Figure 10.54 (a) Nail biting. (b) Nail biting and picking.

Figure 10.55 Nail degloving: epidermolysis bullosa.

Figure 10.56 Nail degloving: Kawasaki disease.

Figure 10.57 (a) Bilateral congenital malalignment of the great toenail. (b) ...

Figure 10.58 Congenital malalignment of the great toenail. (a) Before treatme...

Figure 10.59 (a) Congenital hypertrophic lip of the hallux. (b) Spontaneous r...

Chapter 11

Figure 11.1 Koilonychia resulting from the thinning of the nails in an elderl...

Figure 11.2 Pincer nail on a great toenail; note the distal transverse hyperc...

Figure 11.3 Nail of a 90‐year‐old man: note the dull opaque color, the invisi...

Figure 11.4 Neapolitan nails: note the three different colored zones.

Figure 11.5 Longitudinal ridges, and brittle free edge: age related.

Figure 11.6 Pertinax body of the nail apparatus.

Figure 11.7 Onychomycosis in an elderly man. Distal lateral subungual onychom...

Figure 11.8 Pseudomyxoid cyst. The constant pressure on the underlying matrix...

Figure 11.9 Bowen disease. This long‐lasting lesion was thought to be a wart ...

Figure 11.10 (a) Melanoma, nodular type on the third toenail. This was interp...

Figure 11.11 (a) Painful onychoclavus in the distal median part of the nail a...

Figure 11.12 Onychophosis: hyperkeratosis of the lateral nail folds.

Figure 11.13 Customized orthotic device to avoid overlapping of toes.

Figure 11.14 (a,b) Onychogryphosis. This results from poor nail trimming due ...

Chapter 12

Figure 12.1 Sites of invasion and types of onychomycosis. A: DLSO, distal and...

Figure 12.2 (a) Distal and lateral subungual onychomycosis presenting as one‐...

Figure 12.3 (a, b) Distal and lateral subungual onychomycosis due to

Trichoph

...

Figure 12.4 Distal and lateral subungual onychomycosis restricted to the late...

Figure 12.5 Distal and lateral subungual onychomycosis with median presentati...

Figure 12.6 Onycholysis due to

Trichophyton rubrum

.

Figure 12.7 Onycholysis due to

Trichophyton rubrum

.

Figure 12.8 (a) Onycholysis due to

Candida albicans

. (b) Onycholysis due to

C

...

Figure 12.9 (a) Distal and lateral subungual onychomycosis (DLSO) due to

Neos

...

Figure 12.10 Black nail due to

Candida parapsilosis

.

Figure 12.11 Superficial white onychomycosis due to

Trichophyton interdigital

...

Figure 12.13 Superficial white onychomycosis associated with distal and later...

Figure 12.14 Superficial black onychomycosis due to

Neoscytalidium dimidiatum

Figure 12.15 Endonyx onychomycosis due to

Trichophyton soudanense

.

Figure 12.16 (a) Proximal white subungual onychomycosis. (b) Biopsy restricte...

Figure 12.19 (a) Proximal subungual onychomycosis secondary to chronic parony...

Figure 12.20 Total dystrophic onychomycosis due to

Scopulariopsis brevicaulis

Figure 12.27 Dermoscopy of distal subungual onychomycosis showing a jagged ed...

Figure 12.28 Dermoscopy of distal subungual onychomycosis showing linear whit...

Figure 12.29 Dermoscopy of fungal melanonychia showing a multicolored pigment...

Figure 12.30 Subungual nail scrapings mounted in potassium hydroxide solution...

Figure 12.31 Fungal culture (

Scopulariopsis brevicaulis

).

Figure 12.32 Fungal culture (

Epidermophyton floccosum

).

Figure 12.33 Nail histopathology: advanced distal and lateral subungual onych...

Figure 12.45 Nail histopathology: chronic mucocutaneous candidiasis. Grocott ...

Figure 12.46 Three cases of dermatophytoma (a,c,e) before and (b,d,f) after e...

Figure 12.47 Urea chemical avulsion.

Figure 12.48 Urea chemical avulsion before and after removal of the affected ...

Figure 12.49 Partial removal of the distal portion.

Figure 12.52 Partial removal of the proximal affected nail plate in proximal ...

Figure 12.53 Sporotrichosis.

Figure 12.54 Sporotrichosis (

Sporothrix schenckii

). Grocott stain.

Chapter 13

Figure 13.1 Herpes simplex: proximal nail fold involvement.

Figure 13.5 Subungual hemorrhage following recurrent herpes simplex.

Figure 13.6

Mycobacterium marinum

infection mimicking herpes paronychia.

Figure 13.7 (a,b) Herpes zoster.

Figure 13.8 Onychomadesis in hand–foot–mouth disease.

Figure 13.9 Lesion of orf.

Figure 13.10 Erythematous lesion of molluscum contagiosum at the proximal nai...

Figure 13.11 Intracytoplasmic hyaline eosinophilic inclusion bodies (Henderso...

Figure 13.12 Healed lesion of molluscum contagiosum after curettage, at 6‐mon...

Figure 13.13 Diffuse melanonychia in chikungunya.

Figure 13.14 Acute paronychia.

Figure 13.15 Primary cutaneous gonorrhea.

Figure 13.16 Primary syphilis.

Figure 13.19 Tertiary syphilis.

Figure 13.20 Lepromatous leprosy paronychia.

Figure 13.27 Leprosy: digital ulceration, thin egg shell nails.

Figure 13.29 Leprosy: edema of the feet, subungual and periungual hemorrhage....

Figure 13.30 Lupus vulgaris of the right foot leading to paronychia of four t...

Figure 13.31 Tuberculosis verrucosa cutis around the toenail.

Figure 13.32 Tuberculous dactylitis presenting with paronychia and pseudopter...

Figure 13.33 Norwegian scabies in Down syndrome.

Figure 13.34 Norwegian scabies: isolated subungual hyperkeratosis.

Figure 13.35 Tungiasis.

Figure 13.36 Tungiasis.

Figure 13.37 (a,b) Subungual myiasis.

Figure 13.38 (a) Leishmaniasis affecting the dorsal aspect of the fingers and...

Figure 13.39 Larva migrans.

Chapter 14

Figure 14.1 (a,b) Type I pityriasis rubra pilaris: prominent distal subungual...

Figure 14.2 Type I pityriasis rubra pilaris: mild subungual hyperkeratosis, s...

Figure 14.3 Type V pityriasis rubra pilaris: onychogryphosis.

Figure 14.4 Juvenile pityriasis rubra pilaris: paronychia and redness of the ...

Figure 14.5 (a–c) Pityriasis lichenoides acuta.

Figure 14.6 Lichen planus with typical violaceous papules on the proximal nai...

Figure 14.7 Lichen planus producing a diffuse pink‐red pigmentation of the pr...

Figure 14.8 Lichen planus of the nail matrix: longitudinal fissuring of the n...

Figure 14.9 Lichen planus of the nail matrix: longitudinal fissuring and dist...

Figure 14.10 Lichen planus of the nail matrix: longitudinal fissuring and dis...

Figure 14.11 Lichen planus of the nail matrix: longitudinal fissuring and dis...

Figure 14.12 Lichen planus of the nail matrix: longitudinal fissuring and dis...

Figure 14.13 Lichen planus of the nail matrix of the toenails: longitudinal f...

Figure 14.14 Lichen planus of the nail matrix of the toenails: longitudinal f...

Figure 14.15 Mottled lunulae in nail matrix lichen planus.

Figure 14.16 Diffuse red discoloration of the lunulae in nail matrix lichen p...

Figure 14.17 (a) Longitudinal melanonychia in lichen planus. (b) Histology of...

Figure 14.19 Longitudinal melanonychia associated with nail matrix lichen pla...

Figure 14.20 Longitudinal melanonychia of several nails associated with nail ...

Figure 14.21 Severe nail matrix lichen planus with nail plate atrophy.

Figure 14.24 Severe nail matrix lichen planus with massive nail plate thinnin...

Figure 14.25 Dorsal pterygium: the skin of the proximal nail fold extends dis...

Figure 14.26 Dorsal pterygium: dermoscopy shows how the skin of the proximal ...

Figure 14.27 (a) Dorsal pterygium of the fifth fingernail, resulting in a nar...

Figure 14.28 Several narrow pterygia in the same nail.

Figure 14.29 Dorsal pterygium due to nail lichen planus involving two fingern...

Figure 14.30 Dorsal pterygium due to nail lichen planus involving the toenail...

Figure 14.31 Nail matrix lichen planus producing numerous pits and longitudin...

Figure 14.32 Trachyonychia due to nail lichen planus involving two fingernail...

Figure 14.33 Trachyonychia due to nail lichen planus involving the toenails....

Figure 14.34 Nail thickening with yellow discoloration and longitudinal fissu...

Figure 14.35 Yellow nail syndrome‐like appearance of the toenails in lichen p...

Figure 14.36 Lichen planus of the nail bed presenting with onycholysis.

Figure 14.37 Lichen planus of the nail bed presenting with onycholysis that s...

Figure 14.38 Lichen planus of the nail bed: onycholysis and subungual hyperke...

Figure 14.39 “Pup tent” sign of nail lichen planus in the thumb: the split na...

Figure 14.40 Lichen planus of the nail bed and nail matrix: onycholysis is as...

Figure 14.41 Lichen planus of the nail bed and nail matrix: onycholysis is th...

Figure 14.42 Massive nail thickening and white discoloration due to subungual...

Figure 14.43 Lichen planus – single digit involved; subungual keratotic varie...

Figure 14.44 Bullous lichen planus of the toenails: ulceration of the nail be...

Figure 14.45 Bullous lichen planus: large erosion of the nail bed of the thum...

Figure 14.46 Bullous lichen planus of the great toenail: the nail bed erosion...

Figure 14.47 Bullous nail lichen planus presenting as permanent nail scarring...

Figure 14.48 Idiopathic atrophy of the nails.

Figure 14.49 Idiopathic atrophy of the nails.

Figure 14.50 Acquired leukonychia of the fingernails in a patient with severe...

Figure 14.51 Lichen planus – matrix area, showing prominent, dense, dermal an...

Figure 14.52 Nail lichen planus successfully treated by intramuscular triamci...

Figure 14.53 Nail lichen planus successfully treated by intramuscular triamci...

Figure 14.54 Nail lichen planus of the toenails successfully treated by intra...

Figure 14.55 Lichen aureus.

Figure 14.56 Keratosis lichenoides chronica: hyperkeratotic hypertrophy of th...

Figure 14.57 (a–e) Eczema – spectrum of the nail changes that may be seen.

Figure 14.58 Acute allergic contact dermatitis to tioconazole lotion on the t...

Figure 14.59 Acute allergic contact dermatitis of the hands and fingernails d...

Figure 14.60 Acute eczema of the proximal nail fold with paronychia and a pyo...

Figure 14.61 Paronychia, onycholysis, and subungual hyperkeratosis in allergi...

Figure 14.62 Paronychia, onycholysis, and subungual hyperkeratosis in allergi...

Figure 14.63 Chronic eczema of the fingertips with scales and rhagades in a d...

Figure 14.64 Paronychia, onycholysis, and subungual hyperkeratosis in allergi...

Figure 14.65 (a,b) Discoid lupus erythematosus.

Figure 14.66 Discoid lupus erythematosus.

Figure 14.67 (a,b) Bullous pemphigoid: periungual involvement.

Figure 14.68 Bullous pemphigoid: (a) nail plate and (b) nail bed changes.

Figure 14.69 Pemphigus. (a) Beau’s lines. (b) Paronychia with serohematic dis...

Figure 14.70 Pemphigus vulgaris presenting with hemorrhagic paronychia and on...

Figure 14.71 Pemphigus vulgaris presenting with hemorrhagic bullae around and...

Figure 14.72 (a) Pemphigus vulgaris: matrix histology. (b) Pemphigus vegetans...

Figure 14.73 Hailey–Hailey disease: longitudinal white bands.

Figure 14.74 Darier disease. (a) Longitudinal white lines associated with lon...

Figure 14.75 Darier disease: longitudinal white lines associated with longitu...

Figure 14.76 Darier disease: longitudinal white lines associated with longitu...

Figure 14.77 Darier disease: subungual hyperkeratosis.

Figure 14.78 Darier disease: longitudinal white lines associated with longitu...

Figure 14.79 Hopf acrokeratosis verruciformis in childhood.

Figure 14.80 Paronychia in erythema multiforme.

Figure 14.81 Onychomadesis of the fingernail after erythema multiforme involv...

Figure 14.82 Alopecia areata: pits are small, superficial, regular in size, a...

Figure 14.85 Alopecia areata: geometric pitting.

Figure 14.86 Alopecia areata: nail plate surface abnormalities associated wit...

Figure 14.87 Alopecia areata: nail plate surface abnormalities associated wit...

Figure 14.88 Alopecia areata: onychomadesis after an acute episode of hair lo...

Figure 14.89 Alopecia areata: (a) multiple lines made of regular horizontal p...

Figure 14.90 Alopecia areata: (a) total dystrophic nails, (b) sandpapered twe...

Figure 14.91 Alopecia areata: opaque trachyonychia.

Figure 14.92 Alopecia areata: shiny trachyonychia.

Figure 14.93 Alopecia areata: severe trachyonychia.

Figure 14.94 Alopecia areata: erythema of the lunula and of the proximal part...

Figure 14.95 Alopecia areata: spotted lunula.

Figure 14.96 Alopecia areata: true transverse leukonychia.

Figure 14.97 Alopecia areata: geometric punctate leukonychia.

Figure 14.98 Alopecia areata: severe onycholysis.

Figure 14.99 Porokeratosis of Mibelli.

Figure 14.100 Generalized porokeratosis.

Figure 14.101 (a) Acroosteolysis due to vinyl chloride disease with (b) chara...

Figure 14.102 Granuloma annulare, perforating variety.

Figure 14.103 Juvenile xanthogranuloma and its histology.

Figure 14.104 Juvenile xanthogranuloma of the proximal nail fold.

Figure 14.105 Erythema elevatum diutinum.

Figure 14.106 Vitiligo: absence of the lunulae.

Figure 14.107 Psoriasis: involvement of the proximal nail fold.

Figure 14.108 Psoriasis: multiple pits.

Figure 14.109 Psoriasis: pitting.

Figure 14.110 Psoriasis: transverse furrows.

Figure 14.111 Psoriasis: leukonychia.

Figure 14.112 (a) Psoriasis: discoloration and nail apparatus distortion. (b)...

Figure 14.113 Psoriasis: total matrix and nail plate involvement.

Figure 14.114 Psoriasis: brownish‐red patch in the nail bed known as an “oil ...

Figure 14.115 Psoriasis: pitting and splinter hemorrhages.

Figure 14.116 Psoriasis: involvement of the nail bed and nail plate. PAS stai...

Figure 14.117 Psoriasis: involvement of the nail matrix and nail plate. PAS s...

Figure 14.118 Psoriasis: very inflammatory acrodermatitis continua of Hallope...

Figure 14.119 Psoriasis: acral pustular psoriasis with acroosteolysis.

Figure 14.120 Psoriasis: radiograph showing “resorptive” osteolysis (same pat...

Figure 14.121 Palmoplantar pustulosis.

Figure 14.122 (a) Acral psoriasiform hemispherical papulosis. (b) Histology, ...

Figure 14.123 Psoriasis: distal interphalangeal joint arthropathy and periung...

Figure 14.124 (a) Reactive arthritis. (b) Reactive arthritis: same patient, a...

Figure 14.125 CHILD syndrome.

Figure 14.126 Psoriasis: nail changes induced by lithium therapy.

Chapter 15

Figure 15.1 Clubbing with cyanosis in congenital heart disease.

Figure 15.2 Hypertrophic osteoarthropathy in pulmonary arterial hypertension....

Figure 15.3 Osler’s nodes: hemorrhagic tender nodules around the nail suggest...

Figure 15.4 Acral cyanosis associated with disseminated intravascular coagula...

Figure 15.5 Acute digital ischemia as a paraneoplastic sign revealing a lung ...

Figure 15.6 Buerger disease: intense hyperemia of the distal digits associate...

Figure 15.7 Buerger disease: intense hyperemia of the second and third finger...

Figure 15.8 Nail plate thickening and discoloration in chronic venous insuffi...

Figure 15.9 Acrocyanosis: cyanotic discoloration of the feet associated with ...

Figure 15.10 Acrocyanosis. Nail fold capillaroscopy showing elongated, tortuo...

Figure 15.11 Acrocyanosis. Nail fold capillaroscopy showing dilatation, stasi...

Figure 15.12 Gangrene due to frostbite.

Figure 15.13 Perniosis: erythemato‐violaceous paronychia after exposure to co...

Figure 15.15 Chilblains (perniosis).

Figure 15.16 Beau’s lines and subungual hemorrhages after perniosis with lesi...

Figure 15.17 Raynaud phenomenon of the toes.

Figure 15.18 Raynaud disease and acrosclerosis.

Figure 15.20 Severe acrosclerosis and acroosteolysis in Raynaud disease: the ...

Figure 15.21 Pseudoainhum.

Figure 15.22 Yellow nail syndrome involving both fingernails and toenails.

Figure 15.23 Yellow nail syndrome: absence of the cuticle, yellow nail discol...

Figure 15.26 Yellow nail syndrome: nail changes associated with lymphedema.

Figure 15.27 Periungual brown macules in Peutz–Jeghers syndrome.

Figure 15.28 Koilonychia and nail fragility in Plummer–Vinson syndrome.

Figure 15.29 Severe nail thinning leading to koilonychia in Crohn’s disease....

Figure 15.30 Cronkhite–Canada syndrome: yellow‐brown nails, distally thickene...

Figure 15.31 Cronkhite–Canada syndrome: onychomadesis of fingernails and toen...

Figure 15.32 Terry’s nails in a patient with acute myelogenous leukemia: (a) ...

Figure 15.33 Terry’s nails in a patient with cirrhosis.

Figure 15.34 Muehrcke’s lines: two transverse white bands run parallel to the...

Figure 15.35 Muehrcke’s lines.

Figure 15.36 Half‐and‐half nails: the proximal part of the nail has a white a...

Figure 15.37 Half‐and‐half nails: pressure on the distal nail plate obliterat...

Figure 15.38 Half‐and‐half nail, brown variant.

Figure 15.39 Hemodialysis pseudoporphyria – erosive nail changes.

Figure 15.40 Calciphylaxis. (a) Gangrene. (b) Histology.

Figure 15.41 Calciphylaxis: toe gangrene.

Figure 15.42 Lateral nail ingrowing in pregnancy.

Figure 15.43 Longitudinal melanonychia of several nails during pregnancy.

Figure 15.44 Diabetic foot: (a) periungual blisters, (b) same patient – nail ...

Figure 15.45 Diabetic foot: gangrene of the distal digit.

Figure 15.46 Fingernail onychomycosis in diabetes.

Figure 15.47 Acromegaly: (a) Acromegaly. (b) Radiograph shows anchor‐like sha...

Figure 15.48 Addison disease: longitudinal melanonychia of several nails was ...

Figure 15.49 Hyperparathyroidism: acquired racket nails and koilonychia.

Figure 15.50 Syringomyelia: thickening and callosities of the finger skin, pa...

Figure 15.51 Spinal cord injury: (a) dystrophic periungual skin changes; (b) ...

Figure 15.52 Congenital insensitivity to pain syndrome with anhidrosis: self‐...

Figure 15.53 (a) Acropathia ulceromutilans acquisita: pseudoainhum constricti...

Figure 15.54 Carpal tunnel syndrome: onychomadesis of the first, second, and ...

Figure 15.55 Carpal tunnel syndrome: necrotic eschar of the second fingernail...

Figure 15.56 Carpal tunnel syndrome: bullae of the periungual tissues and of ...

Figure 15.57 Carpal tunnel syndrome: necrotic bulla of the third digit with f...

Figure 15.58 Peripheral nerve injury: atrophy of the fourth and fifth fingers...

Figure 15.59 Peripheral nerve injury: skin atrophy, Beau’s lines, and pterygi...

Figure 15.60 Peripheral nerve injury after cast wearing.

Figure 15.61 Peripheral nerve injury after cast wearing.

Figure 15.62 Peripheral nerve injury after cast wearing.

Figure 15.63 Reflex sympathetic dystrophy.

Figure 15.64 Onychophagia in an adult patient.

Figure 15.65 Habit–tic deformity.

Figure 15.66 Severe onychotillomania.

Figure 15.67 Anorexia: thin and brittle nails.

Figure 15.68 Onychorrhexis associated with osteoarthritis.

Figure 15.69 Primary interphalangeal osteoarthritis of the second finger asso...

Figure 15.70 Hereditary hemorrhagic telangiectasia.

Figure 15.71 (a) Cryoglobulinemia. (b) Cryoglobulinemia – bullous purpura.

Figure 15.72 Plasmacytoma presenting as a subungual nodule.

Figure 15.73 Terry’s nails in POEMS syndrome.

Figure 15.74 (a,b) Paraneoplastic pemphigus involving the nails in a patient ...

Figure 15.75 Leukemic infiltrate of the nail.

Figure 15.76 T‐cell lymphoma of the nail: (a) distal nail involvement, (b) hi...

Figure 15.77 Cutaneous T‐cell lymphoma: (a) tumor of the nail, (b) Sézary syn...

Figure 15.78 Cutaneous T‐cell lymphoma after electron beam therapy.

Figure 15.79 Papuloerythroderma: thrombosed capillaries in the nail folds....

Figure 15.80 Capillaroscopy in connective tissue disease: systemic lupus eryt...

Figure 15.81 Capillaroscopy in connective tissue disease: scleroderma–dermato...

Figure 15.82 Systemic lupus erythematosus: periungual erythema and telangiect...

Figure 15.84 Systemic lupus erythematosus: periungual erythema and telangiect...

Figure 15.85 Systemic lupus erythematosus: proximal nail fold telangiectasias...

Figure 15.86 Systemic lupus erythematosus: skin scaling and atrophy with paro...

Figure 15.87 Systemic lupus erythematosus: onycholysis.

Figure 15.88 Systemic lupus erythematosus: onycholysis.

Figure 15.89 Systemic lupus erythematosus: permanent nail plate dystrophy.

Figure 15.90 Systemic lupus erythematosus with gangrenous digits.

Figure 15.91 Dermatomyositis: ragged cuticles.

Figure 15.92 Dermatomyositis: proximal nail fold erythema and telangiectasia ...

Figure 15.93 Dermatomyositis: Gottron’s papules in a child.

Figure 15.94 Dermatomyositis: complete loss of several toenails.

Figure 15.95 Dermatomyositis: periungual ischemic lesions – predictive sign o...

Figure 15.96 Capillaroscopy in dermatomyositis: sausage‐like capillary dilati...

Figure 15.97 Capillaroscopy in dermatomyositis: irregularly distributed capil...

Figure 15.98 Systemic scleroderma: proximal nail fold telangiectasias and cut...

Figure 15.99 Systemic scleroderma: parrot beak nails.

Figure 15.102 Systemic scleroderma: pterygium inversum unguis.

Figure 15.103 Systemic scleroderma: round fingerpad sign.

Figure 15.104 Systemic scleroderma: round fingerpad sign associated with shor...

Figure 15.105 Systemic scleroderma: sclerodactyly.

Figure 15.106 Systemic scleroderma: sclerodactyly.

Figure 15.107 Complete loss of the fingernails in acral pansclerotic morphea....

Figure 15.108 Systemic scleroderma: ischemic changes of the third fingertip....

Figure 15.109 Systemic scleroderma: ischemic changes of the fingertips.

Figure 15.110 Systemic scleroderma: acute gangrene.

Figure 15.111 Rheumatoid arthritis: longitudinal beading of the nail.

Figure 15.112 Rheumatoid arthritis: red lunula.

Figure 15.113 Rheumatoid arthritis: Bywaters syndrome: small pulp hemorrhages...

Figure 15.114 Rheumatoid arthritis: small subungual eschar.

Figure 15.115 Rheumatoid arthritis: peripheral blisters and lateral periungua...

Figure 15.116 Rheumatoid nodules.

Figure 15.117 Granulomatosis with polyangiitis (Wegener syndrome): subungual ...

Figure 15.118 Periarteritis nodosa.

Figure 15.119 Multicentric reticulohistiocytosis: (a) wart‐like nodules of th...

Figure 15.120 Fibroblastic rheumatism.

Figure 15.121 Kawasaki syndrome: desquamation of the fingertip, 14 days.

Figure 15.122 Dyskeratosis congenita: longitudinal fissuring and distal split...

Figure 15.123 Chronic mucocutaneous candidiasis.

Figure 15.124 Graft‐versus‐host disease: acute periungual erythema with onych...

Figure 15.125 Graft‐versus‐host disease: lichenoid nail changes of all 20 nai...

Figure 15.128 Graft‐versus‐host disease: lichenoid nail changes associated wi...

Figure 15.129 Langerhans cell histiocytosis: (a) childhood, (b) adult, (c) hi...

Figure 15.130 AIDS. (a,b) Cryptococcal whitlow. (c) Herpetic whitlow in an...

Figure 15.131 AIDS. (a) Kaposi sarcoma, subungual location. (b) Kaposi sarcom...

Figure 15.132 Cystic fibrosis: finger clubbing.

Figure 15.133 Gout: nail plate.

Figure 15.134 Gout: periungual ulcer due to traumatized tophi.

Figure 15.135 Ochronosis.

Figure 15.136 Porphyria cutanea tarda: (a) digital blistering, (b) onycholysi...

Figure 15.137 Porphyria cutanea tarda: digital blistering and onycholysis.

Figure 15.138 Systemic amyloidosis: (a) onychoschizia and distal splitting, (...

Figure 15.139 (a,b) Acrokeratosis paraneoplastica.

Figure 15.140 Acrokeratosis paraneoplastica.

Figure 15.141 Pincer nails induced by gastrointestinal malignancy.

Figure 15.142 Malignant acanthosis nigricans.

Figure 15.143 Leukonychia in malignant acanthosis nigricans.

Chapter 16

Figure 16.1 Congenital hypoplasia of the second, third, and fourth fingernail...

Figure 16.2 Photoonycholysis: (a) type I; (b) type II; (c) type III; (d) type...

Figure 16.3 Photoonycholysis, type I: the detachment spares the lateral nail ...

Figure 16.4 Photoonycholysis, type III: the central part of the nail bed on s...

Figure 16.5 (a) Tetracycline: fixed bullous eruption. (b) Minocycline‐induced...

Figure 16.6 Acute paronychia due to cefalexin involving the second and fourth...

Figure 16.7 Amoxicillin‐induced erythema multiforme involving the periungual ...

Figure 16.8 Paronychia and pyogenic granulomas of the toenails during lamivud...

Figure 16.9 Zidovudine‐induced nail pigmentation.

Figure 16.10 “Lacquer nail”: nail plate shortening and distal thinning with f...

Figure 16.11 Whitish discoloration of the nails caused by ciclopirox.

Figure 16.12 Antimalarial‐induced diffuse nail pigmentation.

Figure 16.13 Lithium‐induced psoriatic trachyonychia.

Figure 16.14 Psoriasiform nail changes during propranolol treatment.

Figure 16.15 Lichen planus‐like nail changes induced by captopril.

Figure 16.16 Subungual hematomas of several toes during anticoagulant therapy...

Figure 16.17 “Disappearing digit”: tapering of the distal finger due to atrop...

Figure 16.18 Skin hypopigmentation following intralesional steroid injections...

Figure 16.19 Longitudinal melanonychia of several nails during interferon alf...

Figure 16.20 Longitudinal melanonychia during PUVA therapy for psoriasis.

Figure 16.21 Nail changes due to etretinate. (a) Transverse leukonychia. (b) ...

Figure 16.22 Paronychia and desquamation of the lateral nail folds during etr...

Figure 16.23 Periungual pyogenic granuloma after topical application of tazar...

Figure 16.24 Ingrown toenails during treatment with isotretinoin.

Figure 16.25 Arsenic poisoning. (a) Mees’ lines. (b) Periungual and subung...

Figure 16.26 Argyria: gray‐silver discoloration of the skin and the nail beds...

Figure 16.27 Argyria: slate blue pigmentation of the lunulae.

Chapter 17

Figure 17.1 Combination of nail changes with chemotherapy (onycholysis, onych...

Figure 17.2 Diffuse onycholysis (docetaxel) associated with Beau’s lines.

Figure 17.3 Onycholysis combined with Beau’s lines and onychomadesis (paclita...

Figure 17.4 Multiple melanonychia striata involving all toenails (hydroxyurea...

Figure 17.5 Apparent leukonychia (Terry’s nail) associated with longitudinal ...

Figure 17.6 Diffuse true leukonychia with transverse white opaque bands (comb...

Figure 17.7 Onycholysis involving all fingernails (visible onychomadesis on t...

Figure 17.8 Onycholysis with subungual abscesses and purulent discharge.

Figure 17.9 PATEO syndrome due to taxanes, with a sparing of the left hand af...

Figure 17.10 (a) Persistent onycholysis after chemotherapy; (b) visible subun...

Figure 17.11 Paronychia and pyogenic granuloma‐like lesions due to: (a,b) EGF...

Figure 17.12 Vandetanib‐related photoonycholysis (type 1). Note the sparing o...

Chapter 18

Figure 18.1 Worn‐down nails due to occupational friction and pressure.

Figure 18.2 (a) “Rectangular″ onycholysis – slaughterhouse worker's dystrophy...

Figure 18.3 (a,b) Occupational stigmas in a guitar player using a thumbpick....

Figure 18.4 X‐irradiation nail changes: brittleness and longitudinal ridging....

Figure 18.5 X‐irradiation nail damage: distal subungual warty lesion of the t...

Figure 18.6 X‐irradiation: squamous carcinoma.

Figure 18.7 “Tulip fingers” dystrophy.

Figure 18.8 Fingertip dermatitis with chronic paronychia in a dentist.

Figure 18.9 Propanidid paronychia, usually seen in anesthetists.

Figure 18.10 (a) Cement dermatitis nail signs with lateral subungual hyperker...

Figure 18.11 Codeine sensitization in a pharmaceutical industry worker.

Figure 18.12 Epoxy resin “dermatitis.”

Figure 18.13 (a,b) Nail changes due to contact with onions.

Figure 18.14 Nail dystrophy with subungual hemorrhage due to formaldehyde.

Figure 18.15 Dystrophy due to

p

‐tertiary butylphenol (PTBP) formaldehyde resi...

Figure 18.16 Fisherman’s dystrophy due to escavenitis. Caused by sea‐worm coe...

Figure 18.17 Severe dermatitis and nail dystrophy due to bryozoans.

Figure 18.18 (a,b) Subungual and fingertip inflammatory eruption due to power...

Figure 18.19 Koilonychia in a hairdresser (thioglycolate).

Figure 18.20 Discoloration of the digits and nails with edematous changes, du...

Figure 18.21 Nail discoloration and onycholysis due to 5% dinitro‐orthocresol...

Figure 18.22 Yellow nails in a dinobuton handler.

Figure 18.23 (a,b) Terminal subungual hyperkeratosis and onycholysis due to h...

Figure 18.24 Nail signs (first, second, and third fingers) due to oven‐cleani...

Figure 18.25 (a) Motor mechanic’s fingers after prolonged handling of oil. (b...

Figure 18.26 Leishmaniasis mimicking erysipeloid, usually seen in meat or fis...

Figure 18.27 TB infection: primary (prosector’s paronychia).

Figure 18.28 Verrucous TB, reinoculation type (prosector’s wart).

Figure 18.29 Swimming pool granuloma (

Mycobacterium marinum

infection).

Figure 18.30 Tularemia: inoculation lesion.

Figure 18.31 Orf virus infection.

Figure 18.32 Milker’s nodules (paravaccinia infection).

Figure 18.33 Blastomycosis: primary lesion in a pathologist.

Figure 18.34 Butcher’s leukonychia.

Figure 18.35 Brown discoloration of nails in a hairdresser due to a dye.

Figure 18.36 Color changes in a walnut picker.

Figure 18.37 Yellow staining in a handler of epoxy resin system chemicals. ...

Figure 18.38 (a) Pseudoclubbing due to occupational acroosteolysis. . (b) Occ...

Figure 18.39 Onycholysis and subungual thickening associated with subungual h...

Chapter 19

Figure 19.1 “Tools of the trade” for nail apparatus manicure (see also Table ...

Figure 19.3 Pusher.

Figure 19.4 Showing the esthetic difference between long red nails and uncolo...

Figure 19.5 “Lever” effect of long nails, which may lead to onycholysis. Exce...

Figure 19.6 Manicuring implements: (1) plastic‐backed pads; (2) soft‐bristled...

Figure 19.7 Nail mending kit.

Figure 19.8 (a,b) Equilibrium between formaldehyde and methylene glycol. In t...

Figure 19.9 Professional supplies for applying nail wraps: (1) fiberglass; (2...

Figure 19.10 Structural differences between methacrylate and acrylate monomer...

Figure 19.11 Brush used to apply two‐part artificial nail systems and a dampe...

Figure 19.12 Structure of bisphenol A (diglycidylether) methacrylate (BIS‐GMA...

Figure 19.13 Nail sculpturing.

Figure 19.14 Paronychia induced by nail sculpturing.

Figure 19.16 Sculptured nails. Anonychia.

Figure 19.17 Crack‐, chip‐ and peel‐resistant UVA‐curing nail polish shown be...

Figure 19.18 Self‐adherent plastic nails, press‐on type.

Figure 19.19 Self‐adhering natural nail art.

Figure 19.20 Paronychia due to overzealous manicuring.

Figure 19.21 Discoloration due to nail enamel.

Figure 19.22 (a) Keratin granulation, surface white spots/patches, due to nai...

Figure 19.23 Onycholysis due to cosmetic procedures at different stages (scul...

Figure 19.24 (a) Sites of origin and transfer of allergens. (b) Contact derma...

Chapter 20

Figure 20.1 The normal position of the foot during the normal gait cycle.

Figure 20.2 Onychophosis on the medial side of the great toenail.

Figure 20.3 Onychophosis on both lateral sulci of the second toe.

Figure 20.4 Frictional melanonychia on the fifth toenail.

Figure 20.5 Frictional melanonychia on the fifth, fourth, and third toenails....

Figure 20.6 (a) Discrete frictional onycholysis. (b) Severe frictional onycho...

Figure 20.7 Lateral subungual hematomas resulting from friction in a patient ...

Figure 20.8 (a) Pincer nail induced by pressure between the shoe and the seco...

Figure 20.9 Hypertrophic lip in hallux valgus due to the rotation of the grea...

Figure 20.10 (a) Transverse leukonychia from repeated buffeting against the t...

Figure 20.11 Beau’s line on the second, longer toe of a hockey player.

Figure 20.12 Onychoclavus: (a) view from above; (b) front view; (c) clipping ...

Figure 20.13 Clubbing of a Morton’s toenail.

Figure 20.14 Hyperkeratosis in a Morton’s toe: (a) mild form; (b) severe.

Figure 20.15 Frictional melanonychia in a Morton’s toe: (a) mild form; (b) se...

Figure 20.16 (a) Hyperkeratosis of the hyponychium on a Morton’s toe. (b) Hyp...

Figure 20.17 (a) Hallux valgus. Note the pincer nail, the subungual hyperkera...

Figure 20.18 (a) Hallux erectus. Note the hammer toes and the onycholysis of ...

Figure 20.19 Painful keratotic plug in the lateral sulcus of the fifth toe.

Figure 20.20 (a) Hallux valgus with overlapping of the second toe on the firs...

Chapter 21

Figure 21.1 (a,b) Multiple periungual warts are common in nail biters/pickers...

Figure 21.2 Subungual wart lifting up the nail plate.

Figure 21.3 Wart on the proximal nail fold: pressure has caused a depression ...

Figure 21.4 (a) Tumefaction of the proximal nail fold due to a wart located u...

Figure 21.5 (a,b) Multiple and extensive warts are most frequently seen in im...

Figure 21.6 (a) Onycholemmal horn. (b) Histology.

Figure 21.7 Permanent nail dystrophy from injection of bleomycin with Dermoje...

Figure 21.8 (a) Patchy leukonychia following cryosurgery of a wart on the pro...

Figure 21.9 Permanent nail dystrophy following CO

2

laser therapy for periungu...

Figure 21.10 (a) Syringoma: involvement of the lateral nail bed. (b) Syringom...

Figure 21.11 (a) Chondroid syringoma. (b) Histology of case in (a).

Figure 21.12 (a) Eccrine poroma. (b) Eccrine poroma: histology.

Figure 21.13 (a) Eccrine syringofibroadenoma involving the fifth toenail appa...

Figure 21.14 (a) Proliferating onycholemmal cyst after surgery. (b,c) Histolo...

Figure 21.15 (a) Distal digital keratoacanthoma. The lesion was extremely pai...

Figure 21.16 (a) Digital keratoacanthoma involving the proximal fold presenti...

Figure 21.17 Radiograph of the patient in Fig. 21.15. Note the well‐defined c...

Figure 21.18 Keratoacanthoma (arrows). MR sagittal gradient echo image after ...

Figure 21.19 (a) Subungual incontinentia pigmenti tumor. (b) Dyskeratotic cel...

Figure 21.20 Ungual seborrheic keratosis (“longitudinal subungual acanthoma”)...

Figure 21.21 Ungual seborrheic keratosis, leucoxanthonychia type. (a) Clinica...

Figure 21.22 Onychocytic matricoma. Histopathological aspect. On the left, sc...

Figure 21.23 Distal subungual keratosis with multinucleation.

Figure 21.24 Onychopapilloma of the nail bed showing as longitudinal erythron...

Figure 21.25 Onychopapilloma presenting as a longitudinal leukonychia. Note t...

Figure 21.26 Onychopapilloma presenting as a longitudinal melanonychia.

Figure 21.27 Double interrupted longitudinal lines made up of splinter hemorr...

Figure 21.28 Multiple onychopapillomas on several nails in a patient.

Figure 21.29 Typical dermoscopy of an onychopapilloma.

Figure 21.30 Acantholytic dyskeratotic acanthoma presenting as a median longi...

Figure 21.31 (a) Longitudinal erythronychia (arrow) caused by warty dyskerato...

Figure 21.32 Verrucous epidermal nevus.

Figure 21.33 (a) Inflammatory linear verrucous nevus (ILVEN). (b) ILVEN: mark...