No abstract available.
Onycholysis*

BACKGROUND: Intra-lesional triamcinolone injection is a widely used treatment modality of onychodystrophy. However, clinical evaluation has rarely been performed for the therapeutic effect of intra-lesional triamcinolone injection in the treatment of idiopathic onychodystrophy, except for psoriatic nail. OBJECTIVE: The purpose of this study was to investigate the therapeutic effect of intra-lesional triamcinolone injection on idiopathic onychodystrophy. METHODS: A total of 43 patients diagnosed as idiopathic onychodystrophy were enrolled in this study. At first 2 visits, triamcinolone acetonide (2.5mg/ml) was injected into the proximal nail fold of each nail using the dermo-jet. Thereafter, intra-lesional injection was performed at 4-week intervals with two-fold increased concentration of triamcinolone acetonide (5mg/ml). After a total of 7 treatments, the treated nails were scored by both doctor and patient between 0 and 10 according to the severity. RESULTS: In 26 patients treated for more than 12-weeks, 189 nails were eventually assessed by four grade scale. Therapeutic effects were as follows; excellent improvement in 19.8%, good in 28.8%, moderate in 11.6%, and poor in 38.6%. Onycholysis responded well to this treatment, with 81.1% of good to excellent improvement, whereas trachyonychia was resistent with 78.1% of poor to moderate improvement. There was no significant side effect, except pain on the injection site. CONCLUSION: According to our results, intra-lesional injection of triamcinolone acetonide is an effective and safe treatment modality of idiopathic onychodystrophy. It is suggested that, with intra-lesional triamcinolone injection, the morphologic classification is an important prognostic factor in the treatment of idiopathic onychodystrophy.
Classification ; Humans ; Onycholysis ; Triamcinolone Acetonide ; Triamcinolone*

Onycholysis is defined as a distal or distal lateral separation of the nail plate from the underlying or lateral supporting structures including nail bed, hyponychium, and lateral nail fold. Trauma, infection, psoriasis, thyrotoxicosis, and numerous drugs are common causes of onycholysis. However, there are few specific data on nail findings in Behcet's disease (BD). In this paper, we report on a 60-year-old man with BD, with no past history except BD, who developed recurrent onycholysis. The symptoms of onycholysis are considered to be recurrent depending on the activity of BD. The nail lesion showed improvement after classic treatment of BD and topical steroid ointment.
Humans ; Middle Aged ; Onycholysis* ; Psoriasis ; Thyrotoxicosis

No abstract available.
Humans ; Mucocutaneous Lymph Node Syndrome* ; Onycholysis*

BACKGROUND: The treatment of onychomycosis has improved recently. However, for 25% of patients, persistent disease remains a problem. Predisposing factors that contribute to a poor treatment response include a thick nail, extensive nail involvement, lateral nail involvement, dermatophytoma, onycholysis and yellow spikes. OBJECTIVES: Our purpose was to study the clinical characteristics of onychomycosis contributing to the prognosis. METHODS: On the basis of the charts, photographs and telephone-visiting of the patients who visited St. Mary's hospital from January 2000 to May 2004, we investigated the number and percentage of good-responders according to each prognostic factor and the number of factors. RESULTS: 1. KOH smear, fungus culture and KONCPA test showed positivity rates of 61.0% (347/569), 17.4% (101/581) and 75.1% (284/378), respectively. 2. Triple tests showed positivity rate of 86.9% (271/312) by one or more of the triple tests. 3. The number and percentage of good-responders as a whole was 63.0% (400/635). The 5 prognostic factors contributed to statistically significant outcomes (p< 0.05), and the number and percentage of good-responders showing statistical significance were 53.1% (139/262) in the old-age group (odds ratio (OR) 2.1), 70.0% in the non-old-age; 19.2% (9/47) in the dermatophytoma group (OR 8.4), 66.5% (391/588) in the non-dermatophytoma; 35.3% (18/51) in the yellow-spike group (OR 3.5), 65.4% (382/584) in the non-yellow-spike; 19.5% (32/164) in the thick-nail group (OR 14.7), 78.1% (368/471) in the non-thick-nail; and 35.6% (36/101) in the involvement-more-than-50% group (OR 3.9), 68.2% (364/534) in the involvement-less-than-50%. 4. The 2 prognostic factors did not contribute to the outcomes statistically (p> 0.05) and the number and percentage of good-responders showing no statistical significance were 60.4% (58/96) in the onycholysis group, 63.5% (342/539) in the non-onycholysis; and 62.9% (44/70) in the lateral-involvement group, 63.0% (356/565) in the non-lateral-involvement. 5. The number and percentage of good-responders according to the number of prognostic factors were 92.6% (162/175) in 0-factor group, 62.3% (157/252) in 1-factor, 52.0% (64/123) in 2-factor and 30.9% (17/55) in 3-factor. CONCLUSIONS: Clinical outcomes of onychomycosis depend on what kind of prognostic factor or how many factors the patient has. Therefore, the clinical prognostic factors should be considered before starting the treatment for predicting prognosis and planning therapeutic modalities.
Causality ; Fungi ; Humans ; Odds Ratio ; Onycholysis ; Onychomycosis* ; Prognosis*

Subungual keratoacanthoma is a rare, benign tumor occurring mainly on the thumb of middle-aged Caucasians. It presents as a painful keratotic papule or nodule accompanied by consequential partial onycholysis and bacterial infections. Unlike keratoacanthoma of other sites, subungual keratoacanthoma is not spontaneously resolved and surgical interventions have been recommended for treatment. It also needs to be differentiated from other subungual lesions, especially squamous cell carcinoma. We describe a case of subungual keratoacanthoma, which was completely resolved with extraction of the nail followed by oral methotrexate(MTX) medication.
Bacterial Infections ; Carcinoma, Squamous Cell ; Keratoacanthoma* ; Onycholysis ; Thumb

Green nail syndrome (chromonychia) is a nail disorder characterized by onycholysis and green-black discoloration of the nail bed. This condition is often associated with chronic paronychia. Pseudomonas aeruginosa is the most commonly identified organism in cultures from the affected area. Despite the various treatment options available, removal of the nail is still necessary in many cases. A 35-year-old man presented with dark-greenish discoloration of the nail plate and onycholysis on the left thumbnail. He had been treated with oral antifungal and antibiotic agents for several months; however, the lesion showed no improvement. The diagnosis of green nail syndrome was established after a positive bacterial culture, and on the basis of the antibiotic sensitivity test result, tobramycin eye drop (Tobrex(R)) was then prescribed. Three weeks later, the nail discoloration almost vanished but the onycholysis remained. Herein, we recommend the application of tobramycin eye drop as an easy and safe treatment option for green nail syndrome.
Adult ; Diagnosis ; Humans ; Onycholysis ; Paronychia ; Pseudomonas aeruginosa ; Tobramycin*

BACKGROUND: Onychomycosis is a common fungal nail infection. Characteristic features include ungual and subungual hyperkeratosis, discoloration, onycholysis, nail dystrophy, and periungal pain which may cause cosmetic, social, and psychologic problem to the patients. OBJECTIVE: Our purpose is to evaluate quality of life in patients with onychomycosis. METHOD: We interviewed 100 patients with onychomycosis which was diagnosed by clinical finding and KOH preparation. RESULT: Frequently observed signs and symptoms of onychomycosis were discoloration of nail, hyperkeratosis, nail dystrophy, onycholysis, periungual pain, and periungual inflammation, in descending order Source of infection suspected by patients included military service, shoes, tines pedis, prolonged contact with water, trauma, etc. Most patients suffered from problems with daily and social activity, and psychologic problem at the rate of 64%, 58%, 66%, respectively. Patients who wanted to take medication or treatment were 73%, but they also had several worries about treatment. CONCLUSION: Many patients with onychomycosis suffered from problems with daily and social activity, and psychologic problem. Therefore, more attention should be paid to the patients with onychomycosis as the development of cultural, social, and economic status.
Humans ; Inflammation ; Military Personnel ; Onycholysis ; Onychomycosis* ; Quality of Life* ; Shoes ; Water

BACKGROUND: There have been a few reported cases of congenital great toenail dystrophy (GTND), described as a congenital malalignment of the great toenails. However, acquired GTDN is rare, and has not been documented extensively. This study aimed to describe the clinical features of 21 patients with acquired GTND. METHODS: Twenty-one patients with acquired GTND who visited Yeouido St. Mary's Hospital between June 2005 and August 2012 were retrospectively reviewed. RESULTS: The mean patient age was 43.1 years (range, 17 to 88 years), and the cohort predominantly comprised women (18/21). In our experience, all acquired GTND patients presented with yellow or yellow-brownish chromonychia, onychotrophy, and onycholysis. Conservative treatment with tape methods and grinding, as well as nail extraction, was provided and yielded little improvement in any case. CONCLUSION: This study provides initial data on the nail changes affecting the great toenail, such as yellowish chromonychia, onychomadesis, and onycholysis. These data may help physicians to distinguish various nail disorders, including onychomycosis, congenital malalignment of the great toenails, and yellow nail syndrome.
Cohort Studies ; Female ; Humans ; Nails* ; Onycholysis ; Onychomycosis ; Retrospective Studies ; Yellow Nail Syndrome

Paclitaxel is one of the taxoid-antineoplastic agents. These agents are used in the treatment of breast, lung and ovary cancer. Nail changes due to treatment with the taxanes (mainly docetaxel) are reported in 30~40 percent of patients. Paclitaxel is not commonly associated with dermatological reactions, although localized skin reactions and tissue necrosis following extravasation have been reported. Reports of the incidence of nail changes associated with paclitaxel is noted as the pigmentation or discoloration of the nail bed, vary from 2~20%. We report a patient with onycholysis and subungual suppuration during treatment with paclitaxel.
Breast ; Humans ; Incidence ; Lung ; Nails ; Necrosis ; Onycholysis ; Ovarian Neoplasms ; Paclitaxel ; Pigmentation ; Skin ; Suppuration ; Taxoids