Hair, Nails And Mucous Membrane Disorders Flashcards
The nail is composed of what structures
Matrix, nail bed, hyponychium, cuticle, lunula, nail plate, eponychium
Describe Beau’s Lines
Transverse depression of the nail plate or grooving that goes across the nails
Beau’s Lines are found in what conditions
Zinc deficiency, lupus, psoriasis, serious illness/infection, trauma to the nailbed
Oncholysis occurs when
Distal nail plate detaches
Longitudinal melanoychia appears as what?
Brown-black bands due to melanin in the nail plate
Nails that are extremely hard and difficult to trim are most likely due to
Pachonychia congentia
Pachyonychia congenita is a very rare genetic disorder with what symptoms
Thickened nails, painful callouses and blisters on the bottoms of the feet and possibly the hands
Twenty nail dystrophy is associated with what conditions
Amylodosis, alopecia areata, lichen planus, psoriasis, pemphigus vulgaris, Sarcoidosis
Twenty nail dystrophy (trachyonychia) is described as what
Brittle nails with diffuse longitudinal ridging that can also have pitting, loss of Lustre or toughened nail plate
Clubbing of the nail is associated with what condition
COPD
A nail condition caused by frequent handwashing, detergent and water is
Onychoschizia - this is caused by frequent wetting and drying of the nails which leads to peeling of the nail plate layers
Squamous cell carcinoma of the nail may present as
Hyperkeratosis, onycholysis, veruccal, paronychia, nail plate dystrophy or sugungual mass
The ABCDEF of nail melanoma includes
Age of the patient, band of brown-black color, change in size or growth, digit (thumb, big toe or index finger usually affected), extension of color (Hutchinson sign) and family hx of melanoma
First line pharmaceutical treatment of chronic paronychia is
High potency topical corticosteroids
The hair growth cycle where hair growth and metabolic processes are decreasing and regression of the hair follicle is noted
Catogen
Longest phase of the hair cycle, lasting 2 to 5 years, is when the hair is in the “growth phase”
Anagen
Hair growth cycle where hair is in a resting phase. Usually lasts 3-4 months and ends with hair falling out.
Telogen
Hair growth cycle where 50-100 hairs a day are shed from the scalp. This phase can last 2-5 months as new hair is growing into follicles
Exogen
Non scarring alopecias
Alopecia areata, telogen effluvium, anogen effluvium, traction alopecia, androgenetic alopecia
What medication is FDA approved for treatment of female pattern hair loss?
Topical 2% minoxidil
Potential adverse reaction of finasteride
Erectile dysfunction
The NP obtains a screening PSA on a 58 year old male who is taking finasteride for hair loss. She should know that when interpreting the PSA
The PSA level should be doubled yo obtain the accurate result
A medication associated with the development of telogen effluvium is
Oral retinoid
Diagnosis of telogen effluvium can be made when there is an increase in what percentage of telogen hairs
15%
A moth eaten pattern of hair loss is suggestive of alopecia associated with
Syphillis
Hair loss in a band-like pattern in the occupital/temporal areas of the scalp describes
Ophiasis
The correct technique of intralesional corticosteroid in alopecia areata includes
Injecting outer edge of the hair loss
Anthralin can cause
Staining of the skin
Lichen planopilaris occurs most frequently in
Caucasians
Frontal fibrosis alopecia is a subset of
Lichen planopilaris
Folliculitis decalvans is most commonly associated with what organisms
Staphylococcus
The most common bacterial agent responsible for paronychia
Staphylococcus
Chronic paronychia is defined as inflammation of the nail fold that lasts longer than
6 weeks
Approximately 80% of individuals with alopecia universalis will respond to use of systemic corticosteroids, however what percentage of individuals will relapse upon cessation of systemic corticosteroids?
50%
The female to male ratio in Central centrifugal cicatricial alopecia is
3 to 1
The treatment of central centrifugal cictricial alopecia is
Doxycycline 100 mg/day
An inflammatory type of scarring alopecia associated with the development of sinus tracts describes
Dissecting Cellulitis of the scalp
Sjogren syndrome diagnosis is often delayed
6-10 years
Sjogren syndrome is usually managed by what specialty?
Rheumatology
Sjogren syndrome symptoms are usually managed effectively with
Multiple strategies with mixed supporting evidence
At presentation, the typical individual with sjogren syndrome is
Female and 40 years old
First line treatment for lichen sclerosis includes
Long term high potency topical corticosteroids
Incidence rates of lichen sclerosus are
Varied due to poor reporting but estimated between 1 in 300 and 1 in 1000
One example of first line treatment for lichen sclerosus is
Clobetasol propionate 0.05% ointment BID for 1 month, once daily for 1 month then taper to 2x/weekly for a month
Scarring in lichen sclerosus is found
In late disease
Ocular symptoms occur in what percent of Behcet’s disease cases
90%
Pathogenesis of behcet’s syndrome is
Autoinflammatory disorder with substantial host predilection
Systemic therapy in treating behcet syndrome should be considered in
Patients with systemic symptoms
A behcet syndrome patient that has ocular involvement. First line treatment considerations include
Cyclosporine, corticosteroids, azathioprine
