Nail Disorders Flashcards
what is pitting associated with?
3 things
- psoriasis
- eczema
- alopecia areata
what is transverse ridging assoicated with?
3 things
- eczema
- paronychia
- psoriasis
what is a beau line?
- transverse depression
- affects all nails
- stops nail growth
what is a beau line assoicated with?
- acute systemic illness
- high fever, measles, mumps, pneumonia, etc
what is onychorrhexis?
longitudinal bridging on the nail plate
what is onychorrhexis associated with?
6 things
- increased age
- lichen planus
- psoriasis
- onychomycosis
- Darier disease
- habit of picking
what is a longitudinal groove associated with?
2 things, 1 location
- digital myxoid cyst or wart
- overlying the proximal nail matrix
how does median canaliform nail dystrophy present?
2 components
- feathery, central, longitudinal ridge with a fir tree pattern
- usually on the thumb nails
what is median canaliform nail dystrophy associated with?
1
repetitive trauma
what is onychogryphosis?
a thick, hard, curved nail plate in the shape of a Ram’s horn
what is onychogryphosis associated with?
3
- increased age
- psoriasis
- trauma
what is leukonychia?
white spots on the nails
what is leukonychia thought to be from if the white spots are transverse?
manicuring
what is leukonychia associated with?
3 things
- familial
- hypoalbuminemia
- chronic renal failure
what does koilonychia look like?
thin, spoon shaped nail
what is koilonychia associated with?
5 things
- iron deficient anemia
- DM
- protein deficiency
- connective tissue disease
- exposure to solvents
Onychomycosis
which fungi/yeast cause this?
2, 1
- Trichphyton rubrum, Tinea interdigitale
- yeast: candida albicans
Onychomycosis
common in who?
older age
Onychomycosis
often results from?
untreated…
* tinea pedis
* tinea manuum
Onychomycosis
clinical presentation
- subungual hyperkeratosis, onycholysis, scaly or flaky patches under the nail, pis ,brittle nails
Onychomycosis
Dx
- KOH exam
- Periodic Acid-Schiff test (most sens)
Onychomycosis
Tx
Boards vs real life vs OTC
- Boards: terbinafine PO
- practice: topical antifungals
- OTC: vicks
Paronychia
acute vs chronic
- acute < 6 wks
- chronic > 6 wks
Paronychia
inflammation of?
skin around a finger or toenail
Paronychia
caused by which bacteria?
- skin flora (staph or strep)
- oral flora (nail biting)
- candida (chronic)
Paronychia
pathophys
comonly occurs after penetrating skin trauma
Paronychia
clinical presentation
3
- rapid onset of painful erythema and swelling to the proximal/lateral nail folds
- occurs within 2 to 5 days of local trauma
- may have purulent discharge or superficial abscess
Paronychia
tx when mild
- warm water
- antiseptic soaks (chlorhexidine, povidone-iodine + topical antibacterial agent)
Paronychia
tx when moderate
- oral abx (cephalexin, dicloxacillin, augmentin if nail biter)
Paronychia
tx if MRSA
- trimethoprim-sulfamethoxazle DS
- clindamycin
- doxy
Paronychia
abscess tx
- incision & drainage
- warm soaks
- abx if cellulitis
Felon
clinical manifestation
severe, throbbing pain, erythema, swelling, and fluctuance to the pad of the fingertip
Felon
general overview
3 things
- clsoed space infection/abscess
- can be progression of paronychia
- most commonly occurs after skin trauma
Felon
tx
w & w/out flactuant
- w/out fluctant: elevation, warm water/saline soaks, oral abx (cephalexin)
- w/ fluctant: incision & drainage
