NAIL SKIN DISORDERS TERMS PART B

Question 1

name this condition:

AKA Mee’s lines

• arsenic
• chemotherapy

Answer 1

transverse leukonychia

Question 2

name this angle:

angle between the nail plate and the proximal nail fold when viewed form the side >180 degrees in clubbed nails and 160 degrees in normal nails

Answer 2

lovibond angle

Question 3

name this condition:

spoon shaped nails

• iron deficiency anemia association
• converse of clubbing
• central nail bed atrophy
• concave everted edges
• thumbs more than toes

Answer 3

koilionychia

Question 4

name this condition:

fragile abnormal layering

• layering and splitting
• distal nail plate splits
• acquired by excessive water exposure then drying cycles

*remember, different than onychorrhexis which displays longitudinal ridging

Answer 4

onychoschizia

Question 5

name this condition:

pits

onycholysis

oil drop sign

onychomycosis

trachonychia

splinter hemorrhages

sublingual hyperkeratosis

Answer 5

psoriatic nails

Question 6

name this condition:

less than half nail bed ecchymotic

nail plate intact and not tender

reassurance

monitor for spread verses outgrowth

consider subungual melanoma

dermoscopy shows globules of red

hem occult test of nail plate-trephine nail plate

Answer 6

partial subungual hematoma

Question 7

name this condition:

serum or cold abscess

thickened nail plus shoe

rule out osteomyelitis or subungual exostosis

systemic antibiotics usually not indicated

Answer 7

nail bed seroma

Question 8

name this condition:

dense corn like hyperkeratosis between the nail plate and nail bed or lip

pressure corn within nail groove

common finding in elderly

apply 1-2 drops of KOH wit DMSO

Answer 8

onychophosis

Question 9

name this condition:

distal expansion of the hyponychium
-obliteration of the distal nail groove

caution
-avoid debridement abrasions

Answer 9

ventral pterygium

Question 10

name this condition:

small brown to black 2-3 mms long linear strokes

multiple nails consider systemic disease

few nails-trauma

Answer 10

splinter hemorrhages

Question 11

name this condition:

periungual tumors

• fleshy hyperkeratotic growths of the proximal nail fold
• distortion and destruction of the nails
• half of tuberous sclerosis patients
• tuberous sclerosis complex (TSC)

*cafe au lait spots

Answer 11

Koenen’s tumors

Question 12

name this condition:

clinical types

• distal subungual and lateral
• superficial white type accounts for 2%
• proximal sublingual is rarest
• total dystrophic type represents end stage of chronic infection

dermatophytes cause tinea unguium

oncychomycosis
-dermatohpytes, saprophytes, yeasts

Answer 12

onychomycosis

Question 13

name this condition:

pruritic pink to purple papules and polygonal plaques
-dorsal pterygium

Answer 13

lichen planus

Question 14

name this condition:

yellow nails
absent lunulas and cuticles
periungual swelling
impaired lymphatic drainage

Answer 14

yellow nail syndrome

Question 15

name this condition:

red pink or brown distal band comprising 20-60% of the total nail plate with the remaining proximal portion being clear or whitish

• prominent onychodermal band, wite proximal nails
• found in patients with renal failure

Answer 15

half and half nails

Question 16

name this condition:

benign tan
melanocytes normal, more plentiful in distal matrix
pigment localized in dorsal half of nail plate arises from proximal matrix

Answer 16

longitudinal melanonychia

Question 17

name this condition:

nail bed pigment spreads into proximal nail fold skin

also,

normal longitudinal melanonychia is seen through transparent cuticle
-proximal nail fold skin clear of pigment
monitor with sequential photographs

Answer 17

subungual melanoma via Hutchinson’s sign

pseudo-hutchinson’s sign

Question 18

name this condition:

benign fibroepithelial growths with rough hyperkeratotic surface

treatment resistant

Answer 18

periungual verrucae

Question 19

name this condition:

proud flesh-capillary overgrowth

Answer 19

pyogenic granuloma

Question 20

name this condition:

periungual fibrokeratomas

• benign nodules with hyperkeratotic tips arising form the proximal nail fold
• garlic clove fibromas

Answer 20

periungual fibromas

Question 21

name this condition:

rare benign tumor
painful benign overgrowth of digital glomerulus 
intense pulsating migrainous pains
MRI
surgical biopsy

Answer 21

glomus tumor

Question 22

name this condition:

atopic dermatitis or atopic eczema

Answer 22

eczema

Question 23

name this condition:

localized inflammatory skin response to chemical or physical agents
occlusion or chemical or physical irritants

Answer 23

irritant contact dermatitis

Question 24

name this condition:

T cell mediated generally found in delayed type IV reaction

Answer 24

allergic contact dermatitis

Question 25

name this condition:

symmetrical fissuring
favors thick skin of soles
fx of atopic eczema
initial symptom of relief
long term prevention

Answer 25

juvenile plantar dermatosis

Question 26

name this condition:

acute palmoplantar eczema

• intensely pruritic
• recurrent episodes
• nickel hypersensitivity
• potent corticosteroids

Answer 26

dyshidrotic eczema-pompholyx

Question 27

name this type of tinea pedis?

lateral soles
chronic papulosquamous pattern
Rx econazole cream two months

Answer 27

hyperkeratotic type

Question 28

name this type of tinea pedis?

medial arch
T mentagrophytes
topical corticosteroids initially

Answer 28

vesicular type

Question 29

name this type of tinea pedis?

lesser toe webs
erythematous peeling eroded toe webs
anti fungal and cotton toe web spacers

Answer 29

interdigital type

Question 30

name this type of tinea pedis?

unilateral toe
webs and forefoot
fungus and secondary bacterial infection
oral antibiotics, topical antifungal, soaks

Answer 30

ulcerative type

Question 31

name this condition?

corynebacteria minutissimum
upper layer of moist epidermis
predisposing factors like high humidity
fluoresces coral red under woods light exam
treatment options
-foot and toe web provide scrubs
-econazole 
-extensive cases require oral erythromycin

Answer 31

erythrasma

Question 32

name this condition?

nodular melanoma
acral lentiginous melanoma
superficial spreading melanoma
subungual melanoma

Answer 32

pedal melanomas

Question 33

name this condition?

type I infects soles
incubation period ranges 2-6 months
asymmetrical infection 
disruption skin dermatoglyphic lines
hyperkeratotic papules and plaques

Answer 33

HPV infections-warts

Question 34

name this condition?

peak incidence 5-16 years
7-10% of population infected 
spontaneous remission
clinical diagnosis
-epidermal ridge flattening
-dilated dermal papillae
-petechial hemorrhages

Answer 34

plantar verrucae

Question 35

name this type of verrucae?

HPV type 1,2,4
hands, forearms, 0.25 to 1 cm diameter

Answer 35

common warts

Question 36

name this type of verrucae?

auto inoculated
-nail biters and cuticle pickers

Answer 36

periungual warts

Question 37

name this type of verrucae?

flesh colored 2-4 mms papules; may number in the hundreds

face, neck, forearms, knees and dorsal hands

Answer 37

flat warts

Question 38

name this type of verrucae?

slender, threadlike. horny growths

face, around eyes and eyelids

Answer 38

filiform warts