Nail matrix arrest in the course of hand, foot and mouth disease
ABSTRACT Onychomadesis describes complete nail shedding from the proximal portion; it is consecutive to a nail matrix arrest and can affect both fingernails and toenails. It is a rare disorder in children. Except for serious generalised diseases or inherited forms, most cases are considered to be idiopathic. Few reports in literature concern common triggering phenomena. We present four patients in whom the same benign viral condition in childhood appeared as a stressful event preceding onychomadesis. In each case, spontaneous complete healing of the nails was achieved within a few weeks. Conclusion: onychomadesis and/or onycholysis is a newly recognised complication in the course of viral infections presenting clinically as hand, foot and mouth disease, and because of mild forms, is probably underestimated.
Article: Pediatric nail conditions[Show abstract] [Hide abstract]
ABSTRACT: Pediatric nail findings are plentiful and can range from benign processes to the initial signs of a systemic condition. The examination of the nail is an essential part of the pediatric physical examination. The nail unit consists of the nail plate, the nail matrix, the hyponychium, the nail bed, and the surrounding nail folds. Conditions that affect the nail unit have a variety of etiologies; these include inflammatory, congenital, and hereditary conditions as well as tumors and trauma. This review describes many of the nail conditions that are seen in the pediatric population.Clinics in dermatology 09/2013; 31(5):564-572. DOI:10.1016/j.clindermatol.2013.06.017 · 1.93 Impact Factor
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ABSTRACT: Immunoglobulin class switch recombination deficiencies (Ig CSR deficiencies) or Hyper IgM syndromes (HIGM) are a group of primary immunodeficiency diseases, characterized by defective CD40 signaling of B cells, resulting in reduced CSR and somatic hypermutation. The affected patients are characterized by low serum levels of IgG and IgA, and normal or elevated levels of IgM, which lead to an increased susceptibility to infections. We describe a 3 year-old boy with frequent bacterial infections of the skin and respiratory tract, mucosal ulcers, and diarrhea. He experienced onychomadesis of both fingernails and toenails during a recent bacterial infection. Quantitative immunoglobulin measurements revealed high levels of serum IgM and very low levels of IgG, IgA, and IgE. Clinical and immunologic studies supported the diagnosis of HIGM. Exclusion of CD40L, CD40, AID and UNG genes by molecular analysis in this patient may suggest a new form of selective CSR deficiency.Iranian journal of allergy, asthma, and immunology 04/2008; 7(1):41-4. · 1.01 Impact Factor
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