Acroosteolysis presenting with brachyonychia following exposure to cold

Abstract

It had been repeatedly reported that frostbite, Raynaud's disease and diseases associated with repeated chilblains may be associated with secondary cold-induced acroosteolysis. Here, we present a case of acroosteolysis associated with brachyonychia following exposure to severe cold not mounting to frostbite.

Brachyonychia Associated with Acroosteolysis in Chronic Kidney Disease: How Phalange Shape Influences Nail Morphology

“…Brachyonychia was described by DuBois in 1926 as an altered shape of the nail plate, which is short, broad, and flat, secondary to the deformity of the underlying bone and soft tissue of the terminal phalanges [1, 5, 6]. Two forms have been described: genetic and acquired.…”

“…Nail dystrophy has been described as a sign of phalangeal osteolysis, since the function and shape of the nail unit is in part dependent on the underlying bone [1, 2]. Clinically, nail dystrophy can present as pseudoclubbing, brachyonychia, koilonychia, pincer nails, and anonychia [1, 3, 4].…”

“…Osteoclast formation is also induced by hypoxia. [1, 12, 13]. (b) Vasodilatation increases blood flow (hyperemia), which in turn elevates oxygen partial pressure, favoring modulation and activity of osteoclast, resulting in bone resorption.…”

“…Clinically, nail dystrophy can present as pseudoclubbing, brachyonychia, koilonychia, pincer nails, and anonychia [1, 3, 4]. …”

“…It can be classified as primary or familial, idiopathic or nonfamilial, and occupational or secondary, as a consequence of several conditions. The most common causes being inflammatory diseases, sensory neuropathy, vascular disease, metabolic diseases, exposure to vinyl chloride, and trauma (Table 2) [1, 2, 8-10]. …”