Coexisting median canaliform nail dystrophy and habit‐tic deformity in a patient with atopic dermatitis

Wang, Charlie C. L.; Lee, Senhong; Howard, Anne; Foley, Peter

doi:10.1111/ajd.13084

Cited by 4 publications

(5 citation statements)

References 3 publications

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“…Wang et al . published a case report exhibiting the co‐occurrence of median canal dystrophy and habitual tic deformity in a patient with AD 15 . Nail findings, including pitting, punctate leuconychia, trachyonychia, onycholysis and onychomadesis, were detected in all the participants of the current study, with pitting being the only finding that was significantly higher in the patient group.…”

Section: Discussionsupporting

confidence: 48%

Assessment of nail findings in children with atopic dermatitis

Demir

Çiçek

Yüksel

2021

Clin Experimental Derm

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Background. Cutaneous findings are well known in atopic dermatitis (AD), but nail changes have not received as much attention. Aim. To determine the clinical and disease-related capillaroscopic findings of nail findings in paediatric patients with AD. Methods. In total, 100 participants aged 2-16 years were sourced from the dermatology outpatient clinic: 50 of these had been diagnosed with AD according to the Hanifin-Rajka criteria, and the others were 50 healthy controls (HCs) without AD. The AD severity score (SCORing Atopic Dermatitis; SCORAD) was calculated for all patients with AD. A digital epiluminescence device was used for nailfold capillaroscopy.Results. The nail findings detected in patients with AD were pitting, punctate leuconychia, trachyonychia, onycholysis and onychomadesis. Pitting was significantly (P < 0.01) more frequent in the patient group (26%) than in the HC group (6%). Similarly, the patient group had significantly higher rates for capillary density decrease (P < 0.01), capillary array irregularity (P < 0.001), capillary dilatation increase (P < 0.001), tortuosity (P = 0.04), ramification increase (P = 0.02), bushlike appearance (P = 0.02) and avascular areas (P < 0.01). Significant correlations were determined between pitting and trachyonychia (P < 0.05, r = 0.21), capillary density decrease (P < 0.05, r = 0.25), avascular areas (P < 0.001; r = 0.29) and SCORAD (P < 0.05, r = 0.35). Conclusion. The nailfold capillaroscopic images of children with AD were similar to those of scleroderma spectrum disorder. Thus, we believe it would be beneficial to support detailed clinical examination of patients with a capillaroscopic examination.

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Section: Discussionsupporting

confidence: 48%

Assessment of nail findings in children with atopic dermatitis

Demir

Çiçek

Yüksel

2021

Clin Experimental Derm

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“…20 MCD is diagnosed clinically and is commonly described in the literature as a "fir tree pattern." 8,9,[12][13][14][15][16][18][19][20] Fungal infection should be included in the differential diagnoses and excluded prior to making a diagnosis of MCD. 2,10,15,19 Differential diagnoses can include habit tic deformity and glomus tumors.…”

Section: Discussionmentioning

confidence: 99%

“…2 Reported topical treatments include topical corticosteroids, 12,21 topical tacrolimus, 8,10,11,21 topical urea cream, 12 flurandrenolide tape, 14 and YAG laser. 19 Systemic therapies include an investigative janus kinase inhibitor 9 or dupilumab. 1 Other treatments include psychiatric counseling 8,10,11 and antipsychotics (Table 10).…”

Section: Discussionmentioning

confidence: 99%

“…7 It is postulated that MCD is induced by trauma, medication, or unknown etiology. Reported modes of trauma include nail biting, 8 from scratching caused by pruritus associated with atopic dermatitis, 9 self-induced with stress or anxiety, [10][11][12] and cryotherapy. 7 Medications that have been reported to induce median canaliform dystrophy include isotretinoin, [13][14][15][16][17] aliretinoin, 18 and HIV treatment ritonavir.…”

Section: Discussionmentioning

confidence: 99%

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Median canaliform nail dystrophy in a 2‐year‐old boy: Case report and review of the literature

Wilson

Khan

Murrell

2022

Pediatric Dermatology

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Median canaliform nail dystrophy (MCD) is a rare nail abnormality with an unknown etiology. We report the case of MCD of both great toenails in a 2‐year‐old boy presenting with a fir tree nail pattern and longitudinal splits. MCD was treated with topical marigold therapy (Tagetes sp.). By 15 weeks, the proximal 50% of the MCD had normalized. The report highlights a potential new treatment of marigold therapy for MCD.

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“…We considered that the cause of the canaliform dystrophy was probably due to the chronic pruritus related to AD, as described by Wang et al . Given the severity of the AD, dupilumab therapy was administered at an initial dose of 600 mg, followed by 300 mg every 2 weeks.…”

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confidence: 99%