Pathology of the Nail Unit

Ruben, Beth S.

doi:10.1016/j.det.2020.12.009

Cited by 6 publications

(8 citation statements)

References 47 publications

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“…Diverse risk factors increase the probability of suffering this disease, such as age, trauma, disease (diabetes, obesity, etc. ), immunosuppression, psoriasis (56% increased risk), tinea pedis infection, genetics (associated to genes such as mhc or hla-dr8), direct transmission from an infected person or lifestyle habits (sports, smoking or the type of shoes) [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Combined laser and ozone therapy for onychomycosis in an in vitro and ex vivo model

Fernández

Fernández²,

Villar

et al. 2021

PLoS ONE

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In order to develop a fast combined method for onychomycosis treatment using an in vitro and an ex vivo models, a combination of two dual-diode lasers at 405 nm and 639 nm wavelengths, in a continuous manner, together with different ozone concentrations (until 80 ppm), was used for performing the experiments on fungal strains growing on PDA agar medium or on pig’s hooves samples. In the in vitro model experiments, with 30 min combined treatment, all species are inhibited at 40 ppm ozone concentration, except S. brevicaulis, which didn’t show an inhibition in comparison with only ozone treatment. In the ex vivo model experiments, with the same duration and ozone concentration, A. chrysogenum and E. floccosum showed total inhibition; T. mentagrophytes and T. rubrum showed a 75% growth inhibition; M. canis showed a delay in sporulation; and S. brevicaulis and A. terreus did not show growth inhibition. This combined laser and ozone treatment may be developed as a fast therapy for human onychomycosis, as a potential alternative to the use of antifungal drugs with potential side effects and long duration treatments.

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Section: Introductionmentioning

confidence: 99%

Combined laser and ozone therapy for onychomycosis in an in vitro and ex vivo model

Fernández

Fernández²,

Villar

et al. 2021

PLoS ONE

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“…The letter designation was adopted for the description of NU: “d” for the finger of the dominant hand and “nd” for the non-dominant one. The number describes the type of finger, and so the number ( 1 ), corresponded to the thumb; ( 2 ), the index finger; ( 3 ), the middle finger; ( 4 ), the ring finger; and ( 5 ), little finger.…”

Section: Methodsmentioning

confidence: 99%

“…Nowadays special attention is also paid to the aesthetic function of NU ( 2 ), and deterioration in its appearance may negatively affect the quality of life ( 3 ). For those reasons, diseases of NU seem to be hot topics for researchers around the world ( 4 , 5 ). There is a significant tendency to look for non-invasive research methods that facilitate the recognition of NU structure and function.…”

Section: Introductionmentioning

confidence: 99%

High-Frequency Ultrasonography and Evaporimetry in Non-invasive Evaluation of the Nail Unit

et al. 2021

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Background: The nail unit (NU) is a complex structure that performs a number of functions, including protection, defense, manipulation, and palpation. Non-invasive research methods can facilitate the recognition of NU structure and function. Evaporimetry and HF-USG due to their availability of equipment and low research costs seem to be particularly noteworthy, but so far have been assessed to a limited extent. The aim of the presented study was to check the usefulness of TOWL and HF-USG in examination of NU.Materials and Methods: A total of 58 volunteers aged 25–65 years (mean age: 41 ± 10.16 years) were qualified for the study. The subjects did not present symptoms of clinically evident onychopathy and did not suffer from any dermatoses associated with lesions occurring within the NU. Additionally, the patients did not suffer from systemic diseases that could affect NU (including heart, lung, and endocrine diseases). In all volunteers, the measurement of TOWL and 20 MHz ultrasonography [high-frequency ultrasonography (HF-USG)] with the special emphasis on determination of nail plate thickness were performed.Results: Analysis of 464 HF-USG images revealed that the nail plate presented as two hyperechoic, parallel streaks (railway sign) with a linear hypoechoic middle layer between them. Matrix was visualized as a hypoechoic structure with blurred boundaries, mostly within the fourth and fifth fingers and more often in women. We found statistically significant correlations between the type of a finger and the thickness of the nail plate both in the entire study group and taking into account gender. In the dominant hand, the results were r = −0.341; p < 0.001; r = −0.417, p < 0.001; and r = 0.337; p = 0.001 (for the whole group, for women, and for men, respectively). In the non-dominant hand, the results were r = −0.465; p < 0.001; r = −0.493, p < 0.01; and r = −0.503; p < 0.01 (for the whole group, for women, and for men, respectively). There were statistically significant differences in the thickness of the nail plates of the corresponding types of fingers between female and male NUs. Statistically significant correlations were found between the type of a finger and the TOWL value in the whole group and taking into account gender (p < 0.05), except for the non-dominant hand in men. There were no statistically significant differences in the TOWL values of the corresponding types of fingers between male and female NUs (p > 0.05). There was no statistically significant correlation between the TOWL value and the nail plate thickness in any of the tested NUs, apart from the one statistically significant correlation in nd5 (r = 0.390, p = 0.021).Conclusions: To sum up, non-invasive methods, such as HF-USG and TOWL, enable assessment of the NU and are useful in examination of its structure and function. HF-USG shows characteristic elements of NUs that can be distinguished because of differences in their echogenicity. The thickness of the nail plate and TOWL depend on the type of finger, and show a relationship with gender.

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“…The nail unit is composed of four main elements: nail matrix, nail bed, nail plate, and nail folds. [34][35][36] Each element has distinct histologic features. The nail matrix epithelium is composed of a basophilic basal and an eosinophilic superficial component.…”

Section: Normal Anatomymentioning

confidence: 99%

“…Both the nail matrix and nail bed lack a granular layer. 36 The nail plate is composed of densely packed, weakly eosinophilic onychocytes. 34 The onychocytes typically lack nuclei.…”

Section: Normal Anatomymentioning

confidence: 99%

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

Jiang¹,

Abbott

Higgins

et al. 2023

J Cutan Pathol

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Melanoma of the nail apparatus is challenging to diagnose for both dermatologists and dermatopathologists. Misdiagnosis or delayed diagnosis of nail unit melanoma can have fatal consequences and legal ramifications. This review educates dermatopathologists on challenges and traps they should be aware of to avoid misdiagnosis of nail unit melanoma. We present illustrative difficult cases that introduce several themes regarding challenges in the diagnosis of nail unit melanoma: specimens with subtle histopathologic findings, challenges in immunoperoxidase interpretation, and how clinical knowledge and surgical procedural knowledge are mandatory to make the diagnosis. Dermatopathologists will be aware of when and how to suspect nail unit melanoma in unusual circumstances.

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Pathology of the Nail Unit

Cited by 6 publications

References 47 publications

Combined laser and ozone therapy for onychomycosis in an in vitro and ex vivo model

Combined laser and ozone therapy for onychomycosis in an in vitro and ex vivo model

High-Frequency Ultrasonography and Evaporimetry in Non-invasive Evaluation of the Nail Unit

Clinicohistopathologic challenges and traps in the diagnosis of nail unit melanoma

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