Cases reported "Nail Diseases"

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1/7. Perinatal manifestations of maternal yellow nail syndrome.

    A term female firstborn infant had unexplained nonimmune fetal hydrops and recurrent left chylothorax at 4 weeks of age. A few months before conception, her mother had had acute dystrophic nail changes and is being treated for recurrent sinusitis, bronchiectasis, and a deficiency of serum IgG2. We suggest that they both suffer from a dominantly inherited congenital lymphedema syndrome known as 'yellow nail dystrophy.' Prenatal manifestation of this disorder has not been reported previously. The child's anthropometric and neurological development was normal at 1 year of age, whereas mild ankle edema and marbling of the skin of the limbs were salient clinical findings. Inherited lymphedema leading to nonimmune fetal hydrops also has been recognized in chromosomal disorders, Noonan's syndrome, multiple pterygium syndrome, pulmonary lymphangiectasis, and mixed-vessel lymphatic dysfunction. Indicators of parental lymphedema are not on record in those instances.
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2/7. Congenital pseudoclubbing of a fingernail caused by subungual hemangioma.

    BACKGROUND: Nail dystrophies in newborns are rare and are particularly frightening when they appear as masses involving a single digit, suggesting the possibility of a tumor. OBJECTIVE: The aim of this study is to report 3 infants with a congenital pseudoclubbing appearance of a digit and with a reddish discoloration caused by the presence of a subungual hemangioma. methods: diagnosis was based on clinical examination and ultrasonography. RESULTS: Clinical presentation and vitrocompression showed the presence of a vascular mass. ultrasonography confirmed the diagnosis of a subungual hemangioma. The lesions showed a spontaneous regression on follow-up. CONCLUSION: Localization of hemangioma under the proximal nailfold is extremely rare and produces nail pseudoclubbing caused by capillary vessel proliferation in the soft tissue of the subungual region, which is associated with a reddish discoloration of the nail that typically fades with compression. Hemangiomas of infancy located in the proximal nailfold are rare, and, in our opinion, not at risk to become big masses with tissue damage and compression.
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3/7. angiolymphoid hyperplasia with eosinophilia affecting the nail bed and underlying bone.

    A 69-year-old Japanese woman had a dark red, 1-cm nodule located in the nail bed of the middle toe of her right foot. An X-ray examination revealed an osteolytic lesion of the distal phalanx of the right middle toe. Histopathology showed a proliferation of blood vessels surrounded by epithelioid cells and an infiltration of many eosinophils and some inflammatory cells. There has been no recurrence after surgical excision of the skin lesion and the distal phalanx of the right middle toe.
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4/7. yellow nail syndrome.

    The yellow nail syndrome is characterized by yellow, slow-growing nails in association with lymphedema, idiopathic pleural effusions, chronic bronchiectasis, and chronic sinusitis. We report two patients with yellow nail syndrome in whom spontaneous clearing of the nail changes occurred without resolution of the respiratory involvement. This observation suggests that nail changes may not result from the systemic manifestations. We also report for the first time the histopathologic findings of the nail matrix and bed, which demonstrate dense, fibrous tissue replacing subungual stroma with numerous ectatic, endothelium-lined vessels that are similar to that in the pleura in yellow nail syndrome. We hypothesize that primary stromal sclerosis may lead to lymphatic obstruction, thus explaining the clinical manifestations.
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5/7. Hereditary acrolabial telangiectasia. A report of familial blue lips, nails, and nipples.

    We describe a mother and two daughters who had the following clinical manifestations: bluish discoloration of the vermillion ridge of the lips, nipple areolae, and nail beds; discrete telangiectasia of the chest, elbows, and dorsa of the hands; varicosities of the lower part of the legs; and (in the two daughters) migraine headaches. Routine histologic examination of tissue from the lips and elbows disclosed extensive, dilated, horizontal subpapillary telangiectases. Enzyme histochemical stains demonstrated activity of adenosine triphosphatase and leucine aminopeptidase around these dilated vessels. Alkaline phosphatase activity was strikingly absent from the dilated subpapillary vessels. By electron microscopy, these vessels were demonstrated to be postcapillary venules. We propose an autosomal dominant mode of inheritance.
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6/7. Nail bleeding associated with neurological diseases: all that uncommon? Report of 3 cases.

    We report 3 patients, without bleeding disorders, presenting with onychomadesis and focal haemorrhages at multiple proximal nail folds or in the nail tissue. In one of our patients it was possible to check the appearance of a drop of blood on each side, beneath the proximal nail fold when he pressed the pulp of the fingers of his previously fractured forearm on a hard surface. All patients had major peripheral or major peripheral and central neurological deficits, prior to the nail bleeding. Peripheral vascular dilatation produced by paralysis of the vasoconstrictors in the nail area slows the venous return in the dilated vessels, mainly in the proximal nail fold.
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7/7. reflex sympathetic dystrophy with prominent involvement of the nail apparatus.

    After closed hand trauma, a 17-year-old boy had acute inflammatory changes that resembled bacterial whitlows of the third and fourth right fingers. Clearing of the inflammatory changes was followed by the development of cyanosis, hyperhidrosis, and roentgenographic evidence of patchy osteoporosis in the involved extremity. Findings of a biopsy specimen revealed that the inflammatory lesions in the proximal nail folds were caused by proliferation of capillary vessels embedded in edematous loose connective tissue. This is the first report of cutaneous histopathologic findings in the first stage of reflex sympathetic dystrophy, although similar features have been described in synovial and bone biopsy specimens of patients with reflex sympathetic dystrophy.
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