The Dermatologist's Approach to Onychomycosis
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General Dermatology an Atlas of Diagnosis and Management 2007
An Atlas of Diagnosis and Management GENERAL DERMATOLOGY John SC English, FRCP Department of Dermatology Queen's Medical Centre Nottingham University Hospitals NHS Trust Nottingham, UK CLINICAL PUBLISHING OXFORD Clinical Publishing An imprint of Atlas Medical Publishing Ltd Oxford Centre for Innovation Mill Street, Oxford OX2 0JX, UK tel: +44 1865 811116 fax: +44 1865 251550 email: [email protected] web: www.clinicalpublishing.co.uk Distributed in USA and Canada by: Clinical Publishing 30 Amberwood Parkway Ashland OH 44805 USA tel: 800-247-6553 (toll free within US and Canada) fax: 419-281-6883 email: [email protected] Distributed in UK and Rest of World by: Marston Book Services Ltd PO Box 269 Abingdon Oxon OX14 4YN UK tel: +44 1235 465500 fax: +44 1235 465555 email: [email protected] © Atlas Medical Publishing Ltd 2007 First published 2007 All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, without the prior permission in writing of Clinical Publishing or Atlas Medical Publishing Ltd. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. A catalogue record of this book is available from the British Library ISBN-13 978 1 904392 76 7 Electronic ISBN 978 1 84692 568 9 The publisher makes no representation, express or implied, that the dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. -
Common Derm Conditions and Treatments
4/10/17 Classes of Dermatologic Medications What is that?! Common Dermatologic Conditions and ● Topical Immune Suppressants ● Immune Suppressants How to Treat Them ● Vitamin D Derivatives ● Antibiotics, Antivirals, Antiparasitic Matthew Fox, MD ● Retinoids ● Antimalarials Assistant Professor, Division of Dermatology ● Biologic Agents Dell Medical School, University of Texas at Austin Director of Dermatologic Surgery, Seton Healthcare Family ● Chemotherapeutic agents Learning Objectives Approach to Dermatologic Conditions • Know the clinical subtypes of acne *Know the mechanism and recommended dosing of topical retinoids, oral antibiotics and oral retinoids in the management of acne Acne • Understand the clinical presentation cutaneous dermatophyte infection Infectious diseases of the Skin *Know the classes and recommended dosing of antifungal treatments • Recognize the clinical manifestations of dermatitis Eczema *Know the relative potencies, side effects and indications of topical steroids Psoriasis • Describe the classic clinical findings for psoriasis *Know the mechanism of action and side effects of systemic antipsoriatic medications Sun Damage / Actinic Keratoses • Know the pertinent history and physical exam findings associated with a diagnosis of skin cancer, including the ABCDEs of melanoma Fundamentals Words to the wise… • All medications have side effects If you advise the patients of side effects ahead of time, you are informing the • Always consider drug interactions, patient. including with food and supplements If you did not tell the patient about a known • Always consider pregnancy and lactation side effect until after they experience status that side effect, it is an excuse 1 4/10/17 Reference: Approach to Dermatologic Conditions • Wolverton SE, ed. Acne Comprehensive Infectious diseases of the Skin Dermatologic Drug Eczema nd Therapy, 2 Ed. -
Therapeutic Class Overview Antifungals, Topical
Therapeutic Class Overview Antifungals, Topical INTRODUCTION The topical antifungals are available in multiple dosage forms and are indicated for a number of fungal infections and related conditions. In general, these agents are Food and Drug Administration (FDA)-approved for the treatment of cutaneous candidiasis, onychomycosis, seborrheic dermatitis, tinea corporis, tinea cruris, tinea pedis, and tinea versicolor (Clinical Pharmacology 2018). The antifungals may be further classified into the following categories based upon their chemical structures: allylamines (naftifine, terbinafine [only available over the counter (OTC)]), azoles (clotrimazole, econazole, efinaconazole, ketoconazole, luliconazole, miconazole, oxiconazole, sertaconazole, sulconazole), benzylamines (butenafine), hydroxypyridones (ciclopirox), oxaborole (tavaborole), polyenes (nystatin), thiocarbamates (tolnaftate [no FDA-approved formulations]), and miscellaneous (undecylenic acid [no FDA-approved formulations]) (Micromedex 2018). The topical antifungals are available as single entity and/or combination products. Two combination products, nystatin/triamcinolone and Lotrisone (clotrimazole/betamethasone), contain an antifungal and a corticosteroid preparation. The corticosteroid helps to decrease inflammation and indirectly hasten healing time. The other combination product, Vusion (miconazole/zinc oxide/white petrolatum), contains an antifungal and zinc oxide. Zinc oxide acts as a skin protectant and mild astringent with weak antiseptic properties and helps to -
Federal Register/Vol. 83, No. 31/Wednesday, February 14, 2018
Federal Register / Vol. 83, No. 31 / Wednesday, February 14, 2018 / Notices 6563 Wireless Telecommunications Bureau Signed: DEPARTMENT OF HEALTH AND and Wireline Competition Bureau (the Dayna C. Brown, HUMAN SERVICES Bureaus) may implement, and (3) certify Secretary and Clerk of the Commission. Centers for Disease Control and its challenge. The USAC system will [FR Doc. 2018–03166 Filed 2–12–18; 4:15 pm] validate a challenger’s evidence using Prevention BILLING CODE 6715–01–P an automated challenge validation [CDC–2018–0004; NIOSH–233–B] process. Once all valid challenges have been identified, a challenged party that NIOSH List of Antineoplastic and Other chooses to respond to any valid FEDERAL RESERVE SYSTEM Hazardous Drugs in Healthcare challenge(s) may submit additional data Settings: Proposed Additions to the via the online USAC portal during the Change in Bank Control Notices; NIOSH Hazardous Drug List 2018 established response window. A Acquisitions of Shares of a Bank or AGENCY: Centers for Disease Control and challenged party may submit technical Bank Holding Company information that is probative regarding Prevention, HHS. ACTION: Notice of draft document the validity of a challenger’s speed tests, The notificants listed below have available for public comment. including speed test data and other applied under the Change in Bank device-specific data collected from Control Act (12 U.S.C. 1817(j)) and transmitter monitoring software or, SUMMARY: The National Institute for § 225.41 of the Board’s Regulation Y (12 alternatively, may submit its own speed Occupational Safety and Health test data that conforms to the same CFR 225.41) to acquire shares of a bank (NIOSH) of the Centers for Disease standards and requirements specified by or bank holding company. -
NAIL DISEASES and NAIL HEALTH Your Nails Can Tell You a Lot About Your Health
Dermatology Patient Education NAIL DISEASES AND NAIL HEALTH Your nails can tell you a lot about your health. Nail diseases and warning signs of other health problems appear on the nails. Your nails also reveal whether you are taking good care them. Good nail care is important because it can help prevent many common nail problems. NAIL DISEASES The skin around our nails and the tissue beneath are susceptible to many diseases. If you see any of the following, promptly see a dermatologist. Early diagnosis and proper treatment offer the best outcome. If allowed to progress, nail disease can be challenging to treat. Melanoma under the nail • Dark spot or streak Melanoma (skin cancer): Nail streaks are common in people of color. While many nail streaks are harmless, it is important to know that about 30% to 40% of melanomas that occur in people of color develop under a nail. While melanoma under the nail is more common in people of color, anyone can get melanoma under a nail. If your nail has a dark streak or spot and you do not remember injuring the nail, promptly see a dermatologist. When caught early, melanoma can be cured. • Growth Skin cancer: Many different types of skin cancer, including melanoma and Squamous cell carcinoma, can form under or around a nail. If you see a growth under or around your nail, promptly see a dermatologist. Your dermatologist can tell you whether the growth should be removed. Wart: A growth on the skin surrounding a nail is often a wart. Warts are common on the hands and feet. -
A RARE PRESENTATION of INGROWN TOE NAIL *Alagar Samy R
CIBTech Journal of Surgery ISSN: 2319-3875 (Online) An Open Access, Online International Journal Available at http://www.cibtech.org/cjs.htm 2015 Vol. 4 (1) January-April, pp.24-27/Samy Case Report A RARE PRESENTATION OF INGROWN TOE NAIL *Alagar Samy R. ESIC Medical College and Hospital, Coimbatore, Tamilnadu, India *Author for Correspondence ABSTRACT Onychocryptosis or ingrown toenail is a very common pathology of the toenail unit, chiefly affecting adolescents and young adults. The ingrown toenail is responsible for disabling complaints like pain and difficulty in walking. It is associated with significant morbidity, hampering the quality of life as it interferes with sporting activities, school, or work. It principally occurs in the hallux. It is ascribed to poor trimming of the nails in combination with local pressure due to ill-fitting footwear, hyperhidrosis, poor foot hygiene and nail abnormalities. Pain, swelling and discharge are the main clinical features. Four stages of the condition have been described. Diagnosis is usually evident, but it should be differentiated from subungual exostosis and tumors of the nail bed (James et al., 2006). I report a case of in grown toe nail involving right great toe with a swelling in the same toe with occasional pain. There was no history of trauma or any co morbid illness. Hence the right great toe nail with a swelling excised intoto. The Histopathological examination revealed only chronic inflammation. The post operative period was uneventful and discharged on third post operative period. It is being presented for its rarity. Keywords: Onychocryptosis, Hallux, Ingrown, Avulsion INTRODUCTION Onychocryptosis or ingrown toenail is a very common pathology of the toenail unit, chiefly affecting adolescents and young adults. -
Ehealth DSI [Ehdsi V2.2.2-OR] Ehealth DSI – Master Value Set
MTC eHealth DSI [eHDSI v2.2.2-OR] eHealth DSI – Master Value Set Catalogue Responsible : eHDSI Solution Provider PublishDate : Wed Nov 08 16:16:10 CET 2017 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 1 of 490 MTC Table of Contents epSOSActiveIngredient 4 epSOSAdministrativeGender 148 epSOSAdverseEventType 149 epSOSAllergenNoDrugs 150 epSOSBloodGroup 155 epSOSBloodPressure 156 epSOSCodeNoMedication 157 epSOSCodeProb 158 epSOSConfidentiality 159 epSOSCountry 160 epSOSDisplayLabel 167 epSOSDocumentCode 170 epSOSDoseForm 171 epSOSHealthcareProfessionalRoles 184 epSOSIllnessesandDisorders 186 epSOSLanguage 448 epSOSMedicalDevices 458 epSOSNullFavor 461 epSOSPackage 462 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 2 of 490 MTC epSOSPersonalRelationship 464 epSOSPregnancyInformation 466 epSOSProcedures 467 epSOSReactionAllergy 470 epSOSResolutionOutcome 472 epSOSRoleClass 473 epSOSRouteofAdministration 474 epSOSSections 477 epSOSSeverity 478 epSOSSocialHistory 479 epSOSStatusCode 480 epSOSSubstitutionCode 481 epSOSTelecomAddress 482 epSOSTimingEvent 483 epSOSUnits 484 epSOSUnknownInformation 487 epSOSVaccine 488 © eHealth DSI eHDSI Solution Provider v2.2.2-OR Wed Nov 08 16:16:10 CET 2017 Page 3 of 490 MTC epSOSActiveIngredient epSOSActiveIngredient Value Set ID 1.3.6.1.4.1.12559.11.10.1.3.1.42.24 TRANSLATIONS Code System ID Code System Version Concept Code Description (FSN) 2.16.840.1.113883.6.73 2017-01 A ALIMENTARY TRACT AND METABOLISM 2.16.840.1.113883.6.73 2017-01 -
Nail Involvement in Alopecia Areata
212 CLINICAL REPORT Nail Involvement in Alopecia Areata: A Questionnaire-based Survey on DV Clinical Signs, Impact on Quality of Life and Review of the Literature 1 2 2 1 cta Yvonne B. M. ROEST , Henriët VAN MIDDENDORP , Andrea W. M. EVERS , Peter C. M. VAN DE KERKHOF and Marcel C. PASCH1 1 2 A Department of Dermatology, Radboud University Nijmegen Medical Center, Nijmegen, and Health, Medical and Neuropsychology Unit, Institute of Psychology, Leiden University, Leiden, The Netherlands Alopecia areata (AA) is an immune-mediated disease at any age, but as many as 60% of patients with AA will causing temporary or permanent hair loss. Up to 46% present with their first patch before 20 years of age (4), and of patients with AA also have nail involvement. The prevalence peaks between the 2nd and 4th decades of life (1). aim of this study was to determine the presence, ty- AA is a lymphocyte cell-mediated inflammatory form pes, and clinical implications of nail changes in pa- of hair loss in which a complex interplay between genetic enereologica tients with AA. This questionnaire-based survey eva- factors and underlying autoimmune aetiopathogenesis V luated 256 patients with AA. General demographic is suggested, although the exact aetiological pathway is variables, specific nail changes, nail-related quality of unknown (5). Some studies have shown association with life (QoL), and treatment history and need were evalu- other auto-immune diseases, including asthma, atopic ated. Prevalence of nail involvement in AA was 64.1%. dermatitis, and vitiligo (6). ermato- The specific nail signs reported most frequently were Many patients with AA also have nail involvement, D pitting (29.7%, p = 0.008) and trachyonychia (18.0%). -
NAIL CHANGES in RECENT and OLD LEPROSY PATIENTS José M
NAIL CHANGES IN RECENT AND OLD LEPROSY PATIENTS José M. Ramos,1 Francisco Reyes,2 Isabel Belinchón3 1. Department of Internal Medicine, Hospital General Universitario de Alicante, Alicante, Spain; Associate Professor, Department of Medicine, Miguel Hernández University, Spain; Medical-coordinator, Gambo General Rural Hospital, Ethiopia 2. Medical Director, Gambo General Rural Hospital, Ethiopia 3. Department of Dermatology, Hospital General Universitario de Alicante, Alicante, Spain; Associate Professor, Department of Medicine, Miguel Hernández University, Spain Disclosure: No potential conflict of interest. Received: 27.09.13 Accepted: 21.10.13 Citation: EMJ Dermatol. 2013;1:44-52. ABSTRACT Nails are elements of skin that can often be omitted from the dermatological assessment of leprosy. However, there are common nail conditions that require special management. This article considers nail presentations in leprosy patients. General and specific conditions will be discussed. It also considers the common nail conditions seen in leprosy patients and provides a guide to diagnosis and management. Keywords: Leprosy, nails, neuropathy, multibacillary leprosy, paucibacillary leprosy, acro-osteolysis, bone atrophy, type 2 lepra reaction, anonychia, clofazimine, dapsone. INTRODUCTION Leprosy can cause damage to the nails, generally indirectly. There are few reviews about the Leprosy is a chronic granulomatous infection affectation of the nails due to leprosy. Nails are caused by Mycobacterium leprae, known keratin-based elements of the skin structure that since ancient times and with great historical are often omitted from the dermatological connotations.1 This infection is not fatal but affects assessment of leprosy. However, there are the skin and peripheral nerves. The disease causes common nail conditions that require diagnosis cutaneous lesions, skin lesions, and neuropathy, and management. -
Hair and Nail Disorders
Hair and Nail Disorders E.J. Mayeaux, Jr., M.D., FAAFP Professor of Family Medicine Professor of Obstetrics/Gynecology Louisiana State University Health Sciences Center Shreveport, LA Hair Classification • Terminal (large) hairs – Found on the head and beard – Larger diameters and roots that extend into sub q fat LSUCourtesy Health of SciencesDr. E.J. Mayeaux, Center Jr., – M.D.USA Hair Classification • Vellus hairs are smaller in length and diameter and have less pigment • Intermediate hairs have mixed characteristics CourtesyLSU Health of E.J. Sciences Mayeaux, Jr.,Center M.D. – USA Life cycle of a hair • Hair grows at 0.35 mm/day • Cycle is typically as follows: – Anagen phase (active growth) - 3 years – Catagen (transitional) - 2-3 weeks – Telogen (preshedding or rest) about 3 Mon. • > 85% of hairs of the scalp are in Anagen – Lose 75 – 100 hairs a day • Each hair follicle’s cycle is usually asynchronous with others around it LSU Health Sciences Center – USA Alopecia Definition • Defined as partial or complete loss of hair from where it would normally grow • Can be total, diffuse, patchy, or localized Courtesy of E.J. Mayeaux, Jr., M.D. CourtesyLSU of Healththe Color Sciences Atlas of Family Center Medicine – USA Classification of Alopecia Scarring Nonscarring Neoplastic Medications Nevoid Congenital Injury such as burns Infectious Systemic illnesses Genetic (male pattern) (LE) Toxic (arsenic) Congenital Nutritional Traumatic Endocrine Immunologic PhysiologicLSU Health Sciences Center – USA General Evaluation of Hair Loss • Hx is -
A Leukonychia Nail Disease Detection Using Deep Learning Approach
8 III March 2020 International Journal for Research in Applied Science & Engineering Technology (IJRASET) ISSN: 2321-9653; IC Value: 45.98; SJ Impact Factor: 7.429 Volume 8 Issue III Mar 2020- Available at www.ijraset.com A Leukonychia Nail Disease Detection using Deep Learning Approach Naveen1, Gaurav Rai2, Aquib Hussain3, Amit Kumar4, Rahul Nijhawan5 1, 2, 3, 4Student, COER Roorkee, Uttarakhand, India 5Guide, GEU Dehradun, Uttarakhand, India Abstract: Nail Diseases are some kind of deformities in nails. Detection of Nail Disease (Leukonychia) using modern state-of- the-art technological tools, thereby reducing the dependency on medical experts. It is still challenging to identify the disease in Nails. Leukonychia, is a medical term for white discoloration appearing on nails. The most common cause is injury to the base of the nail where the nail is formed. The common causes that are noticed around the nails are changing the color of nails to dark streaks, white streaks, changes in nail shape, changes in nail thickness, bleeding around nails or change in nail color. This affection of the disease is about 31% in the adult population. Treatment of leukonychia has been reported from treating malnutrition associated with zinc deficiency and other minerals. This paper strives for a deep convolutional neural network to classify Leukonychia disease from images that are provided in the dataset. The skeleton uses (VGG)-16, (VGG)-19 and INCEPTION-V3 for extracting the features. Due to the absence of an active dataset, a new dataset was created for testing the correctness of our debatable framework. This work is tested on our dataset and is measured with other advanced algorithms (Artificial Neural Network, Support Vector Machine, Random Forest, Adaboost, CN2 Rule Induction, K-Nearest Neighbour, Naive Bayes and Logistic Regression) which results in considerable performance in extraction of features. -
Pili Torti: a Feature of Numerous Congenital and Acquired Conditions
Journal of Clinical Medicine Review Pili Torti: A Feature of Numerous Congenital and Acquired Conditions Aleksandra Hoffmann 1 , Anna Wa´skiel-Burnat 1,*, Jakub Z˙ ółkiewicz 1 , Leszek Blicharz 1, Adriana Rakowska 1, Mohamad Goldust 2 , Małgorzata Olszewska 1 and Lidia Rudnicka 1 1 Department of Dermatology, Medical University of Warsaw, Koszykowa 82A, 02-008 Warsaw, Poland; [email protected] (A.H.); [email protected] (J.Z.);˙ [email protected] (L.B.); [email protected] (A.R.); [email protected] (M.O.); [email protected] (L.R.) 2 Department of Dermatology, University Medical Center of the Johannes Gutenberg University, 55122 Mainz, Germany; [email protected] * Correspondence: [email protected]; Tel.: +48-22-5021-324; Fax: +48-22-824-2200 Abstract: Pili torti is a rare condition characterized by the presence of the hair shaft, which is flattened at irregular intervals and twisted 180◦ along its long axis. It is a form of hair shaft disorder with increased fragility. The condition is classified into inherited and acquired. Inherited forms may be either isolated or associated with numerous genetic diseases or syndromes (e.g., Menkes disease, Björnstad syndrome, Netherton syndrome, and Bazex-Dupré-Christol syndrome). Moreover, pili torti may be a feature of various ectodermal dysplasias (such as Rapp-Hodgkin syndrome and Ankyloblepharon-ectodermal defects-cleft lip/palate syndrome). Acquired pili torti was described in numerous forms of alopecia (e.g., lichen planopilaris, discoid lupus erythematosus, dissecting Citation: Hoffmann, A.; cellulitis, folliculitis decalvans, alopecia areata) as well as neoplastic and systemic diseases (such Wa´skiel-Burnat,A.; Zółkiewicz,˙ J.; as cutaneous T-cell lymphoma, scalp metastasis of breast cancer, anorexia nervosa, malnutrition, Blicharz, L.; Rakowska, A.; Goldust, M.; Olszewska, M.; Rudnicka, L.