Nail Disorder Flashcards Preview

Dermatology - Clinical Medicine IV > Nail Disorder > Flashcards

Flashcards in Nail Disorder Deck (36):
1

What are the nail disorders?

Psoriasis
Onycomycosis
Onycholysis
Paronychia
Subungual Hematoma
Ingrown Toenail (unguis incarnatus)

2

How do onychomycosis appear?

complaints about the appearance of the nail, with no physical symptoms
As the disease progresses, interference with standing, walking, and exercising
Paresthesia, pain, discomfort, and loss of dexterity
Loss of self-esteem and inhibited social interaction

3

How do you dx onycomycosis?

KOH in DMSO

4

What are the topical treatment for onycomycosis?

Ciclopirox olamine 8% nail lacquer solution
Efinaconazole 10% topical solution (the first FDA-approved topical triazole for toenail onychomycosis)
Topical treatments may be useful to prevent recurrence in patients cured with systemic agents

5

What is the systemic treatment for onychomycosis?

Terbinafine
Itraconazole

6

What co infection is suspected with onycholysis?

yeast infection is suggested- Perform mycologic studies to exclude onychomycosis, including potassium hydroxide wet mount and fungal cultures

7

How do you treat onycholysis?

tx underlying cause,topical antifungal imidazole or allylamine twice daily to avoid superinfection of the nail.

8

What is the tx for onycholysis due to psoriasis or eczema?

midstrength topical corticosteroid

9

How do you tx onycholysis with onychomycosis?

oral broad-spectrum antifungal agent (ie, fluconazole, itraconazole, terbinafine)

10

What do you see in nails with psoriasis?

oil stain or nail pitting

11

What are nail disorders associated with systemic disease?

Muehrckes Nails
Half and Half
Nail Fold Telangiectasia
Onycholysis
Periungual Fibroma
Yellow Nail Syndrome
Blue Nails
Splinter Hemorrhage
Beau’s Lines
Koilonychia
Clubbed Fingers
Terry’s Nails

12

What are paired horizontal white bands that are immobile and what causes this?

muehrckes nails due to nephrotic syndrome or low serum albumin

13

What are Proximal 2/3 white Distal 1/3 red nails and what causes it?

terry's nail, CHF and hepatic cirrhosis

14

What is Dilation of terminal small blood vessels?

telangiectasia

15

What causes nail fold telangiectasia?

Dermatomyositis
SLE
Scleroderma
RA

16

What causes blue nails?

wilson's disease - accumulation of copper

17

What medication do you give for blue nails?

minocycline, quinacrine

18

What is clubbed nails?

acquired via cardiopulm disease

19

What causes koilonychia?

spoon nail due to iron def anemia

20

What is Temporary growth arrest, due to any stress?

beau's lines

21

What causes splinter hemorrhages?

bacterial endocarditis

22

What causes unguis incarnatus?

Wearing shoes that are so tight they compress the ridges of the cuticles against the relatively stiff nail material, turning the nail into a cutting surface
cutting nails too short

23

What toe is most involved in ingrown toenail?

big toe, lateral side more than medial

24

What is Soft tissue infection around a fingernail that begins as cellulitis but that may progress to a definite abscess?

paronychia

25

How does acute paronychia present?

painful, purulent condition

26

How can you remove nail?

life nail out, entire lateral side of nail and cauterize so it doesnt grow back

27

What is the most common cause of paronychia?

staphylococci

28

What test do you get if herpetic whitlow is suspected in paronychia?

tzanck smear

29

How do you treat early paronychia?

warm soaks 3-4 times daily[1

30

How do you tx pt with cellulitis with paronychia?

clindamycin, Augmentin, or Keflex

31

What do you have to do for paronychia abcess?

incision and drainage

32

What causes subungual hematoma?

blunt or sharp trauma

33

What happens in subungual hematoma?

blood builds up and can cause nail bed to fall off and never come back

34

How do you treat subungual hematoma?

nddle 18 guage - within first few days, get x ray to check for fracture

35

Does drainage of subungual hematoma accelerate healing?

no

36

Is subungual hematoma painful?

no