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Bianca Maria Piraccini - One of the best experts on this subject based on the ideXlab platform.
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Management and Outcome of Taxane-Induced Nail Side Effects: Experience of 79 Patients from a Single Centre.
Skin appendage disorders, 2019Co-Authors: Aurora Alessandrini, Michela Starace, Giulia Cerè, Nicolò Brandi, Bianca Maria PiracciniAbstract:Background Nail changes are a common side effect of taxane chemotherapy, although their correct management is poorly standardized. Objective To evaluate incidence, clinical aspects, and response to treatment of taxane-induced nail side effects in patients treated with taxanes for malignancies. Patients and methods We performed a retrospective clinical study of 79 patients with taxane-induced nail changes from January 2015 to July 2018. Results Paclitaxel was the most responsible drug and both hands and feet were often affected (46.8%). Grade 2 nail toxicity was seen in 63.3% of the patients, including painful subungual hematoma, hemorrhagic Onycholysis, and paronychia. Grade 3 nail toxicity was seen only in 2.5% of the patients, including hemorrhagic Onycholysis and pyogenic granuloma. Removal of the detached nail plate with application of topical antibiotics and steroids induced regression of symptoms within 2 weeks. Conclusions Nail toxicity develops mostly at the end of therapy, and total drug dosage is the only known factor that predisposes to these side effects. Trauma possibly plays a role as the most severe signs are located on the great toenails. Although it is impossible to prevent taxane-induced nail side effects, a careful patient monitoring permits to immediately recognize and manage the symptoms in order to induce their remission and improvement of the patient's quality of life.
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dermoscopy of subungual exostosis a retrospective study of 10 patients
Dermatology, 2017Co-Authors: Vincenzo Piccolo, Aurora Alessandrini, Michela Starace, Giuseppe Argenziano, Teresa Russo, Bianca Maria PiracciniAbstract:Introduction: Subungual exostosis (SE), the most common nail tumor of young adults, is a benign bony proliferation of the distal phalanx occurring beneath the nail. Misdiagnosis or late diagnosis frequently occurs and no dermoscopy features of this tumor were previously outlined. Material and Methods: To describe the dermoscopic appearance of SE, 10 patients with radiologically and histologically confirmed SE were retrospectively retrieved from our tertiary referral centers. Data regarding age, gender, time to diagnosis, clinical presentation, dermoscopic features, involved nail and history of trauma were recorded for each patient. Results: In our patients, clinical findings were similar to previous reports. Among the dermoscopic features, vascular ectasia was the most common finding (70%), followed by hyperkeratosis (60%), Onycholysis (40%), and ulceration (30%). Conclusion: Dermoscopy could be a useful technique aimed at creating diagnostic suspicion of this benign nail condition, although X-ray examination and histopathology are mandatory for the diagnosis.
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Nail digital dermoscopy (Onychoscopy) in the diagnosis of onychomycosis
Journal of the European Academy of Dermatology and Venereology : JEADV, 2011Co-Authors: Bianca Maria Piraccini, Michela Starace, Riccardo Balestri, Giulia RechAbstract:Background Distal subungual onychomycosis and traumatic Onycholysis are the most common causes of toenail abnormalities, and differential diagnosis is often impossible without mycology. Objectives To identify and describe dermoscopic signs specific for distal subungual onychomycosis that could facilitate its diagnosis and differentiation from traumatic mycologically negative Onycholysis and to determine the sensitivity and specificity of these dermoscopic features. Methods We performed a retrospective study at the Outpatient Consultation for Nail Diseases of the Department of Dermatology of the University of Bologna. Dermoscopic digital images of 57 consecutive patients who underwent global photography, videodermoscopy and mycological examination for Onycholysis of a single toenail between 1 December, 2010 and 30 June, 2011, were evaluated and compared. Digital dermoscopic images of Onycholysis of the great toenail were evaluated for the presence of peculiar dermoscopic features. The presumptive dermoscopic diagnosis was compared with results of mycology. Results Evaluation of videodermoscopic images allowed us to identify three recurring peculiar dermoscopic features, two of which were present only in distal subungual onychomycosis (jagged proximal edge with spikes of the onycholytic area and longitudinal striae) and one only in traumatic Onycholysis (linear edge – without spikes – of the onycholytic area). Conclusions We found distinctive dermoscopic signs that are exclusive to distal subungual onychomycosis and to traumatic Onycholysis. Detection of these signs is simple and can, in selected cases, help to avoid mycology.
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Taxane-induced nail changes: incidence, clinical presentation and outcome
Annals of oncology : official journal of the European Society for Medical Oncology, 2003Co-Authors: Alessandro Marco Minisini, Bianca Maria Piraccini, Antonella Tosti, Alberto Sobrero, Mauro Mansutti, Cosimo Sacco, Fabio PuglisiAbstract:The clinical characteristics of nail changes in seven patients receiving taxane-containing chemotherapy are described. They include nail pigmentation, subungual hematoma, Beau's lines and Onycholysis and subungual suppuration. The incidence of such changes (ranging from 0% to 44%) is reviewed from a Medline search of the literature.
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© 2003 European Society for Medical Oncology Taxane-induced nail changes: incidence, clinical presentation
2002Co-Authors: Alessandro Marco Minisini, Bianca Maria Piraccini, Antonella Tosti, Alberto Sobrero, Mauro Mansutti, Cosimo Sacco, Fabio PuglisiAbstract:The clinical characteristics of nail changes in seven patients receiving taxane-containing chemotherapy are described. They include nail pigmentation, subungual hematoma, Beau’s lines and Onycholysis and subungual suppuration. The incidence of such changes (ranging from 0 % to 44%) is reviewed from a Medline search of the literature
Cecilia M Di Pentima - One of the best experts on this subject based on the ideXlab platform.
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phototoxicity pseudoporphyria and photo Onycholysis due to voriconazole in a pediatric patient with leukemia and invasive aspergillosis
Journal of the Pediatric Infectious Diseases Society, 2015Co-Authors: Zachary Willis, Alan S Boyd, Cecilia M Di PentimaAbstract:Voriconazole is a triazole antifungal agent superior to amphotericin B in the treatment of invasive aspergillosis. It is generally well tolerated and has excellent oral bioavailability,providing significant benefit in the treatment of invasive fungal infections. There have been numerous reports of dermatologic reactions to this agent, including erythroderma, cheilitis, Stevens-Johnson syndrome, discoid lupus erythematosus, pseudoporphyria, squamous cell carcinoma, and photosensitivity reactions. Pseudoporphyria, a dermatologic condition mimicking porphyria cutanea tarda, has been described as an adverse effect of voriconazole use [1, 2]. Clinical findings include photosensitivity, vesicles, bullae, milia, and scarring in sun-exposed areas [2].Photo-Onycholysis is a phenomenon of nail discoloration and Onycholysis that has been described in the setting of a phototoxic drug reaction and pseudoporphyria [3].Implicated drugs have most commonly been tetracyclines, fluoroquinolones, and psoralens; others have been reported as well [4]. We report a case of a pediatric patient with leukemia who developed symptoms consistent with pseudoporphyria and later photo-Onycholysis while being treated with voriconazole. To our knowledge, this is the first reported case of pseudoporphyria due tovoriconazole in a pediatric patient and the first reported case of photo-Onycholysis as a consequence of voriconazole use.
Marcel C. Pasch - One of the best experts on this subject based on the ideXlab platform.
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Fingernail psoriasis reconsidered: A case-control study
Journal of the American Academy of Dermatology, 2013Co-Authors: Haike M.j. Van Der Velden, Karlijn M.g. Klaassen, Peter C.m. Van De Kerkhof, Marcel C. PaschAbstract:Background Literature concerning clinical signs and frequency of nail psoriasis is incomplete. Recent studies focus only on signs included in the Nail Psoriasis Severity Index (NAPSI). Objective We sought to describe clinical characteristics of fingernail psoriasis in comparison with healthy controls. Methods We collected data on 49 patients with fingernail psoriasis who visited our outpatient department and 49 control subjects, through questionnaires and clinical examination. The disease severity was measured by the NAPSI. Results Mean NAPSI score in patients and control subjects was 26.6 and 3.6, respectively. Most items included in the NAPSI were specific for nail psoriasis. Onycholysis and splinter hemorrhages were most frequently observed. Leukonychia was more frequent in control subjects. Longitudinal ridges and Beau lines are not included in the NAPSI but are significantly more frequently seen in patients than in control subjects. Limitations Limited sample size was a limitation. Conclusion The NAPSI was able to discriminate patients with fingernail psoriasis from healthy control subjects. Onycholysis and splinter hemorrhages were the most prevalent fingernail changes in psoriatic patients. Leukonychia was more frequently observed in control subjects, which raises the question of whether leukonychia should remain in the NAPSI. On the other hand, longitudinal ridges and Beau lines occurred more frequently in psoriasis but are not included in the NAPSI.
Mikiya Endoh - One of the best experts on this subject based on the ideXlab platform.
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childhood onset psoriatic onycho pachydermo periostitis treated successfully with infliximab
European Journal of Dermatology, 2015Co-Authors: Daisuke Watabe, Koki Endoh, Fumihiko Maeda, Toshihide Akasaka, Mikiya EndohAbstract:An 8-year-old girl presented with a two-year history of nail changes and alopecia areata on the scalp. Although the alopecia was improved by topical applications of corticosteroids, nail changes developed on all fingers and toes. After six months, all fingers and toes showed redness and swelling; physical examination revealed Onycholysis with subungueal debris (figure 1A). Erythematous swelling of the soft tissues of the distal interphalangeal (DIP) joint was evident on all fingers and toes, which [...]
Zachary Willis - One of the best experts on this subject based on the ideXlab platform.
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phototoxicity pseudoporphyria and photo Onycholysis due to voriconazole in a pediatric patient with leukemia and invasive aspergillosis
Journal of the Pediatric Infectious Diseases Society, 2015Co-Authors: Zachary Willis, Alan S Boyd, Cecilia M Di PentimaAbstract:Voriconazole is a triazole antifungal agent superior to amphotericin B in the treatment of invasive aspergillosis. It is generally well tolerated and has excellent oral bioavailability,providing significant benefit in the treatment of invasive fungal infections. There have been numerous reports of dermatologic reactions to this agent, including erythroderma, cheilitis, Stevens-Johnson syndrome, discoid lupus erythematosus, pseudoporphyria, squamous cell carcinoma, and photosensitivity reactions. Pseudoporphyria, a dermatologic condition mimicking porphyria cutanea tarda, has been described as an adverse effect of voriconazole use [1, 2]. Clinical findings include photosensitivity, vesicles, bullae, milia, and scarring in sun-exposed areas [2].Photo-Onycholysis is a phenomenon of nail discoloration and Onycholysis that has been described in the setting of a phototoxic drug reaction and pseudoporphyria [3].Implicated drugs have most commonly been tetracyclines, fluoroquinolones, and psoralens; others have been reported as well [4]. We report a case of a pediatric patient with leukemia who developed symptoms consistent with pseudoporphyria and later photo-Onycholysis while being treated with voriconazole. To our knowledge, this is the first reported case of pseudoporphyria due tovoriconazole in a pediatric patient and the first reported case of photo-Onycholysis as a consequence of voriconazole use.
