The human nail unit is a highly specialised, keratinised structure belonging to the group of skin appendages. It performs many important functions necessary to maintain homeostasis, such as protection of the distal phalanx against damages or stabilisation of the fingertips. Human nail unit is formed by the nail plate and the proximal nail fold, lateral nail folds, nail matrix, nail bed and hyponychium. Human nail unit diseases are often diagnosed with delay, mainly due to anatomical conditions, but also due to understating the problem not only by the patients themselves, but also by doctors. Changes within the human nail unit are a frequent component of many dermatoses or separate disease entities. The main disturbances associated with pathologies within the nail matrix include the Beau lines (transverse pits indicating temporary disruption of the nail plate growth), onychomadesis (nail shedding), onychorrhexis, nail pitting, koilonychia (spoon nails) or trachonychia (sandpapered nails). The group of diseases associated with disorders of the nail bed includes onycholysis (loss of communication between the nail plate and the nail bed), subungual hyperkeratosis, apparent leukonychia (associated with the swelling of the nail bed) and subungual petechiae. The article also presents selected nail diseases associated with the deposition of dye (including melanonychia), some congenital disorders of the nail unit (such as, for example, malalignment of the great toenail or nail-patella syndrome) and selected manifestations of systemic diseases within the human nail unit. Getting familiar with the correct onychological nomenclature and presented issues will certainly facilitate establishing a dialogue between specialists in skin diseases and general practitioners. Keywords: human nail unit, nail matrix diseases, disorders within the nail bed, congenital nail disorders Aparat paznokciowy (narząd paznokciowy) to wysoce wyspecjalizowana, skeratynizowana struktura należąca do grupy przydatków skóry. Pełni on wiele istotnych funkcji niezbędnych do utrzymania homeostazy, takich jak ochrona paliczka dystalnego przed uszkodzeniami czy stabilizacja opuszek palców. Aparat paznokciowy tworzą płytka paznokciowa oraz proksymalny wał paznokciowy i wały boczne, macierz paznokcia, łożysko paznokcia i obrąbek (hyponychium). Schorzenia aparatu paznokciowego rozpoznawane są nierzadko z opóźnieniem, przede wszystkim ze względu na warunki anatomiczne, lecz również z powodu bagatelizowania problemu nie tylko przez samych pacjentów, ale także przez lekarzy. Zmiany w obrębie aparatu paznokciowego są częstym elementem składowym wielu dermatoz lub stanowią osobne jednostki chorobowe. Do głównych zaburzeń związanych z patologiami w obrębie macierzy paznokcia należą linie Beau (poprzeczne zagłębienia świadczące o chwilowym zaburzeniu wzrostu płytki paznokciowej), onychomadeza (spełzanie płytek paznokciowych), onychorrhexis, nail pitting (paznokcie dziurkowane), koilonychia (paznokcie łyżeczkowate) czy trachonychia (szorstkość paznokci). W grupie zabur...
Introduction. The nail apparatus is a skin appendage which, among other functions, stabilises the fingertips and protects the distal parts of fingers or toes from injuries. It may become dystrophic following chemotherapy. Diverse nail symptoms require a complex differential diagnosis. Objective. Presentation of a case of Lindsay's nails in a patient treated with paclitaxel for breast cancer. Case report. A 65-year-old woman reported to a dermatology outpatient clinic with changes to her fingernails and toenails. Six months earlier, she had undergone left-sided mastectomy for breast cancer and then commenced chemotherapy with paclitaxel in combination with trastuzumab. A few weeks after starting this chemotherapy regimen, the patient noticed pronounced haemorrhages in the region of the toes, followed by matt whitening of the proximal part of the fingernail apparatus, sharply demarcated from the brown-coloured distal part. In addition, the patient experienced neuropathic symptoms in the fingers. The clinical picture of the lesions and the patient's disease history suggested a variant of leukonychia, i.e. Lindsay's nails, induced by chemotherapy. Conclusions. The presented case of Lindsay's nails ("half-and-half" nails) is unique, as it was never before reported in the literature in association with paclitaxel therapy. streszczenie Wprowadzenie. Aparat paznokciowy jest strukturą zaliczaną do przydatków skóry, która m.in. stabilizuje opuszki palców i chroni dystalne części kończyn przed urazami. Często ulega on uszkodzeniom w trakcie chemioterapii, a różnorodna manifestacja takich zmian wymaga przeprowadzenia złożonej diagnostyki różnicowej. Cel pracy. Przedstawienie przypadku paznokci Lindsaya u chorej leczonej paklitakselem w przebiegu raka sutka.
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