Longitudinal nail biopsy in evaluation of acquired nail dystrophies

Hanno, Ruth; Mathes, Barbara; Krull, Edward A.

doi:10.1016/s0190-9622(86)70097-2

Cited by 52 publications

(65 citation statements)

References 7 publications

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“…The salient features of nail histopathology in selected diseases are outlined in Table 2. [2,4,13] One fact to be borne in mind is that the thin nail bed epithelium is tightly adherent to the nail plate and tends to get avulsed along with it. Hence, a NBB performed after avulsing the nail plate may not give adequate histopathological information, especially in case of inflammatory nail pathology (personal observation) [ Figure 3].…”

Section: Histopathologymentioning

confidence: 99%

“…Hanno et al studied predominantly inflammatory nail pathologies and found diagnostic features in 40% of their cases. [4] In the series by de Berker et al comprising mainly of tumors, 93.93% biopsies were diagnostic. [5] Grover et al evaluated 60 nail biopsies of infective as well as noninfective disorders, and found diagnostic histopathology in 64% cases.…”

Section: Indicationsmentioning

confidence: 99%

“…[2] NB was reported especially useful for definitive diagnosis in nail tumors and infections. [2,4,5] All these studies have documented a low risk of side-effects to NB and demonstrated it to be a simple and safe procedure. [2,7,12] A skillfully performed adequate NB, handled, processed, and interpreted properly, can be an important part of the dermatologist's armamentarium in providing excellent, comprehensive patient care.…”

Section: Indicationsmentioning

confidence: 99%

“…[25] Nail psoriasis NB for nail psoriasis has been an area of interest, especially because 1-5% of the cases with psoriasis may present with purely nail manifestations only. [8] Hanno et al proposed diagnostic criteria of nail psoriasis in the form of presence of neutrophils in the nail bed epithelium (major criterion), hyperkeratosis with parakeratosis, serum exudates, focal hypergranulosis, and nail bed epithelium hyperplasia (minor criteria) [4] [ Figure 9]. As onychomycosis may show similar features, Grover et al suggested that PAS negativity for fungal hyphae should be included as a major criterion for the diagnosis of nail psoriasis.…”

Section: Onychomycosismentioning

confidence: 99%

“…[2] Only a few studies with a limited number of patients have been carried out to assess the utility of NB in dermatology, [2][3][4][5] while some others have focussed on histopathology of specific nail diseases, e.g. onychomycosis, [6,7] psoriasis, [4,8] melanonychia, [9,10] etc. Apart from these attempts, NB and nail histopathology have not been in much vogue either in the literature or in practice due to various factors.…”

Section: Introductionmentioning

confidence: 99%

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Role of nail biopsy as a diagnostic tool

Grover

Chaturvedi

Reddy

2012

Indian J Dermatol Venereol Leprol

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Nail biopsy (NB) is an investigation that is not routinely resorted to by most of the dermatologists. The commonly cited reasons are the complexity of the procedure, risk of scarring and the reluctance of the patient. However, in cases with isolated nail psoriasis, isolated nail lichen planus, onychomycosis not confirmed on direct microscopy and culture, or longitudinal melanonychia, the treating dermatologist is left with no choice but to resort to this procedure. Nail as a unit, is capable of projecting only a limited number of clinical manifestations. This is responsible for the more or less similar clinical presentation of many different nail disorders. Hence, a practical knowledge of the indications, appropriate patient selection, procedural details and histopathological interpretation of a NB is a must-have for any practicing dermatologist. The risk of scarring is none to minimal if appropriate type of biopsy is performed, not to mention the wealth of histopathological data that can be retrieved from the nail unit. This article aims to explore the various practical do's and don'ts for the NB and tells us what to expect from of the procedure.

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Section: Histopathologymentioning

confidence: 99%

Section: Indicationsmentioning

confidence: 99%

Section: Indicationsmentioning

confidence: 99%

Section: Onychomycosismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role of nail biopsy as a diagnostic tool

Grover

Chaturvedi

Reddy

2012

Indian J Dermatol Venereol Leprol

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Isolated Congenital Nail Dysplasia

Hamm

Karl²,

Bröcker³

2000

Arch Dermatol

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Developmental nail abnormalities are extremely heterogeneous, with hereditary isolated conditions being a small and rare subgroup. An unusual congenital nail dysplasia observed in a large South German kindred was characterized clinically to review the question of uniqueness.Design: Case series of affected family members.Setting: University department of dermatology and houses of patients. Patients:The history and clinical features in 22 affected family members (13 females and 9 males, aged 5 to 74 years) were recorded and documented by photographs. Nail biopsy samples were taken from 2 patients. Interventions: None.Results: The pedigree spanning 5 consecutive generations was best compatible with autosomal dominant in-heritance with complete penetrance. Nail alterations were mostly present since birth and soon reached an individually variable degree of severity. Affected persons showed longitudinal streaks and thinning of nail plates, mostly of all fingernails and toenails, with some accentuation of the thumbnail and big toenails, poorly developed lunulae, longitudinal angular ridges of individual nail plates occasionally starting proximally from a reddish prominence, platonychia and koilonychia of individual nails often overgrowing the lateral folds, and notches and fissures of the free margins. Histological abnormalities included a prominent granular layer of the nail matrix and epithelial strands and buds extending from the nail bed. There were no associated anomalies. Other nail dystrophies were excluded by differences in clinical and histological features. Conclusion:The nail abnormality observed in our family represents a new autosomal dominant disorder for which we propose the term isolated congenital nail dysplasia.

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