Nail Biopsy: Assessment of Indications and Outcome

Grover, Chander; Nanda, Soni; Reddy, B. Naresh Kumar; Chaturvedi, K. Uma

doi:10.1111/j.1524-4725.2005.31042

Cited by 18 publications

(30 citation statements)

References 11 publications

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“…Nail plate biopsy (NPB) is the easiest and the least-scarring technique, wherein a part of the nail plate (onycholysed or not) is separated and sent for histopathologic analysis. [7] It gives limited histopathological data but is useful in suspected cases of onychomycosis (demonstrates nail plate fungal invasion), [7] warts (adherent epithelium will show koilocytes [2] ) [ Figure 3], and also nail psoriasis (nail plate neutrophilic infiltration, serum crusts, and parakeratosis can be easily seen). The utility of NPB in systemic disease has also been explored extensively.…”

Section: Techniques/typesmentioning

confidence: 99%

“…[1] It is an investigation that not only provides etiologic, diagnostic and prognostic information but also aids in understanding the pathogenesis of nail diseases. [2] No doubt it is of great academic value, but the question addressed in this manuscript is the practical utility of NB in our day to day dermatologic practice. This article is not aimed at teaching the NB techniques in great detail but at putting forth practical tips, do's and don'ts with respect to a NB.…”

Section: Introductionmentioning

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.…”

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: Techniques/typesmentioning

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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“…In order to evaluate morphological and immunohistochemical picture of onychomycosis, nail 5 mm punch biopsies from nail were taken [8] . Th e study included 22 patients corresponding to the pre-established selection criteria to the exclusion of a variety of possible factors infl uencing the results (a previous drug therapy, the nail condition aff ecting diseases).…”

Section: Methodsmentioning

confidence: 99%

Defensins and cytokins in nail unit affected by onychomycosis: a pilot study

Zaikovska

Ķīsis

Pilmane

2013

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Onychomycosis is a chronic infection disease that is induced by different types of fungi. Changes of nail color, shape and thickness are disease clinical findings. The disease affects all ages and genders of people, however higher incidence is observed in the people who have reduced immunity.To study natural immunity of the nail, 22 nail biopsies from onychomycosis patients were taken. Material was stained with hematoxilin and eosin and immunohistochemical methods were used.We found the nests of hypertrophy in the granulose layer of the epidermis, with focal acanthosis. In the horn layer, we identified the nests of parakeratosis of various sizes, with the incorporations of homogenous and eosinophil masses.We found high levels of IL-6 and IL-10 positive cells in the bed of the nail and in the bloodstream. IL-1, however, was not a part of any of the functional units of any of the nails. High amount hBD-2-containing fibres was found in the bed and the plate of the nail. Interestingly, hBD-3 and hBD-4 were not found in any of the samples.So, when it comes to onychomycosis infected nails, the most effective morphopathogenic processes include cytokine and defensin excretion occurs in the bed of the nail.

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“…4 Diagnostic biopsy should be avoided where possible, given the likelihood of permanent nail dystrophy. 5 Features that should prompt histopathologic examination include increasing width or darkening of the lesion, pigment variegation, periungual pigmentation or dystrophy of the nail plate. 3,4 Clinicians should advise parents of pediatric patients to monitor lesions closely for any of these described changes and present for prompt evaluation should they occur.…”

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confidence: 99%