Baran & Dawber's Diseases of the Nails and their Management

820 Pages·2012·31.725 MB·English

by  Robert Baran, David A. R. de Berker, Mark Holzberg, Luc Thomas (editors)

Baran & Dawber’ s
Diseases of the Nails
and their Management
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Baran & Dawber’ s
Diseases of the

Nails and their
Management

FOURTH EDITION
EDITED BY
Robert Baran
MD
Honorary Professor, University of Franche-Comté
Consultant Dermatologist, Gustave Roussy Cancer Institute, Villejuif
Nail Disease Center, Cannes, France
David A.R. de Berker
MD
Consultant Dermatologist and Senior Clinical Lecturer
Bristol Dermatology Centre
Bristol Royal Infi rmary
Bristol, UK
Mark Holzberg
MD
Clinical Assistant Professor of Dermatology
Department of Dermatology
Emory University School of Medicine
Atlanta, GA, USA
Luc Thomas
MD, PhD
Professor and Chairman
Department of Dermatology
Lyon 1 University
Centre Hospitalier Lyon Sud
Pierre Bénite, France
A John Wiley & Sons, Ltd., Publication
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This edition first published 2012, © 2012 by John Wiley & Sons, Ltd
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Library of Congress Cataloging-in-Publication Data
Baran & Dawber’s diseases of the nails and their management / edited by Robert Baran ... [et al.]. – 4th ed.
p. ; cm.
Baran and Dawber’s diseases of the nails and their management
Diseases of the nails and their management
Includes bibliographical references and index.
ISBN 978-0-470-65735-5 (hardcover : alk. paper)
I. Baran, R. (Robert) II. Dawber, R. P. R. (Rodney P. R.) III. Title: Baran and Dawber’s diseases of the nails
and their management. IV. Title: Diseases of the nails and their management.
[DNLM: 1. Nail Diseases. 2. Nails–physiology. 3. Nails, Malformed. WR 475]
616.5′47–dc23
2011042075
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be
available in electronic books.
Set in 9.5/12 pt Palatino by SPi Publisher Services, Pondicherry, India

1 2012
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v
Contents
List of Contributors, vii 8 Drug-induced Nail Changes, 413
Robert Baran, Bruno Fouilloux and Caroline Robert
Preface, ix
9 Occupational Abnormalities and Contact
List of Abbreviations, xi Dermatitis, 443
Robert Baran and Richard J.G. Rycroft
10 Cosmetics: the Care and Adornment of the Nail, 471
1 Science of the Nail Apparatus, 1 Douglas Schoon and Robert Baran
David A.R. de Berker and Robert Baran
11 Hereditary and Congenital Nail Disorders, 485
2 Physical Signs, 51 Smail Hadj-Rabia, Lennart Juhlin and Robert Baran
Adam I. Rubin and Robert Baran
12 Nail Surgery and Traumatic Abnormalities, 549
3 Imaging the Nail Unit, 101 Luc Thomas, Elvin G. Zook, Timothy J. Rosio,
Luc Thomas, Myriam Vaudaine, Ximena Wortsman, Rodney P.R. Dawber, Eckart Haneke and Robert Baran
Gregor B.E. Jemec and Jean-Luc Drapé
13 Tumors of the Nail Apparatus
4 The Nail in Childhood and Old Age, 183 and Adjacent Tissues, 637
David A.R. de Berker, Bertrand Richert and Robert Baran Luc Thomas, Elvin G. Zook, Eckart Haneke,
Jean-Luc Drapé and Robert Baran
5 Fungal (Onychomycosis) and Other Infections ( with the participation of Jürgen F. Kreusch )
Involving the Nail Apparatus, 211
Roderick J. Hay and Robert Baran Appendix: Differential Diagnosis
of Nail Findings, 745
6 The Nail in Dermatological Disease, 257 Mark Holzberg
Mark Holzberg and Robert Baran
Index, 799
7 The Nail in Systemic Disease, 315
Mark Holzberg
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vii
List of Contributors
Rodney P.R. Dawber, MA, MB, ChB, FRCP Lennart Juhlin, MD (Deceased)
Formerly, Consultant Dermatologist and Clinical Senior Lecturer Formerly, Professor and Head
Department of Dermatology Department of Dermatology
The Churchill Hospital University Hospital
Oxford, UK Uppsala, Sweden
Jean-Luc Drapé, MD, PhD Jürgen F. Kreusch, MD, PhD
Department of Radiology Moislinger Allée 95
Hôpital Cochin 23558 Lübeck, Germany
University Paris Descartes
Paris, France Bertrand Richert, MD, PhD
Dermatology Department
Bruno Fouilloux, MD University Hospitals Brugmann – Saint Pierre and
Children’s Hospital Reine Fabiola
Onychology Unit
Université Libre de Bruxelles
Department of Dermatology
Brussels, Belgium
CHU Hôpital Nord
Saint-Etienne, France
Caroline Robert, MD, PhD
Gustave Roussy Cancer Institute
Smail Hadj-Rabia, MD, PhD
Villejuif, France
Department of Dermatology
Hôpital Necker-Enfants Malades
Timothy J. Rosio, MD
Paris, France
Anew Skin Dermatology
El Dorado Hills, CA, USA
Eckart Haneke, MD
Dermatology Department Adam I. Rubin, MD
University Hospital
Director, Nail Practice of the University of Pennsylvania
Bern, Switzerland
Assistant Professor of Dermatology
Perelman School of Medicine
Roderick J. Hay, DM, FRCP, FMedSci University of Pennsylvania
Dermatology Department Philadelphia, PA, USA
King’s College NHS Trust
London, UK Richard J.G. Rycroft, MD, FRCP, FFOM, DIH
Formerly, St John’s Institute of Dermatology
Gregor B.E. Jemec, MD, DMSc St Thomas’s Hospital
London, UK
Professor, Chairman
Department of Dermatology
Douglas Schoon, BSc, MSc (Chem)
Roskilde Hospital
Health Sciences Faculty President
University of Copenhagen Schoon Scientifi c + Regulatory Consulting, LLC
Roskilde, Denmark Dana Point, CA, USA
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viii List of Contributors
Myriam Vaudaine, MD Elvin G. Zook, MD
Department of Dermatology Emeritus Professor
Lyon 1 University Formerly, Plastic Surgery Institute
Centre Hospitalier Lyon Sud Southern Illinois University
Pierre Bénite, France School of Medicine
Springfi eld, IL, USA
Ximena Wortsman, MD
Adjunct Associate Professor
Department of Radiology
Clinica Servet, Faculty of Medicine
University of Chile
Santiago, Chile
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ix
Preface
Since our first edition appeared in 1984, B aran & Dawber's all-important addition of an original appendix providing
Diseases of the Nails and their Management has been one differential diagnosis of nail findings in both color and
of the most important sources for nail specialists. This shape by anatomic site ensures overall continuity.
fourth edition has been enriched by numerous additional I would like to express my particular gratitude to
con tributions, and now constitutes a true encyclopedia of Martin Sugden, the commissioning editor, for his support
the nail. and encouragement all along, and my heartfelt thanks to
We owe this to the young collaborators who were Nicole Baran, my wife, for her unflagging energy and
entrusted with either writing new chapters such as ‘Imaging dedication in taking up and sharing the challenge.
the Nail Unit’, or with thorough updating, as in the chapter
on ‘Hereditary and Congenital Nail Disorders’. Finally, the Robert Baran
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xi
List of Abbreviations
3D three-dimensional EGFR epidermal growth factor receptor
ACA anticardiolipin antibody EM electron microscopy
ACTH adrenocorticotropic hormone EMA epithelial membrane antigen
ADFK acquired digital fi brokeratoma EO endonyx onychomycosis
ADL activities of daily living FDA Food and Drug Administration
AER apical ectodermal ridge FEDL fl ashlamp excited dye laser
AIDS acquired immunodefi ciency syndrome FEF forced expiratory fl ow
ALHE angiolymphoid hyperplasia with FEV forced expiratory volume in 1 sec
1
eosinophilia GVHD graft-versus-host disease
ALM acrolentiginous melanoma H&E hematoxylin and eosin
AORN Association of Operating Room Nurses HEMA hydroxy-ethylmethacrylate
APACHE acral pseudolymphomatous angiokeratoma HFMD hand, foot and mouth disease
of children HIV human immunodefi ciency virus
APES aminopropyltriethoxysilane HOOD hereditary osteoonychodysplasia
AVA arteriovenous anastomoses HPV human papillomavirus
AVF arteriovenous fi stula HSR high spatial resolution
AZT azidothymidine HSV herpes simplex virus
BDD blistering distal dactylitis HTLV human T-cell leukemia virus
BMP bone morphogenetic protein IDS International Society for Dermoscopy
BMZ basement membrane zone ILM incident light microscopy
BPNH bilateral periventricular nodular heterotopia ILVEN infl ammatory linear verrucous epidermal
CA cyanoacrylate nevus
CARI congenital autosomal recessive ichthyosis IP incontinentia pigmenti
CDC Centers for Disease Control IU international units
CEA carcinoembryonic antigen IVT ischemic venous thrombosis
CMC chronic mucocutaneous candidiasis KA keratoacanthoma
CMV cytomegalovirus KID keratosis, ichthyosis and deafness
COIF congenital onychodysplasia of the index LE lupus erythematosus
fi ngers LED light-emitting diode
CT computed tomography LM longitudinal melanonychia
DBP dibutyl phthalate MES multiple exostoses syndrome
DEB dystrophic epidermolysis bullosa MIC minimum inhibitory concentration
DIP distal interphalangeal MIM Mendelian Inheritance in Man
DLSO distal and lateral subungual onychomycosis MIP maximum intensity projection
DMPS dimercapto-propane-sulfonate MMA methylmethacrylate
DMSA dimercaptosuccinic acid MRI magnetic resonance imaging
DMSO dimethyl sulfoxide MSH melanocyte-stimulating hormone
EB epidermolysis bullosa NAPSI Nail Psoriasis Severity Index
EBA epidermolysis bullosa acquisita NTOM nerve territory-orientated macrodactyly
ED ectodermal dysplasia PA posteroanterior
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xii List of Abbreviations
PAI plasminogen activator inhibitor SM subungual melanoma
PaO partial pressure of oxygen in arterial blood SNR signal-to-noise
2
PAS periodic acid-Schiff SO subungual onychomycosis
PCB polychlorinated biphenyl SSM superfi cial spreading melanoma
PCR polymerase chain reaction STIR short time inversion recovery
PIU pterygium inversum unguis SWO superfi cial white onychomycosis
PNF proximal nail fold T tesla
PRP pityriasis rubra pilaris TAR thrombocytopenia absent radius
PSO proximal subungual onychomycosis TDO total dystrophic onychomycosis
PUVA psoralen ultraviolet A TGF transforming growth factor
PVC polyvinyl chloride TNF tumor necrosis factor
PWSO proximal white subungual TOWL transonychial water loss
onychomycosis TTD trichothiodystrophy
RA rheumatoid arthritis TUDDS transungual drug delivery system
ROS reactive oxygen species TUNEL terminal deoxynucleotidyl transferase dUTP
RV residual volume nick end labelling
SCC squamous cell carcinoma US ultrasonography
SE spin echo UV ultraviolet
SLE systemic lupus erythematosus UVB ultraviolet B
SLN sentinel lymph node VEGF vascular endothelial growth factor
SLR single lens refl ex
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1
CHAPTER 1
Science of the Nail Apparatus
David A.R. de Berker1 and Robert Baran2
1 Bristol Dermatology Centre , Bristol Royal Infi rmary , Bristol, UK
2 Nail Disease Center, Cannes; Gustave Roussy Cancer Institute, Villejuif, France
Gross anatomy and terminology, 1 Venous drainage, 19 Physical properties of nails, 35
Embryology, 3 Effects of altered vascular supply, 19 Strength, 35
Morphogenesis, 3 Nail fold vessels, 19 Permeability, 35
Tissue differentiation, 4 Glomus bodies, 20 Radiation penetration, 37
Factors in embryogenesis, 4 Nerve supply, 21 Imaging of the nail apparatus, 37
Regional anatomy, 5 Comparative anatomy and function, 21 Radiology, 37
Histological preparation, 5 The nail and other appendages, 22 Ultrasound, 37
Nail matrix and lunula, 7 Phylogenetic comparisons, 23 Profi lometry, 38
Nail bed and hyponychium, 9 Physiology, 25 Dermoscopy (epiluminescence), 38
Nail folds, 11 Nail production, 25 Photography, 38
Nail plate, 15 Normal nail morphology, 27 Light, 40
Vascular supply, 18 Nail growth, 28 Other techniques, 41
Arterial supply, 18 Nail plate biochemical analysis, 31
Gross anatomy and terminology with the ventral aspect of the proximal nail fold. The
intermediate matrix (germinative matrix) is the epithe-
Knowledge of nail unit anatomy and terms is important for lial structure starting at the point where the dorsal
clinical and scientific work [1]. The nail is an opalescent win- matrix folds back on itself to underlie the proximal nail.
dow through to the vascular nail bed. It is held in place by The ventral matrix is synonymous with the nail bed
the nail folds, origin at the matrix and attachment to the nail and starts at the border of the lunula, where the inter-
bed. It ends at a free edge distally, overlying the hyponych- mediate matrix stops. It is limited distally by the hypo-
ium. These structures are illustrated in Figures  1.1 and 1.2 . nychium.
Definitions of the components of the nail unit are as follows. • Lunula (half moon) : the convex margin of the interme-
• Nail plate (nail) : durable keratinized structure which diate matrix seen through the nail. It is paler than the
continues growing throughout life. adjacent nail bed. It is most commonly visible on the
• Lateral nail folds : the cutaneous folded structures pro- thumbs and great toes. It may be concealed by the proxi-
viding the lateral borders to the nail. mal nail fold.
• Proximal nail fold (posterior nail fold) : cutaneous • Nail bed (ventral matrix, sterile matrix) : the vascular
folded structure providing the visible proximal border bed upon which the nail rests, extending from the
of the nail, continuous with the cuticle. On the under- lunula to the hyponychium. This is the major territory
surface this becomes the dorsal matrix. seen through the nail plate.
• Cuticle (eponychium): the layer of epidermis extend- • Onychodermal band : the distal margin of the nail
ing from the proximal nail fold and adhering to the dor- bed has a contrasting hue in comparison with the rest
sal aspect of the nail plate. of the nail bed [3]. Normally, this is a transverse band
• Nail matrix (nail root) : traditionally, this can be split of 1–1.5 mm of a deeper pink (Caucasian) or brown
into three parts [2]. The dorsal matrix is synonymous (Afro-Carribean). Its colour, or presence, may vary
Baran & Dawber’s Diseases of the Nails and their Management, Fourth Edition. Edited by Robert Baran, David A.R. de Berker,
Mark Holzberg and Luc Thomas.
© 2012 John Wiley & Sons, Ltd. Published 2012 by John Wiley & Sons, Ltd.
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