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Background. Psoriasis, a persistent inflammatory condition, is linked to several concurrent health issues. Among these, obesity stands out as a significant contributing factor, significantly influencing the development and seriousness of psoriasis. Furthermore, behavioral elements such as eating styles could potentially contribute to the activity of the disease. Objective. To investigate the relationships between eating styles and the clinical severity of psoriasis. Materials and Methods. A cross-sectional study among 158 chronic plaque psoriasis patients was conducted. Sociodemographic data and clinical presentation of psoriasis including risk factors and treatment, eating, stress, and sleep data were obtained from questionnaires. Psoriasis disease severity, weight, and height measurements, including bioelectrical impedance analysis were assessed. A multivariate logistic regression analysis was employed to assess eating patterns and identify notable factors linked to the severity of the disease. Results. After adjusting for the potential confounder, the emotional eating style was significantly associated with an increase in risk of psoriasis severity when compared to the restrained eating style (odds ratio, 3.9; 95% confidence interval, 1.52–9.81). Body mass index, body fat mass, eating attitude, alcohol consumption, nail involvement, psoriasis treatment, smoking status, duration of sleep, and stress status were not significant risk factors for disease severity. Conclusions. There is a significant correlation between emotional eating style and the severity of chronic plaque-type psoriasis in Asian patients. Further exploration into utilizing cognitive-behavioral therapy to address emotional eating styles as part of psoriasis management is warranted. [ABSTRACT FROM AUTHOR]

Onychomycosis is a frequent fungal nail disease that is hard to treat and, in most cases, needs long-term therapy with oral agents. Traditionally, oral agents are favored over topical agents, but it should not be overlooked that they come with broad adverse effects and concomitant drug interactions, which can be unsuitable for many individuals. Therefore, alternative approaches need to be addressed by the medical team for numerous cases. On the other hand, local administration of antimicrobials can come as advantageous because of having a more selective site of activity, avoiding off-target systemic adverse effects, and rapid administration at the site of infection. In this study, we are evaluating a new topical delivery method of amphotericin B. To investigate the efficacy and safety of topical nanoliposomal amphotericin B 0.4% as a possible therapeutic option, this pilot, single-group, before-after clinical study was conducted on 15 onychomycosis patients. The evaluation was processed during 36 weeks of follow-up and on three endpoints of week 12, week 24, and week 36, for both clinical and mycological responses. Three patients were excluded; of the remaining 12, 50% showed a complete cure, 16.66% had an effective clinical response, 16.66% had a partial clinical response, and 16.66% showed no response at week 12. Mycological cure was calculated as 50% at week 12. At week 24, our measurements were calculated as 91.66% for complete cure, 8.33% for no response, and 91.66% for mycological cure. One patient reported nail plate detachment at week 2 but continued the topical application; follow-up between weeks 2 and 24 showed a complete cure and regrowth of healthy nails. No other adverse effects were detected. Overall, our study suggests that topical nanoliposomal amphotericin B 0.4% is an effective treatment, which is accessible, affordable, and user-friendly, has minimum adverse effects, and could be regarded as an alternative treatment for those ineligible for systemic therapy. This trial is registered with IRCT20150101020514N18. [ABSTRACT FROM AUTHOR]

There is a lack of efficacious topical treatments for patients suffering from psoriatic nail disease (PND). We investigated the efficacy of Calcipotriol‐Betamethasone Dipropionate (Cal/BD) foam with and without ablative fractional laser (AFL) in patients with PND. A total of 144 nails from 11 patients were treated in a 24‐week long, open‐label, randomized, intra‐patient controlled proof‐of‐concept hybrid trial. In addition to daily Cal/BD foam application, half of each patient's psoriatic nails were randomized to receive optical coherence tomography (OCT)‐guided AFL treatment at baseline, 6‐, and 12‐week follow‐ups. In‐clinic assessment (N‐NAIL), patient‐reported outcomes (PROMs), and drug consumption were supplemented by remote evaluation of 15 subclinical OCT features, smartphone app‐based safety monitoring, and photo‐based assessment (NAPSI). After 24 weeks of Cal/BD foam treatment, patients achieved a significant improvement (p < 0.001) in both clinical (N‐NAIL −76%, NAPSI −68%) and subclinical (OCT −43%) PND severity as well as a 71% reduction in PROMs. AFL‐assisted Cal/BD treatment led to higher clinical (N‐NAIL −85%, NAPSI −78%) and OCT‐assessed (−46%) reduction of PND signs than Cal/BD alone (N‐NAIL −66%, NAPSI −58%, OCT −37%), but did not reach statistical significance. Smartphone app images documented adverse events and mild local skin reactions, particularly erythema (75%), laser‐induced swelling (28%), and crusting (27%). This hybrid trial demonstrated a reduction in clinical NAPSI and N‐NAIL scores, subclinical OCT features, and PROMs, suggesting that Cal/BD foam is a safe and efficacious treatment for PND. Larger trials are warranted to prove the clinical benefit of AFL pretreatment as a Cal/BD delivery enhancer. [ABSTRACT FROM AUTHOR]

Nail psoriasis is a chronic nail disorder that commonly affects psoriatic patients causing severe distress despite the limited body surface area. Treatments for nail psoriasis are limited, as nails are often difficult to treat with topical therapies, and among different systemic agents responses are unpredictable. We carried out a prospective study in order to analyze the effectiveness and tolerability of topical cyclosporine hydrogel ointment in nail psoriasis. Three patients, for a total of 44 nails, were treated with topical cyclosporine hydrogel ointment. All nails were evaluated, before starting the treatment, every 28 days and after 12 weeks of therapy, by the same dermatologists, through clinical and onychoscopic evaluations. The patients were also asked to assess on the compliance with product use. Complete response (CR) was observed in 2 of 3 patients; a partial response (PR) was observed in the other patient. Overall, 24 of 44 nails had CR and 20 had a PR. Cyclosporine hydrogel ointment has shown efficacy and safety in the treatment of nail psoriasis. The product has also been shown to be stable in composition, easy to apply and not discomfortable for the patient. [ABSTRACT FROM AUTHOR]

Although onychopapilloma (OP) is a benign tumor of the nail bed and distal matrix, there is nevertheless a demand for treatment in some patients. Classical longitudinal excision (CLEx) with avulsion of the nail plate was the most suitable surgical procedure. However, there may be better ways to produce a pleasing esthetic effect. The aim of this study was to modify CLEx to render it more effective, reduce the rate of recurrence, and achieve better esthetic results. We identified 23 patients with OP in varying clinical manifestations that were treated with CLEx and modified CLEx with or without avulsion of the nail plate. With the procedure of modified CLEx without avulsion of the nail plate, there was no bleeding as a side effect and recovery was faster. The appearance of the nail was nearly unchanged and no patient complained about the cosmetic results. We modified CLEx to treat OP to improve the esthetic effect while maintaining surgical effectiveness. [ABSTRACT FROM AUTHOR]

Typical manifestations of nail LP include longitudinal pattern of nail plate ridging and fissuring.[4] Nail LP needs to be differentiated from onychomycosis, nail lichen striatus, nail psoriasis and trauma-associated nail abnormalities. Here, we present one child with linear LP and nail involvement, who exhibited complete response to topical Crisaborole treatment. Lichen planus (LP) is a chronic inflammatory disorder affecting skin, mucous membranes, hair follicles and nails. [Extracted from the article]

Dear Editor, Psoriasis is a chronic inflammatory skin disease, with a prevalence of 1%-5%.1 The scalp is the most frequently affected area, up to 79%.2 Nail psoriasis is also common, involving about 50%.1 The effectiveness of adalimumab for nail and scalp psoriasis has been demonstrated. RCM is a promising instrument for monitoring nail and scalp psoriasis. Nail and scalp psoriasis are difficult to treat and cause severe quality of life impairment.8 The evaluation of psoriasis severity through RCM is a useful tool to investigate not only clinical but also subclinical changes, as suggested for the first time by Ardigò et al. in 2013.9 Then, a recent study tried to evaluate the RCM improvement of 48 patients with psoriasis, but scalp and nails lesions were excluded from the assessment.10 To the best of our knowledge, this is the first case of an adolescent patient with nail and scalp psoriasis successfully treated with adalimumab biosimilar and followed by RCM evaluation. [Extracted from the article]

The SARS‐CoV‐2 infection, responsible for COVID‐19, has raised the interest for infection‐associated muco‐cutaneous symptoms. While dermatologic symptoms in general gained an increasing awareness, affection of the nail organ has been mentioned only recently. We provide a narrative review on COVID‐19 manifestation on the nail organ and add symptoms induced by personal protective measures and SARS‐CoV‐2 vaccination. Available treatment options are discussed. [ABSTRACT FROM AUTHOR]

Subungual melanoma (SUM) is subset of acral melanoma that develops within the nail unit and is associated with a poor prognosis. Nail biopsy is the only way to definitively diagnosis SUM. Our objectives were to analyze the Medicare database for nail biopsy utilization and to compare the annual nail biopsy rate with the estimated incidence of SUM in the United States. A retrospective study on nail biopsy data was performed using the Medicare Provider Utilization and Payment Database 2012 to 2017. The number of nail biopsies performed per 100 000 people was compared to SUM incidence per 100 000 people. Podiatrists, dermatologists, other physicians, and NP/PAs respectively performed 12.12, 0.42, 0.08, 0.07 nail biopsies per 100 000 people annually. Dermatologists performed adequate nail biopsies to cover the minimum (0.7%), but not the maximum (3.5%) estimated incidence of SUM. Only 0.28% and 1.01% of general dermatologists and Mohs surgeons, respectively, performed nail biopsies in 19/50 (38.00%) states and 69/929 (7.42%) zip codes. Limitations of our study were that nail biopsies on patients less than 65 years, and those with no or commercial health insurance were not analyzed. In sum, very few dermatologists performed nail biopsies in the Medicare database. Increased efforts are needed to educate dermatologists on nail surgery. [ABSTRACT FROM AUTHOR]

As seen in Table 1, low potency TCS may result in successful treatment option for HGT.1,3 While the majority of reported cases describe use of potent TCS,2,5-9 we recommend initial treatment with low potency TCS before proceeding to therapy with potent TCS. [Extracted from the article]

Lichen planus (LP) is a common, chronic, Inflammatory, T-cell mediated autoimmune dermatosis that affects skin, oral, and genital mucosae, scalp and nail. All finger and toenails revealed nail plate thinning, longitudinal ridging, fissuring, and distal nail plate splitting with partial/complete destruction of the nail plate but without pterygium formation. Nail lichen planus (NLP) is very rare in the pediatric age group with publications limited to anecdotal case reports and single case series.2,3 A 3.5-year-old boy was brought with fast progressive and destructive nail lesions involving all fingernails and toenails of 1 year duration. [Extracted from the article]

While fluorescence was seen in the middle portion of nail plates in Case 1, it was seen half portion of the nail plates near the proximal nail folds in Case 2 and 3. Fluorescence is seen on one half of the nail plate beginning from the proximal nail fold gl GLO:ETZ/01jan21:dth14740-fig-0003.jpg PHOTO (COLOR): 3 Fluorescence on the nail and hair on Case 4. Fluorescence is seen on the portion of the nail plate near to the proximal nail fold and lunula gl GLO:ETZ/01jan21:dth14740-fig-0004.jpg PHOTO (COLOR): 4 The nail and hair of Case 5. [Extracted from the article]

Onychomycosis (OM) is a chronic fungal infection of the nail caused by dermatophytes, yeasts, and nondermatophytes. Tioconazole is one of the topical antifungal belonging to imidazole derivatives. Tazarotene is a synthetic retinoid, with immunomodulating properties and anti‐inflammatory activity. To evaluate the efficacy of tazarotene 0.1% gel alone in comparison with its combination with tioconazole nail paint in the treatment of onychomycosis. Forty patients presented with onychomycosis, subjected to a full history taking, clinical examination, and nail examination, which includes a clinical, dermoscopic, assessment of severity by using Onychomycosis Severity Index (OSI), KOH examination, and fungal culture. There was a statistically significant increase in the response of treatment in patients treated by a combination of tazarotene and tioconazole compared to tazarotene alone through (decrease in OSI, dermoscopic features, and mycological clearance). Tazarotene had antifungal activity specially against Aspergillus niger while its combination with tioconazole gave better results and can be used as an adjuvant to the standard systemic or topical antifungal treatment for OM. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory skin disease that negatively affects the quality of life with remissions and relapses. Smoking, which is known to accelerate the development of comorbidities that can accompany psoriasis such as atherosclerotic heart disease, metabolic syndrome, is also an independent risk factor for psoriasis. In our study, we aimed to investigate the relationship between smoking and psoriasis. The study included a total of 476 participants with 276 psoriasis patients and 200 healthy volunteers. One hundred and thirty‐nine (69.5%) cases in the psoriasis group and 61 (30.5%) cases in the control group were smoking. Patients with psoriasis had more cigarette smoking than the control group (P <.001). Smoking was present in 100 cases (61%) of 164 cases with nail psoriasis and psoriatic nail was significantly more frequently observed in patients with psoriasis when smoking was present (P <.001). It was observed that systemic treatment requirements were higher in smoking psoriasis patients (P =.04). It is known that cigarette use increases in patients with psoriasis compared to the normal population, and cigarette use also increases the psoriasis area severity index (PASI). In our study, a significant relationship was found between smoking and psoriasis nail involvement first in the literature. Furthermore, the need for systemic treatment was higher in smokers. [ABSTRACT FROM AUTHOR]

Longitudinal melanonychia (LM) presents as vertical linear hyperpigmented streaks in the nail plate.1 Etiologies include benign diseases (eg, melanocytic nevus) and malignancies (eg, subungual melanoma). Pediatric subungual melanoma, however, is rarely reported in any race.2 Here, we present a case of subungual melanoma in a Chinese girl. Nuclear and cytoplasmic features in the diagnosis of banal nevi, Spitz nevi, and melanoma. [Extracted from the article]

A regrowing nail tip after nail avulsion may excessively curve and invaginate into the nail bed. This is treated as a type of ingrown toenail, and is known as distal nail embedding. In most cases, further growth restores the original shape evenly over the nail bed. However, it is often painful and such cases may require treatment. We report a surgical approach that we applied to six cases of distal nail embedding involving pain or deformity of nails caused by a nail tip invaginating into the nail bed and/or cessation of forward nail growth. As our method involves removing a portion of the embedded tip edge nail and inserting the removed nail into the remaining depressed portion, the nail can grow over the bulge. In all six patients in whom we applied this method, the pain and nail deformity resolved and there was no recurrence. We used autogenous nails, which can reduce the pressure imbalance on a nail bed, and this contributed to improving the morphology of nails and nail beds. In addition, the risk of a hypertrophied nail is reduced because half of the nail adheres to the nail bed. Special materials are unnecessary and this method can be conducted with simple outpatient department procedures. There were no cases of a fixed nail section detaching due to a bulge at the nail tip. The inserted nail was maintained in all cases for several months until the nail grew over the bulge. [ABSTRACT FROM AUTHOR]

The apparent nail bed is atrophic (B, C): HE ×10 (C): HE ×20 A biopsy from a fingernail bed showing an orthohyperkeratosis, Civatte bodies of the deeper parts of epidermis and a subepidermal lichenoid lymphocytic infiltration. GLO:ETZ/01nov21:dth15135-fig-0001.jpg PHOTO (COLOR): 1 Effect of platelet-rich plasma injection for a nail lichen planus: (A) Preprocedural aspect: onychodystrophy in 68 year old related to lichen planus with a nail atrophy; the remaining nail is triangular with longitudinal ridges, splitting, thinning. Nail lichen planus (NLP) affects 10% of patients with lichen planus (LP).1 Isolated nail symptoms or twenty-nail dystrophy may occur.2 It can have an aggressive course leading to a definitive destruction of the nail plate. [Extracted from the article]

Pemphigus vegetans (PVeg) is a clinical variant of pemphigus vulgaris (PV) that makes up about 2% of all cases. It is distinguished from PV by the presence of vegetative plaques that are usually found in the oral mucosa or intertriginous areas. PVeg can present as one of two clinical subtypes: Hallopeau type and Neumann type. The Hallopeau type is a milder form of the disease, often sparing the oral mucosa. The Neumann type is a more severe form that often includes oral mucosal involvement. Nail unit disease of PVeg is rare, lending to limited recommendations for management. Herein, we present a case of PVeg with paronychia‐like changes following rituximab therapy, along with a brief review of PVeg nail unit disease management. Previously reported treatments include prednisone, azathioprine, dapsone, and cyclosporine. In this patient with nail disease, despite rituximab therapy, intralesional triamcinolone acetonide was effective, thereby avoiding the need for additional immunosuppression. [ABSTRACT FROM AUTHOR]

Nail dystrophy can be temporary or permanent and affects quality of life for many patients. It can be secondary to an inflammatory condition; however, many cases are idiopathic. Despite many efforts, there is no promising treatment. Local steroid injection is one of the standard therapies offered for nail dystrophy, but there have been few formal open trials or case reports of its efficacy. This study investigated the impact of intralesional triamcinolone injections on the management and safety of nail dystrophy. Overall, 12 patients with 55 nails affected by nail dystrophy were enrolled. All lesions were injected with triamcinolone acetonide (2.5 mg/mL, 0.1 cc) through the proximal nail fold with a 30 g needle. Injections were administered every 4 weeks. Efficacy was retrospectively evaluated using physician's global assessment of clinical photographs graded on a 5‐point scale as 0, no improvement; 1, slight improvement; 2, moderate improvement; 3, marked improvement; and 4, almost resolved. All adverse events that occurred during treatment were recorded. All patients presented with slight improvement of nail dystrophy after 1 to 3 months. The treatment durations varied from 6 to 12 months (mean, 8.58 months). The average time to observed therapeutic effect was 1.91 months after first treatment. The mean outcome assessment score was 2.8 points, with two patients each showing slight and moderate improvement and five showing marked improvement; in three, the dystrophy was almost resolved. Side effects of this regimen were minimal. Intralesional triamcinolone injections are an effective and safe method for the treatment of nail dystrophy. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic immune‐mediated inflammatory skin disorder, with a prevalence of 2% to 3% worldwide. Psoriatic lesions affecting scalp, nails, palms, and soles are considered difficult‐to‐treat and require specific management. When psoriasis involves these areas, it may be considered more severe even if the lesions are not extensive. Adalimumab (Humira) is a fully human monoclonal antibody against tumor necrosis factor (TNF), administered via subcutaneous injection. It has already been used in the treatment of adults and children with moderate‐to‐severe chronic plaque psoriasis. In literature, few studies investigated its efficacy in difficult‐to‐treat areas, hence we conducted an observational prospective study of 24 weeks to assess its role in patients with difficult to treat psoriasis. We found out a significant improvement in nail and scalp psoriasis, while palmoplantar and genital psoriasis showed an improvement though not statistically significant. Therefore, adalimumab can be used in difficult‐to‐treat areas with great results, also allowing an improvement in the quality of life of affected patients, both adults and children. [ABSTRACT FROM AUTHOR]

Retrospective study of nail telemedicine visits during the COVID-19 pandemic Dear Editor The COVID-19 pandemic has resulted in rapid adoption of telemedicine, with recent teledermatology interest and recommendations.1 Nail telemedicine has not been explored and guidelines are lacking. Our study objectives were to analyze characteristics of nail teledermatology visits and provide recommendations for virtual nail visits. [Extracted from the article]

Cupping therapy as alternative medicine turns into a trigger of disease via the Koebner phenomenon: A case report of Hijama-induced psoriasis and review of the literature Cupping therapy (CT), an alternative medicine therapy,1 is called wet or dry cupping depending on whether or not a bleeding process is induced during the procedure. The Koebner phenomenon (KP) was first described in 1876 by Heinrich Koebner as the formation of psoriasiform lesions after cutaneous trauma in the uninvolved skin of patients with psoriasis. [Extracted from the article]

A healthy 58-year-old man first presented to our dermatology unit in 2008 with an asymptomatic brown pigmented longitudinal band on his finger nail. Hematoxylin-eosin stained revealed epidermal atypia, hypergranulosis, and koilocytic changes. Bowen disease of the nail bed presenting as longitudinal melanonychia: detection of human papillomavirus type 56 DNA. [Extracted from the article]

Acrodermatitis continua of Hallopeau (ACH) is an uncommon chronic inflammatory disease manifesting as sterile pustules of the fingers and toes with possible involvement of nail bed.1 ACH can involve the nail matrix with onychodystrophy, possibly progressing to anonychia and rarely to mutilation of the distal phalanges. Mutilation arises from involvement of the bone, radiographically visible as osteolysis of the distal phalange, often perceived by the patient as joint pain and stiffness.2 ACH pathophysiology is still unproven. An infant with acrodermatitis continua of Hallopeau: successful treatment with thalidomide and UVB therapy. [Extracted from the article]

Onychomycosis is a common chronic fungal infection of the nails caused by dermatophytes, yeasts, and non‐dermatophyte filamentous fungi. A relatively high incidence of resistance and treatment failure of onychomycosis to traditional systemic antifungal agents such as terbinafine and itraconazole has been reported. Voriconazole is a novel broad spectrum systemic antifungal that has shown high efficacy against various types of dermatophytes including Trichophyton and Microsporum species in many in vitro and, recently, in two in vivo studies of resistant dermatophytosis. Herein, we report the successful treatment of a resistant case of finger nail onychomycosis by oral voriconazole in a liver transplant patient who failed to respond to traditional systemic antifungals. [ABSTRACT FROM AUTHOR]

The paper "Intramatricial platelet-rich plasma therapy: a novel treatment modality in refractory nail disorders" aroused interest,1 although we deem it important to discuss some notable inconsistencies of the paper with esteemed authors and readers. 1 We request them to elaborate on what all treatment options (other than TCS monotherapy and IM-TA shots) were offered, attempted, and failed in the next 2 months, prompting them to try IM-PRP therapy. REFERENCES 1 Kaur I, Jakhar D. Intramatricial platelet rich plasma therapy: a novel treatment modality in refractory nail disorders. [Extracted from the article]

Dear Editor, Cisplatin is one of the most potential and widely used drugs for the treatment of various solid cancers such as testicular, ovarian, head and neck, bladder, lung, cervical cancer, melanoma, lymphomas, and several others.[1] Multiple cutaneous adverse effects have been reported with this molecule, such as skin rashes or nail changes. Drug-provoked psoriasis: is it drug induced or drug aggravated? A 76-year-old patient, with a history of chronic heavy smoking, was treated for small cell lung cancer with cisplatin (40 mg/m SP 2 sp ) and etoposide-based chemotherapy without growth factors nor concomitant radiotherapy. [Extracted from the article]

The novel coronavirus disease 2019 (COVID‐19) pandemic has resulted in a paradigm shift in disease management. Since immunosuppression may cause increased susceptibility to COVID‐19, there is uncertainty as to whether systemically treated nail psoriasis patients are at increased infection risk. While specific data on nail psoriasis treatments and COVID‐19 is lacking, we present clinical trial data on rates of upper respiratory infections, nasopharyngitis, viral infection, pneumonia and overall infections. Some systemic medications and biologics are associated with increased in infections risk compared to placebo in clinical trials. However, this data should be regarded cautiously since clinical trials on nail psoriasis, particularly controlled studies, are lacking. Our recommendations may be helpful in guiding physicians managing nail psoriasis patients during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Nivolumab, a fully human IgG4 immune checkpoint modulator, binds to the programmed cell death 1 (PD‐1) receptor on T cells and blocks their inhibition. Thus, it increases the anticancer host immune response by allowing T cells to attack tumor cells. Although anti‐PD‐1 immunotherapy is typically well accepted, deregulation of immune tolerance caused by nivolumab may determine immune‐related adverse events, among which skin toxicities represent the most common. We report a case of severe new‐onset palmoplantar and nail psoriasis after receiving nivolumab treatment for metastatic melanoma. [ABSTRACT FROM AUTHOR]

A 51-year-old male visited our department with complaints of discoloration and pain involving all fingernails and his great toenail of left foot. Grade 2 (G2) included hemorrhagic onycholysis that is tender with moderate-to-severe nail fold inflammation, coupled with impaired functioning or pain. [Extracted from the article]

Due to the rarity of this condition, recommendations are limited to case reports and few real-life experiences.3 First line treatment of ACH is characterized by conventional topical and systemic therapies for psoriasis such as topical and systemic corticosteroids, calcipotriol, topical calcineurin inhibitors, methotrexate and cyclosporine.3 However, ACH is usually refractory to these therapies. Acrodermatitis continua of Hallopeau (ACH) is considered a form of chronic and relapsing localized pustular psoriasis, initially affecting the tips of fingers and/or toes with an unknown pathogenesis.1 ACH strongly affects the quality of life of patients and it is characterized by a sterile pustular eruption with a slow growth, which can lead to atrophy, onychodystrophy and osteolysis, hence requiring prompt diagnosis and treatment.2,3 Herein we describe a case of a 72-year-old man referring to our department for nail dystrophy, painful pustules and periungual erythema of the right third fingernail, refractory to topical corticosteroids. [Extracted from the article]

The efficacy and safety of amorolfine 5% nail lacquer in combination with systemic antifungal agents in the treatment of the onychomycosis were evaluated. According to our meta-analysis, combination treatment of amorolfine 5% nail lacquer and systemic antifungals can result in higher percentage of complete clearance of onychomycosis. It showed that the experimental combination group was more effective than monotherapy of the systemic antifungals [OR (odds ratio) = 1.97, 95%CI (95% confidence interval) = 1.44-2.69], and no more adverse events happened with the addition of amorolfine 5% nail lacquer (OR = .96, 95%CI = .56-1.63, p = .95). This effect strengthens the fact that amorolfine 5% nail lacquer in combination with systemic antifungal agents was better than the monotherapy of systemic antifungals like itraconazole and terbinafine. [ABSTRACT FROM AUTHOR]

Transverse orange nail lesions following SARS-CoV-2 infection Neri et al2 reported the case of a COVID-19 patient who developed the "red half-moon" sign, which consists in "distally convex half-moon-shaped red bands surrounding the distal margin of the lunula". However, unlike the evidence that we found in the literature, the nail lesions of our patient were located distally in the nails. [Extracted from the article]