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Lichen striatus(LS) is an uncommon dermatosis. Nail involvement in this disorder is rare. Diagnosis is usually based on characteristic clinical features include linear papules along Blaschko lines and partial dystrophy of a single nail. LS is self-resolving and gradually improves over several months to years. We report a 5-year- old girl with LS that presented with asymptomatic linear skin colored papules which had extended from left elbow to left index finger nail. Simultaneous lateral nail dystrophy was consistent with nail LS diagnosis. Currently there is no specific treatment for LS and its nail dystrophy. However, prescription of topical steroid and calcineurin inhibitors have been ordered. For the current case, we prescribed topical triamcinolone. [ABSTRACT FROM AUTHOR]

Rapid and proper diagnosis of mucocutaneous presentations of COVID-19 which in many cases are representing internal organ damage is a key way to better approach these patients, and it could be even lifesaving. In this original study, we reported consultant critical and non-critical cases of admitted COVID-19 patients and some interesting outpatient cases for 14 months, and some newly encountered vaccine-associated dermatoses. We presented 121 cases divided into 12 categories; all had full multi-aspects photographs attached as an atlas to a Supplementary File. These categories were:1- Generalized papulopustular eruptions (3 patients), 2- Erythroderma (4 patients), 3- Maculopapular lesions(16 patients), 4- Mucosal lesions (8 patients), 5- Urticarial lesions and angioedema (16 patients), 6- Vascular injuries (22 patients), 7- Vesiculobullous lesions (12 patients), 8- The specific new onset of mucocutaneous presentations or aggravation of any especial previous dermatoses (9 patients), 9- Nail changes (3 patients), 10- Hair loss (2 patients), 11- Non-specific mucocutaneous problems (16 patients) and 12-Vaccine-associated dermatoses (10 patients). In the pandemic, if we countered with extensive mucocutaneous lesions with vascular components or vesiculobullous erosive lesions in association with any cutaneous rash that could be an alarming sign of a probable life-threatening systemic event, we would need to approach them as soon as possible. [ABSTRACT FROM AUTHOR]

Onychomycosis, a nail fungal infection, is normally caused by dermatophytes. However, yeasts and non‐dermatophyte moulds (NDM) are among pathogens that cause nail disease. Regarding, this study aimed to describe the molecular epidemiology of Fusarium onychomycosis in the North of Iran. Two hundred and fifty seven nail samples collected from the patients clinically suspected of onychomycosis were subjected to direct microscopy, calcofluor white staining and culture. Fusarium isolates were identified at a species level through determination of multi‐locus sequences for internal transcribed spacer and translation elongation factor 1 alpha. Based on the findings, Fusarium species were isolated from onychomycosis patients (n = 27). According to a previous partial genes analysis, the species in the recent study belonged to the members of F. fujikuroi species complex (n = 14), Fusarium incarnatum‐equiseti species complex (n = 1) and F. solani species complex (n = 12). In this study, F. proliferatum was the dominant Fusarium species collected from the samples. The correct identification of Fusarium species is essential regarding the increased prevalence of Fusarium onychomycosis and the inherent resistance of these agents to a wide spectrum of antifungals. The obtained results indicated variation in the epidemiology of Fusarium species isolated from onychomycosis. Moreover, the minimum inhibitory concentration (MIC) of luliconazole and lanoconazole was in the range of 0.001–1 μg/ml, with the geometric mean of MICs obtained at 0.0103 and 0.0343 μg/ml against Fusarium species, respectively. These findings can increase researchers' knowledge regarding diversity of species, distribution of onychomycosis and the choice of a proper treatment. [ABSTRACT FROM AUTHOR]

Background. Psoriatic arthritis (PsA) results in an increased burden of psoriasis and impairs both quality of life and an individual’s functional capacity. The relationship between nail involvement and PsA in psoriasis is not fully characterized. Aim. To evaluate the frequency and characteristics of nail involvement in psoriatic patients and to assess the relationship with joint involvement. Methods. A total of 197 patients with moderate-to-severe psoriasis were consecutively invited to participate in this cross-sectional study. The patients are divided into two groups: those with and those without psoriatic arthritis. Results. 69.5% of psoriatic (137 out of 197) patients had nail involvement. The most common nail abnormality was onycholysis, followed by pitting and oil droplet changes. Nail involvement was more common in patients with psoriatic arthritis (82.1% versus 57.8%, p=0.001). Conclusion. Nail involvement is commonly associated with PsA. Onycholysis, splinter hemorrhage, and oil drop were significantly more common in the PsA group as opposed to patients with just skin findings. In general, psoriatic patients with arthritis had more severe disease. [ABSTRACT FROM AUTHOR]

Kawasaki disease (KD) is a vasculitis that mostly affects children under 5 years of age. This article presents a 2.5-year-old boy who presented with 6 days of fever, generalized maculopapular rash, bilateral non-exudative conjunctivitis, cracked lips, right cervical lymphadenopathy, erythematous extremities, and perianal desquamation. Laboratory studies showed leukocytosis and sterile pyuria. Because diagnosis of KD was proved, oral acetylsalicylic acid with the anti-inflammatory dose and intravenous immunoglobulin were started for him. On the seventh day of admission time, he developed desquamation and erythema on the site of his right cervical lymphadenopathy as well as periungual scaling. About three weeks after starting the treatment, scaling of the cervical lymphadenopathy and periungual area stopped. Echocardiography was performed for him three times: at the time of diagnosis, four weeks, and 6 months later and revealed normal coronary arteries. We report this sign, desquamation on the site of cervical lymphadenopathy, as a new finding. [ABSTRACT FROM AUTHOR]

Onychomycosis is a common nail disorder resulting from the invasion of the nail plate by a dermatophyte, yeast or mould species and gives rise to some diverse clinical presentations. The purpose of the present study was to isolate and identify the causative fungi of onychomycosis in the population of Tehran, Iran. Nail samples from 504 patients with prediagnosis of onychomycosis during 2005 were examined both by direct microscopical observation of fungal elements in KOH preparations and in culture for the identification of the causative agent. All samples were inoculated on (i) Sabouraud dextrose agar (SDA, Merck), (ii) SDA with 5% chloramphenicol and cycloheximide in duplicate for dermatophyte and (iii) SDA with 5% chloramphenicol in triplicate for mould isolation. The criteria for the diagnosis of onychomycosis caused by non-dermatophytic moulds were based on microscopical observation of fungal elements, growth of the same mould in all triplicate culture and no growth of a dermatophyte or yeast in all the cultures. Of 504 cases examined, 216 (42.8%) were mycologically proven cases of onychomycosis (144 fingernails, 72 toenails). Among the positive results, dermatophytes were diagnosed in 46 (21.3%), yeasts in 129 (59.7%) and non-dermatophytic moulds in 41 (19%). Trichophyton mentagrophytes was the most common causative agent ( n = 22), followed by Trichophyton rubrum ( n = 13), Candida albicans ( n = 42), Candida spp. ( n = 56) and Aspergillus spp. ( n = 21). Nearly half of the clinically suspected fungal nail infections are onychomycosis and yeast is responsible for most of the infections in Iran. [ABSTRACT FROM AUTHOR]

Background: In the last few years the number of cases of nondermatophytic onychomycosis has greatly increased. Aim: To evaluate the incidence, the clinic characteristics, and predisposing factors of nondermatophytic onychomycosis. Materials and Methods: All collected specimens were analyzed by direct microscopy and culture. Microscopic examination of these specimens was carried out in potassium hydroxide solution (20%) with dimethyl sulfoxide (4%). These specimens were cultured on sabouraud's glucose agar with chloramphenicol and sabouraud's glucose agar with chloramphenicol and cycloheximide. Cultures were incubated at 25°C for up to 28 days and checked twice weekly for growth. Results: Nondermatophytic onychomycosis were 11.5% of all onychomycosis. We found that Aspergillus spp. were the more responsible etiologic agents of nondermatophytic onychomycosis, resulting in a total of 28 patients (59.6%). In our study other causative agents were Acremonium spp. (17%), Fusarium spp. (12.7%), Geotrichum spp. (4.2%), Trichosporun spp., (4.2%) and Scopulariopsis spp (2.1%). In our patients moulds onychomycosis developed mainly in toenails (74.5%). Conclusion: Knowing the exact pathogen is important and has implications in therapy and prognosis. [ABSTRACT FROM AUTHOR]

Background: Onychomycosis represents the most frequently encountered nail disease, which is difficult to eradicate with drug treatment. Aim: This study was undertaken to document the clinico-mycological pattern of onychomycosis in Iran. Results of mycological tests of nail scrapings collected over a 4-year period were analyzed. Methods: Both direct microscopy and cultures of the nail material were performed to identify the causative agents. Results: The microscopic and/or cultural detection of fungi was positive in 40.2% of samples. The most common clinical type noted was distolateral subungual onychomycosis in 48.4% of cases. Etiological fungal agents were 50% dermatophytes, 46.8% yeasts, and 3.2% saprophytic moulds. The most frequently detected dermatophyte species were Trichophyton rubrum (48.4%) and T. mentagrophytes (41.9%). Among yeasts, Candida albicans (58.6) was most common, followed by C. parapsilosis (17.2%), C. glabrata (10.3%), C. krusei and C. tropicalis (each 6.9%). Aspergillus niger and A. flavus were the most frequent saprophytic moulds. Females were affected more frequently than males, and in both sexes those most infected were between 40-49 years of age. Fingernails were affected more frequently than toenails. Conclusions: The clinico-epidemiological data collected can serve as reference for future research and may be useful in the development of preventive and educational strategies. [ABSTRACT FROM AUTHOR]

A mycological study was undertaken in 488 patients suspected of onychomycosis in Isfahan, a large province of Iran, to gain more insight into the prevalence and aetiology of this infection. Direct microscopy of the nail clips was positive in 194 (39.8%) and fingernail onychomycosis was recognised in 141 (72.7%) and toenail onychomycosis in 53 (27.3%) cases. As agents of onychomycosis, yeast were detected in 112 (57.7%), dermatophytes in 27 (13.9%) and non-dermatophyte fungi in 55 (28.4%) patients. Of the samples cultured, Candida albicans was the most prevalent (84%) yeast. Among dermatophytes, Trichophyton mentagrophytes var. interdigitale was found to be the commonest aetiological agent (8.6%) followed by Epidermophyton floccosum and T. rubrum. Among the non-dermatophyte moulds, Aspergillus flavus was the most prevalent species (13%). Moreover, nine samples with positive direct microscopy yielded no growth. Females were affected more frequently with fingernail candidal infections than males, and children under 7 years of age were predominantly involved with candidal paronychia. The majority of fungal nail infections were characterised clinically by distal and proximal subungual onychomycosis. The growing trend towards the frequency of fingernail onychomycosis in housewives was noticeable in the last decade in Iran. [ABSTRACT FROM AUTHOR]

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A total of 48 patients with fungous nail infection positive in direct examination were cultured. Nineteen cases were positive in culture with tile following results: Trichophyton schoenleinii, 63% T. violaceum, 15% T. rubrum, 10%; T. tonsurans, 5%; T. verrucosum, 5%. [ABSTRACT FROM AUTHOR]