While topical agents such as ciclopirox 8%, efinaconazole 10%, and tavaborole 5% are very appealing from both a safety and convenience perspective, she advises against their use if any nail matrix
involvement is noted.
An improvement in dorsal reverse adipofascial flap for fingertip reconstruction: Nail matrix
With regard to anatomical structure of the nail, achieving sufficient concentrations of topical antipsoriatic drugs in the nail plate, nail bed, or nail matrix
is an issue; therefore, innovative methods providing adequate penetration of the agents are desirable.
The diagnosis of a congenital nail matrix
nevus was established on clinical grounds.
Anti-cancer drugs usually affect rapidly growing cells and hence, the skin, hair follicles and nail matrix
are the frequent targets of their toxicities.
Onychomadesis is discontinuance of growth in the nail matrix
from the proximal part of the nail and onset of separation of the nail from the nail bed.
After infection of the nail matrix
occurs, transverse depressions (Beau's lines) may appear in the nail plate, which becomes convex, irregular, and rough and, ultimately, dystrophic (El-Ewski, 1998).
The ventral layer, which lies closest to the nail bed and thus anchors the whole nail plate to the nail bed, is the thinnest layer and develops, in part, from the epidermal cells of the nail bed, unlike the dorsal and intermediate layers which originate from the nail matrix
cells situated at the proximal portion of the nail plate (de Berker and Angus 1996).
Chemical Matricectomy is ablation of nail matrix
after the partial or total nail avulsion with the help of Phenol or Sodium Hydroxide (NaOH).
In the physical examination skin bridging and epithelialization was observed in midline secondary to soft tissue hypertrophy of the lateral nail matrixes
. Epithelized fibrous tissue was cut across the lateral nail matrix
and left for secondary healing.
Each nail is given a score for nail bed psoriasis (0-4) and nail matrix
psoriasis (0-4) depending on the presence of any of the features of nail psoriasis in that quadrant.
In extended and severe cases of pernio, inflammatory response can lead to nail deformities through chronic damage in the nail matrix
. We believe that nail changes secondary to the inflammation that appears in eczema may occur when an inflammatory response develops in addition to vasoconstriction in severe pernio cases.
Some onychomycosis infections, especially those involving the nail matrix
, may produce permanent scarring of the matrix, and, thus, the nail may never appear normal even after the infection is completely eradicated (Figure 1).
Realistically, patients who have had long-standing infections or chronic onychomycosis are likely to have sustained damage to the nail matrix
or subungual area so that, despite the clearance of infectious organisms, new nail growth may be permanently discolored and/or dystrophic, and some onycholysis (lifting of the nail plate) may persist.
Cytotoxic agents and infections can induce the temporary arrest of proliferation of the nail matrix
, which is called Mees' lines of the nail plate.