Drug responsive onychomycosis

Introduction to drug-responsive nail disease Finger-type bullous lesions can cause partial or complete loss of nails, so any drug that can cause polymorphous erythema bulls can cause nail loss, which is due to the destruction of methyl. High doses of cloxacillin (cloxacillin) and cefotaxime (cephaloridine) can cause temporary nail loss. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: hepatic encephalopathy

The cause of drug-responsive nail disease

(1) Causes of the disease

Therefore, any drug that can cause polymorphous erythema bulls can cause a loss of nails.

(two) pathogenesis

The drug is destroyed by the body's reaction.

Drug-reactive nail disease prevention

The disease belongs to the abnormal color of the nail caused by the drug, so the prevention measures should be carried out according to the cause. For the exact disease, the above drug treatment is needed, and the dosage and rules of the drug should be paid attention to, and at the same time, drinking more water can accelerate drug metabolism. Discharge of waste to reduce the incidence of complications, while also preventing and avoiding damage to the kidneys caused by drug metabolites.

Drug-reactive complications Complications, hepatic encephalopathy

This disease is usually associated with excessive drug use, so it can cause liver function and renal function damage in clinical manifestations. The increase in ALT and AST is usually more than 3 times higher. Some cases may present explosive liver damage and endanger life. Even induced hepatic encephalopathy. Secondly, serum creatinine and urea nitrogen will also increase, but generally do not induce renal failure.

Symptoms of drug-reactive nail disease Common symptoms Finger nail color change nail fragile finger (toe) nail drug rash granuloma

The drug can still cause the color change of A. A flat can make the nail appear light blue, yellowish green or white fluorescence under the Wu's lamp, normal a mild purple blue fluorescence, long-term use of tetracycline can make the yellow Dyeing, chloroquine causes blue-black pigmentation in the nail bed, and other antimalarial drugs can produce longitudinal pigmentation bands on the nail bed. The fixed drug eruption of phenolphthalein occurs in the dark blue on the nail bed, and the silver deposition disease causes a nail. Dark blue-gray, inorganic arsenic causes a longitudinal pigmentation band or white stripes (Mees pattern).

Doxorubicin (adriamycin) can make dark blue, Ethylene and hydroxyurea can cause brown pigmentation.

Acitretin (etretete) and isotretinoin (13-cisretinoic acid) can cause dryness of the nails, thinning of the deck, and brittleness. Some patients can wrinkle near nails and/or lateral nails. There is a granuloma-like granulation tissue.

1. A defect: finger-type bullous lesions can cause partial or complete loss of nails, so it can cause bullous polymorphic erythema drugs such as high-dose chloramphenicol and cephalosporin 2 to produce temporary nail loss.

2. A color change: the drug can still cause the color change of A. A flat can make the nail appear light blue, tetracycline can make the yellow dye, and chloroquine causes the blue bed to produce blue-black pigmentation. Other antimalarial drugs can be used in A. The longitudinal pigmentation band is produced on the bed. If the phenolphthalein-fixed drug eruption occurs in the dark blue on the nail bed, the silver deposition disease makes the nail appear dark blue-gray, and the inorganic arsenic causes the nail to have a longitudinal pigment band or a white stripe (Mess pattern). Doxorubicin can cause dark brown color, and ethylimine and hydroxyurea can cause brown pigmentation.

3. A change in quality: Itratide and 13-cis vitamin A can cause dryness of the nail, the deck becomes thin and brittle, and some patients can have granulomatous tissue in the near nail fold.

Examination of drug-reactive nail disease

Clinical physical examination: The disease is mainly caused by abnormal color of nails and changes in morphology and fragility. The nail color can be darkened, light blue, or yellowish. Pressing the capillaries with force is usually less than 3 seconds.

Laboratory examination: The disease is mainly based on the patient's medication history to check the blood drug concentration. At the same time, there may be a basis for over-medication. The myocardial enzyme spectrum and liver function should be checked to determine whether the above-mentioned organs are damaged due to excessive drug use.

Diagnosis and identification of drug-reactive nail disease

diagnosis

Diagnosis can be made based on medical history, clinical manifestations, and examination.

Differential diagnosis

It should be differentiated from a disease that is caused by systemic diseases. For example, psoriasis nail disease, congenital thick nail disease, congenital white nail disease, eczema, scleroderma, syringomyelia, Raynaud's disease, continuous acral dermatitis, exfoliative dermatitis can cause nail changes. These nail diseases often involve several nails and often occur symmetrically.

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