Pterygium inversum unguis or ventral pterygium is characterized by the adherence of the distal portion of the nailbed to the ventral surface of the nail plate.[3]: 788 The condition may be present at birth or acquired, and may cause pain with manipulation of small objects, typing, and close manicuring of the nail.[3]: 788 secondary due to connective tissue disorders. Pterygium inversum unguis is often asymptomatic.
| Pterygium inversum unguis | |
|---|---|
| Other names | Pterygium inversus unguis,[1] and Ventral pterygium[2]: 660 |
| Specialty | Dermatology |
Signs and symptoms
editPterygium inversum unguis is often asymptomatic. The most commonly reported symptom amongst those who do experience symptoms is bleeding or pain after clipping the affected nails.[4]
Causes
editThe cause of pterygium inversum unguis is unknown. Congenital pterygium inversum unguis is assumed to be brought on by an early abnormality in the fetal ridge and groove formation.[5] Idiopathic forms of pterygium inversum unguis may result from the nail bed's distal expansion, which often aids in the creation of the nail plate.[6] Secondary pterygium inversum unguis is thought to be caused by abnormal distal circulation.[7]
Diagnosis
editA prominent hyperkeratotic stratum corneum with normal nail bed vasculature is seen upon histological analysis. It extends and is firmly linked to the underside of the nail plate.[5]
Treatment
editThe best way to address pterygium inversum unguis is unclear; many approaches, such as topical steroids, keratolytics, and electrocautery-assisted surgical excision, have been shown to be ineffective.[5] Treating the underlying cause of pterygium inversum unguis is the best course of action.[8]
Epidemiology
editAs of 2014, only 37 cases have been reported in literature.[5] Pterygium inversum unguis most commonly affects women ages 20-70.[4]
See also
editReferences
edit- ^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 978-1-4160-2999-1.
- ^ Freedberg, et al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- ^ a b James, William; Berger, Timothy; Elston, Dirk (2005). Andrews' Diseases of the Skin: Clinical Dermatology. (10th ed.). Saunders. ISBN 0-7216-2921-0.
- ^ a b Caputo, Ruggero (1993-10-01). "Pterygium Inversum Unguis: Report of 19 Cases and Review of the Literature". Archives of Dermatology. 129 (10): 1307. doi:10.1001/archderm.1993.01680310077013. ISSN 0003-987X.
- ^ a b c d Baek, Ji Hye; Kim, Hei Sung; Park, Young Min; Kim, Hyung Ok; Cho, Baik Kee; Lee, Jun Young (2014). "A Case of Acquired Idiopathic Pterygium Inversum Unguis". Annals of Dermatology. 26 (3). Korean Dermatological Association and The Korean Society for Investigative Dermatology: 374. doi:10.5021/ad.2014.26.3.374. ISSN 1013-9087.
- ^ Caputo, Ruggero (1973-12-01). "Pterygium Inversum Unguis". Archives of Dermatology. 108 (6): 817. doi:10.1001/archderm.1973.01620270039009. ISSN 0003-987X.
- ^ Patterson, James W. (1977-10-01). "Pterygium Inversum Unguis-like Changes in Scleroderma: Report of Four Cases". Archives of Dermatology. 113 (10): 1429. doi:10.1001/archderm.1977.01640100107021. ISSN 0003-987X.
- ^ Paley, Kristina; English, Joseph C.; Zirwas, Matthew J. (2008). "Pterygium inversum unguis secondary to acrylate allergy". Journal of the American Academy of Dermatology. 58 (2). Elsevier BV: S53–S54. doi:10.1016/j.jaad.2006.05.040. ISSN 0190-9622.
Further reading
edit- Vadmal, Manjunath; Reyter, Ilya; Oshtory, Shaheen; Hensley, Benjamin; Woodley, David T. (2005). "Pterygium inversum unguis associated with stroke". Journal of the American Academy of Dermatology. 53 (3). Elsevier BV: 500–502. doi:10.1016/j.jaad.2005.04.057. ISSN 0190-9622.
- Balma, Alexandra; Pope, Elena (2010-01-28). "Acquired Idiopathic Pterygium Inversum Unguis". Clinical Pediatrics. 49 (4). SAGE Publications: 394–395. doi:10.1177/0009922809346731. ISSN 0009-9228.
- Oiso, N.; Narita, T.; Tsuruta, D.; Kawara, S.; Kawada, A. (2009). "Pterygium inversum unguis: aberrantly regulated keratinization in the nail isthmus". Clinical and Experimental Dermatology. 34 (7). Oxford University Press (OUP): e514–e515. doi:10.1111/j.1365-2230.2009.03601.x. ISSN 0307-6938.