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Figure c95/f001
Figure 95.1
Longitudinal section of a digit showing the dorsal nail apparatus.
Figure c95/f005
Figure 95.5
Clubbing: Lovibond's profile sign. The angle is normally less than 160° but exceeds 180° in clubbing.
Figure c95/f009
Figure 95.9
Pincer nail.
Figure c95/f013
Figure 95.13
Nail pterygium due to lichen planus.
Figure c95/f017
Figure 95.17
Trachyonychia: roughened surface of up to 20 nails.
Figure c95/f021
Figure 95.21
Green pigmentation of onycholytic fingernail due to Pseudomonas .
Figure c95/f025
Figure 95.25
(a) Longitudinal erythronychia. (b) The longitudinal ridge in the nail bed corresponds to the groove on the undersurface of the nail plate.
Figure c95/f029
Figure 95.29
Nail biting can be extensive, with damage to the nail folds and nail plate causing subungual haemorrhage.
Figure c95/f033
Figure 95.33
(a,b) Ingrowing great toenail complicated by proximal ingrowing (retronychia).
Figure c95/f037
Figure 95.37
This lesion was mistaken for an ingrowing toenail. X‐rays confirmed the presence of subungual exostosis.
Figure c95/f041
Figure 95.41
Submatricial fibrokeratoma pressing onto the underlying matrix with subsequent longitudinal smooth groove.
Figure c95/f045
Figure 95.45
X‐rays showing massive osteolysis of the distal bony phalanx associated with subungual keratoacanthoma.
Figure c95/f049
Figure 95.49
Superficial fibromyxoma of the nail bed elevating the distal plate.
Figure c95/f053
Figure 95.53
Narrow longitudinal melanonychia on a thumb. Dermoscopy showed loss of parallelism that prompted excisional biopsy. Histological examination revealed ...
Figure c95/f057
Figure 95.57
(a–c) Chronic paronychia: paronychial swelling, loss of cuticle and mildly dystrophic nail in early disease (a,b); severe nail dystrophy in more advan...
Figure c95/f061
Figure 95.61
Psoriasis: pitting.
Figure c95/f065
Figure 95.65
Multiple transverse grooves of the thumbnails.
Figure c95/f069
Figure 95.69
Lichen planus with longitudinal melanonychia.
Figure c95/f073
Figure 95.73
Ultrasound: grey scale ultrasound (longitudinal view) demonstrates the normal sonographic anatomy of the nail (a); 3D ultrasound reconstruction of the...
Figure c95/f077
Figure 95.77
Normal nail fold capillaries (×60) (a); acrocyanosis showing dilatation of the nail fold capillaries, stasis and thrombosis of many vessels (b); rheum...
Figure c95/f081
Figure 95.81
(a) Avulsion of the proximal third of the plate demonstrates that the pigment area responsible for the pigmentation extends longitudinally on the matr...
Figure c95/f085
Figure 95.85
(a) Dermatophyte onychomycosis with longitudinal spikes. (b) After surgical removal of the yellow streaks.
Figure c95/f089
Figure 95.89
(a) Ingrowing toenail with pyogenic granuloma. (b) After curettage of the pyogenic granuloma, a lateral strip of nail is avulsed. (c) A cotton‐tipped ...
Figure c95/f002
Figure 95.2
Direction of differentiation and cell movement within the nail apparatus.
Figure c95/f006
Figure 95.6
Clubbing: Curth's modified profile sign.
Figure c95/f010
Figure 95.10
Anonychia: nail loss in a 50‐year‐old man with dominant dystrophic epidermolysis bullosa.
Figure c95/f014
Figure 95.14
Ventral pterygium due to allergy to formaldehyde nail hardener.
Figure c95/f018
Figure 95.18
Onychoschizia (lamellar splitting).
Figure c95/f022
Figure 95.22
Total leukonychia.
Figure c95/f026
Figure 95.26
Transverse ridges resulting from habit tic.
Figure c95/f030
Figure 95.30
Early onychogryphosis of the left great toenail.
Figure c95/f034
Figure 95.34
Pyogenic granuloma resulting from friction of the overlapping second toe against the lateral aspect of the great toenail.
Figure c95/f038
Figure 95.38
Digital myxoid pseudocyst type A.
Figure c95/f042
Figure 95.42
Intraungual (dissecting) fibrokeratoma. The lesion grows within the nail plate and emerges at its distal half.
Figure c95/f046
Figure 95.46
Onychomatricoma, pigmented variant: note the very well‐delimited longitudinal thickening of the plate.
Figure c95/f050
Figure 95.50
Onychopapilloma: note the longitudinal erythronychia starting in the distal matrix, the distal splinter haemorrhages and the onycholysis at its distal...
Figure c95/f054
Figure 95.54
Friable granulation tissue under the plate of the great toenail in an old lady wearing sandals all year round. Pyogenic granuloma was suspected but hi...
Figure c95/f058
Figure 95.58
Painful dorsolateral fissure of the fingertip.
Figure c95/f062
Figure 95.62
Psoriasis: salmon patches progressing to onycholysis.
Figure c95/f066
Figure 95.66
Acropustulosis: nail plate has been destroyed by intense pustular inflammation.
Figure c95/f070
Figure 95.70
Anonychia following lichen planus.
Figure c95/f074
Figure 95.74
Nail melanoma: clinical presentation (a); dermoscopy (b) and in vivo reflectance confocal microscopy (c) of the nail matrix in the same patient. (C...
Figure c95/f078
Figure 95.78
Dermatomyositis showing dilated nail folds capillaries and obstructed and thrombosed capillaries (×60) (inset).
Figure c95/f082
Figure 95.82
(a) Avulsion of the proximal third of the plate exposes the wide pigment area responsible for the longitudinal pigmentation. (b) An incision is carrie...
Figure c95/f086
Figure 95.86
(a) Chronic paronychia resistant to topicals and steroid injections. (b) Crescent‐shaped excision of a part of the proximal nail fold. (c) Complete re...
Figure c95/f090
Figure 95.90
Allergy to nail varnish presenting as an eyelid dermatitis.
Figure c95/f003
Figure 95.3
Arterial supply of the distal finger.
Figure c95/f007
Figure 95.7
Schamroth's window is seen clearly in this image of normal nails.
Figure c95/f011
Figure 95.11
Onycholysis: idiopathic type.
Figure c95/f015
Figure 95.15
Median canaliform dystrophy of Heller.
Figure c95/f019
Figure 95.19
Longitudinal ridging of the nail.
Figure c95/f023
Figure 95.23
Punctate leukonychia.
Figure c95/f027
Figure 95.27
Median canaliform dystrophy of Heller affecting distal portion of nail plate; the enlarged lunula and transverse ridging seen proximally reflect chron...
Figure c95/f031
Figure 95.31
Severe onychogryphosis resulting from neglect.
Figure c95/f035
Figure 95.35
Painful glomus tumour of the nail bed. Note the bluish hue.
Figure c95/f039
Figure 95.39
Digital myxoid pseudocyst type B. Note the longitudinal groove arising from underneath the proximal nail fold where the matrix is compressed by the ov...
Figure c95/f043
Figure 95.43
Multiple soft fibrokeratomas in tuberous sclerosis.
Figure c95/f047
Figure 95.47
Onychomatricoma: ‘woodworm’ cavities in the nail plate are especially visible in this longstanding case (>40 years).
Figure c95/f051
Figure 95.51
Bowen disease: warty lesion of the distal bed and hyponychium. The lesion was treated for several years as a wart.
Figure c95/f055
Figure 95.55
Acute bacterial paronychia (whitlow).
Figure c95/f059
Figure 95.59
Figure c95/f063
Figure 95.63
Psoriasis: distal onycholysis.
Figure c95/f067
Figure 95.67
Darier disease: white and red longitudinal lines and distal notching.
Figure c95/f071
Figure 95.71
Paronychia of the little finger in a 2‐year‐old child.
Figure c95/f075
Figure 95.75
Axial T2‐weighted image at the level of the distal interphalangeal joint (arrows): pedicle of the myxoid pseudocyst connected with the joint (arrows) ...
Figure c95/f079
Figure 95.79
Lupus erythematosus (a) and systemic sclerosis (b). (Courtesy of the copyright holder C. Mathis, Belgium.)
Figure c95/f083
Figure 95.83
Lateral longitudinal biopsy. Note the sigmoid shape of the defect that can be easily closed.
Figure c95/f087
Figure 95.87
Two lateral incisions at 45° allow reflection of the proximal nail fold; visualization of the tumour and its removal.
Figure c95/f091
Figure 95.91
Staining of the nail plates from nail varnish.
Figure c95/f004
Figure 95.4
Proliferating epithelial cells of the matrix and ventral aspect of the proximal nail fold, staining with the antibody MIB‐1.
Figure c95/f008
Figure 95.8
Koilonychia. This image is of congenital koilonychia in a young girl.
Figure c95/f012
Figure 95.12
Photo‐onycholysis with a uniform pattern of discoloured onycholysis in the midline.
Figure c95/f016
Figure 95.16
Beau's lines present as transverse grooves in the nail matching the proximal margin of the nail matrix and lunula.
Figure c95/f020
Figure 95.20
Orange pigmentation of onycholytic toenail due to orange dye from work‐boots.
Figure c95/f024
Figure 95.24
Yellow nail syndrome
Figure c95/f028
Figure 95.28
Chronic paronychia.
Figure c95/f032
Figure 95.32
(a–c) Onychogryphosis is often best treated with ablation of the nail matrix.
Figure c95/f036
Figure 95.36
Subungual exostosis: exophytic growth of bone emerging from under the nail plate through collarette of skin (note the telangiectases) (a); exostosis ...
Figure c95/f040
Figure 95.40
Digital myxoid pseudocyst type C. Note the red macule within the lunula.
Figure c95/f044
Figure 95.44
Subungual distal keratoacanthoma. Note the keratotic plug on the distal bed.
Figure c95/f048
Figure 95.48
Onychomatricoma: showing the sea anemone‐like matrix tumour and the cavities in the avulsed nail plate into which digitate projections from the tumour...
Figure c95/f052
Figure 95.52
Onycholysis and oozing of the great toenail bed due to invasive squamous cell carcinoma.
Figure c95/f056
Figure 95.56
Herpetic whitlow.
Figure c95/f060
Figure 95.60
Subungual abscess in neutropenic patient receiving cancer chemotherapy. (Courtesy of B. Fouilloux, France.)
Figure c95/f064
Figure 95.64
Psoriasis: subungual hyperkeratosis.
Figure c95/f068
Figure 95.68
Severe onychatrophy from juvenile onset lichen planus of nails.
Figure c95/f072
Figure 95.72
Transverse acro‐osteolysis of the fingernail (a); acro‐osteolysis of the toenail (b). (Courtesy of J. L. Drapé, France.)
Figure c95/f076
Figure 95.76
Sagittal section T2 fat saturated image: pedicle connecting with the joint (arrow) under the extensor tendon (arrow heads). (Courtesy of the copyrigh...
Figure c95/f080
Figure 95.80
(a) Avulsion of the proximal third of the plate exposes the pigment area responsible for the longitudinal pigmentation. (b) A 3 mm punch is performed ...
Figure c95/f084
Figure 95.84
Lateral avulsion (‘sardine tin’ avulsion) allows exposure of the complete nail bed and excisional biopsy of the nail bed tumour.
Figure c95/f088
Figure 95.88
Trap door avulsion permits access to the nail bed tumour. The latter will be removed in a longitudinal excision.
Figure c95/f092
Figure 95.92
Complication of nail extensions: allergy to acrylate adhesive presenting as onycholysis.