basic nail anatomy - pathcme.com · pterygium erythema, telangiectasia, sclerosis pterygium...
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Morgan AM et al, in Krull E., ed. Nail surgery: a text and atlas, 2001
De Berker D. Nail anatomy. Clinics in Dermatology. 2013;31(5):509–515.
Proximal nail fold
False cuticle
Lateral nail fold
Lunula
Nail plate and bed
Onychodermal band Hyponychium
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Jiaravuthisan MM, Sasseville D, Vender RB, Murphy F, Muhn CY. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J. Am. Acad. Dermatol. 2007;57(1):1–27.
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Distal nail matrix
Nail bed epithelium
True cuticle
False cuticle
Nail plate
A granular zone in the matrix or bed is abnormal
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Jellinek N. J Am Acad Dermatol. 2007;56(5):803-810. Richert B, Theunis A, Norrenberg S, André J. J Am Acad Dermatol. 2013;69(1):96-104.
Haneke E. Anatomy of the nail unit and the nail biopsy. Semin Cutan Med Surg. 2015;34(2):95-100.
Courtesy of Monica Lawry, MD
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Courtesy of Nilton Di Chiacchio, MD, PhD
Courtesy of Phoebe Rich, MD
Courtesy of Phoebe Rich, MD
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Orchard GE, Torres J, Sounthararajah R. Use of softening agents to improve the production of formalin-fixed, paraffin-embedded sections of nail tissue: an assessment. Br J Biomed Sci. 2008;65(2):68-70.Wlodek C, Lecerf P, Andre J, Ruben BS, de Berker D. An international survey about nail histology processing techniques. J Cutan Pathol. 2017;44(9):749-756.
Mondragon G. Histotechnologist to histopathologist: amethod for processing specimens of nails. DermatopatholPractical Conceptual 1996;2:41-2.
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Nazarian RM et al. J Am Acad Dermatol. 2012; 66 (4):655-60. Alers JC, et al. J Histochem Cytochem Off J Histochem Soc. 1999;47(5):703-710.Choi S-E, Hong SW, Yoon SO. J PatholTransl Med. 2015;49(3):236-242.
Hafner J, Haenseler E, Ossent P, Burg G, Panizzon RG. Benzidine stain for the histochemical detection of hemoglobin in splinter hemorrhage (subungual hematoma) and black heel. Am J Dermatopathol. 1995;17(4):362-367.
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Adapted from: Jiaravuthisan MM, Sasseville D, Vender RB, Murphy F, Muhn CY. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J. Am. Acad. Dermatol.
2007;57(1):1–27.
leukonychia
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• Nail pits:
• Leukonychia:
• Splinter hemorrhages:
• Onycholysis/oil spots:
• Thickening:
Nail unit psoriasis
Clippings for diagnosis
Courtesy of Eleni Linos, MD
Pits
Subungual hyperkeratosis
Neutrophils
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Nail pits in psoriasis
Onychomycosis
Werner B, Fonseca GP, Seidel G. Microscopic nail clipping findings in patients with psoriasis. Am J Dermatopathol. 2015;37(6):429-439.
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P04-7660 JT
Pustular psoriasis with onycholysis
(acrodermatitis of Hallopeau)
Courtesy of Janet Hickman, MD
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Lichen planus
Splitting, ridging, thinning
Pterygium
Erythema, telangiectasia, sclerosis
Pterygium
Splitting, ridging, thinning
Graft versus host disease
Courtesy of Sarah Arron, MD, PhD
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Kim M et al. Int J Dermatol. 2015;54(11):1255-1260.
Tosti A, Peluso AM, Misciali C, Cameli N. J Am Acad Dermatol.
1997;36(6 Pt 1):908-913.
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Mattos Simoes Mendonca M, LaSenna C, Tosti A. Severe Onychodystrophy due to Allergic Contact Dermatitis from Acrylic Nails. Skin Appendage Disord. 2015;1(2):91-94.
Trachyonychia
“20 nail dystrophy”
Tosti A, Bardazzi F, Piraccini BM, Fanti PA.
Idiopathic trachyonychia (twenty-nail dystrophy): a
pathological study of 23 patients. Br J Dermatol. 1994
Dec;131(6):866-72.