Hand dermatitis and nail disorders of the workplace

Nails and COVID-19 - A comprehensive review of clinical findings and treatment

The SARS‐CoV‐2 infection, responsible for COVID‐19, has raised the interest for infection‐associated muco‐cutaneous symptoms. While dermatologic symptoms in general gained an increasing awareness, affection of the nail organ has been mentioned only recently. We provide a narrative review on COVID‐19 manifestation on the nail organ and add symptoms induced by personal protective measures and SARS‐CoV‐2 vaccination. Available treatment options are discussed.

The Diagnosis and Treatment of Nail Disorders

BACKGROUND

Nail disorders can arise at any age. About half of all nail disorders are of infectious origin, 15% are due to inflammatory or metabolic conditions, and 5% are due to malignancies and pigment disturbances. The differential diagnosis of nail disorders is often an area of uncertainty.

METHODS

This review is based on publications and guidelines retrieved by a selective search in PubMed, including Cochrane reviews, meta-analyses, and AWMF guidelines.

RESULTS

Nail disorders are a common reason for derma - tologic consultation. They are assessed by clinical inspection, dermatoscopy, diagnostic imaging, microbiological (including mycological) testing, and histopathological examination. Some 10% of the overall population suffers from onychomycosis, with a point prevalence of around 15%. Bacterial infections of the nails are rarer than fungal colonization. High-risk groups for nail disorders include diabetics, dialysis patients, transplant recipients, and cancer patients. Malignant tumors of the nails are often not correctly diagnosed at first. For subungual melanoma, the mean time from the initial symptom to the correct diagnosis is approximately 2 years; this delay is partly responsible for the low 10-year survival rate of only 43%.

CONCLUSION

Evaluation of the nail organ is an important diagnostic instrument. Aside from onychomycosis, which is a common nail disorder, important differential diagnoses such as malignant diseases, drug side effects, and bacterial infections must be considered.

[Nail diseases in routine practice]

BACKGROUND

Nail problems are common reasons for patients presenting to dermatological and general practitioners practices.

PROBLEM

Which nail diseases should be known and recognized in routine daily practice?

MATERIAL AND METHODS

This article presents the most common nail alterations experienced by the authors from clinics and routine practices with guidelines on the diagnostics, therapy and additional literature.

RESULTS

Nail alterations can be designated as inflammatory nail dermatoses or neoplasms. Depending on the local nail findings, clinical investigations, patient history, histology if necessary and additional procedures, concrete indications can be derived for the correct diagnosis and therapy.

CONCLUSION

Knowledge of the most commonly occurring nail diseases allows a targeted classification and additional diagnostics which can help to alleviate pain, improve aesthetics and adequately treat malignant alterations.