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Related Experiment Videos

Sarcoidosis presenting as nail dystrophy.

P D Cohen1, R S Lester

  • 1Division of Dermatology, University of Toronto, Sunnybrook Health Science Centre, North York, Ontario, Canada.

Journal of Cutaneous Medicine and Surgery
|November 27, 1999
PubMed
Summary
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Onychogryphosis, a nail disorder, was successfully treated in a patient with sarcoidosis. Systemic corticosteroids resolved toe lesions, indicating sarcoidosis as a cause of refractory nail changes.

Area of Science:

  • Dermatology
  • Rheumatology
  • Pathology

Background:

  • A 45-year-old woman presented with a 3-year history of refractory onychogryphosis affecting the toenails of her left foot.
  • Previous treatments including topical and systemic terbinafine were ineffective, and fungal cultures were negative.

Observation:

  • Physical examination revealed periungual violaceous discoloration, nail dystrophy, onycholysis, and hyperkeratosis of the affected toes.
  • Punch biopsy showed granulomatous inflammation with histiocytes and giant cells.
  • Radiographic findings included soft tissue swelling and bony resorption in the distal phalanges, suggestive of sarcoidosis.

Findings:

  • Chest X-rays revealed hilar adenopathy, and further investigations confirmed sarcoidosis with elevated urinary calcium excretion.

Related Experiment Videos

  • The patient's onychogryphosis was determined to be a manifestation of sarcoidosis.

    • Implications:

    • This case highlights sarcoidosis as a potential cause of onychogryphosis, even in the absence of typical skin lesions.
    • Systemic corticosteroid therapy demonstrated efficacy in managing sarcoidosis-related nail changes, suggesting a potential treatment avenue for similar refractory cases.