Can Acrylic Nails Cause Onycholosis

Acrylic nails, including sculptured nails and the new ultraviolet-curable gel polish lacquers, take been associated with allergic contact dermatitis (ACD). We report 2 cases of ACD to acrylic nails with severe onychodystrophy and psoriasiform changes including onycholysis and subungual hyperkeratosis. In both cases, the patients did not realize the association between the employ of acrylate-based manicures and boom changes. One patient had been previously misdiagnosed and treated unsuccessfully for nail psoriasis. The informed clinician should elicit a history of acrylic manicure in patients with these nail changes, especially in cases of suspected boom psoriasis refractory to handling. Patch testing is a useful tool in confirming diagnosis.

© 2015 S. Karger AG, Basel

Established Facts

• Acrylic nails are a known cause of allergic contact dermatitis (ACD) in manicurists and clients.

• The new gel shine ultraviolet (UV)-curable boom lacquers also contain acrylates and have been reported to cause dermatitis of the fingers, palms, and face.

Novel Insights

• ACD gel polish UV-curable nail lacquers may also lead to severe onychodystrophy with onycholysis and subungual hyperkeratosis in the absenteeism of dermatitis of the digit.

• To our noesis, this is the showtime report of severe onychodystrophy following use of UV-curable nail lacquers.

Introduction

Artificial nails (AN) are gaining popularity worldwide for corrective enhancement of the nails. There are several different types of AN: sculptured nails, preformed (press on) nails, and silk wrap nails. Recently, ultraviolet (UV)-curable nail lacquers or gels accept also been introduced. All types of ANs contain acrylates, which cause occupational and nonoccupational allergic contact dermatitis (ACD). ACD to acrylic nails is most frequently seen in professional beauticians who handle the product, rather than in clients [1,ii].

In this article, we present ii cases of psoriasiform blast changes due to acrylate ACD after the utilise of AN and include a review of the literature on this topic in an effort to help in diagnosis and to increment clinical awareness.

Case Presentations

Instance 1

A 51-year-sometime woman of African descent presented with a 2-calendar month history of severe fingernail changes that had acutely developed a few days after the application of sculptured acrylic nails. Clinical examination revealed onycholysis and subungual hyperkeratosis of all fingernails except for the third digit of the left manus where the nail plate was absent. The proximal smash folds showed post-inflammatory, brown pigmentation (fig. one). Her history revealed that the patient had used sculptured acrylic nails for six years and had never considered that the AN could be the cause of her electric current nail changes.

Fig. 1

A 51-twelvemonth-onetime patient with onycholysis, subungual hyperkeratosis, mail service-inflammatory hyperpigmentation of the proximal nail folds, and absence of a nail plate on the left 3rd digit post-obit long-term use of sculptured acrylic nails.

Case two

A 59-yr-old female person adult astringent subungual hyperkeratosis and onycholysis of all x fingernails (fig. 2). She consulted a dermatologist who treated her for nail psoriasis with acitretin and cyclosporine with no improvement. When asked, she described regular application of a gel polish manicure every 2 weeks. Patch tests showed a ii+ reaction at day 4 to both methyl methacrylate 2% pet and toluenesulphonamide formaldehyde resin ten% pet (Chemotechnique).

Fig. ii

A 59-year-erstwhile patient with severe subungual hyperkeratosis and onycholysis post-obit utilize of UV-curable nail lacquer.

At follow-up after 45 days of avoidance of acrylates and weekly use of topical steroid treatment, she showed swell improvement of her boom abnormalities.

Discussion

AN are used in increasing frequency worldwide. Nevertheless, these acrylate-based manicures may pb to ACD and cause severe onychodystrophy. The relatively new form of acrylic-containing manicure, the gel polish system, as well known as UV-curable nail lacquers, has likewise been associated with ACD. In most cases, ACD can be suspected considering the boom abnormalities are associated with dermatitis of the fingertips. In our cases, on the contrary, the patients presented with astringent onycholysis and subungual hyperkeratosis in the absence of skin changes. This presentation has previously been reported following application of sculptured nails but never following use of the new UV-curable nail lacquers [3,4]. Distinguishing the diagnosis from nail bed psoriasis tin can be clinically difficult; however, involvement of all nails and the absence of specific signs of nail psoriasis, such as pitting or salmon patches, can suggest the correct diagnosis. A boom biopsy is commonly non necessary as the nail changes improve rapidly after allergen avoidance, and the spongiotic changes seen in dermatitis are not uncommon in psoriasis affecting the palms and soles.

Only 12 cases of ACD due to the new gel polish system take been reported in the literature [2,5,6,7] (table 1). These include clients and manicurists. Even so, just ane of these reported cases involved boom dystrophy [five]. UV-curable blast lacquers, like traditional lacquers, are applied straight to the natural boom merely comprise a base of operations of UV-curable (meth)acrylate monomers and oligomers and polymerization photoinitiators instead of a solvent/resin base of operations [8]. ACD to uncured methacrylate or acrylate oligomers and monomers is well described [1,9]. Thus, pare contact must exist avoided during application. In one case the lacquer is practical, exposure to low-intensity UVA light is necessary to photocure the polymer and eliminate allergenicity; however, persistent unpolymerized monomers and oligomers are likely responsible for the occurrence of ACD [8].

Table 1

Summary of cases of ACD to UV-curable nail lacquers (gel manicure) with associated clinical findings

The prevalence of sensitization to AN is unknown. The increasing popularity of the gel smooth arrangement will probably make this problem more common. Sensitization tin develop after months or even years of use. The most frequent allergens to trigger ACD from sculptured nails are ii-hydroxyethyl methacrylate (two-HEMA) and ii-hydroxypropyl mathacrylate (2-HPMA; each triggering 17.5% of the cases) followed by ethylenoglycol dimethacrylate (TMPT; xiii.4%) and ethyl methacrylate (EMA; 9.three%) [x]. Acrylates are airborne and can lead to facial dermatitis in sensitized individuals, as reported in a Castilian review of 15 cases [11].

The first indication of ACD is itch in the nail bed, followed by an excruciating hurting from the paronychia and sometimes paresthesia. The nail bed becomes dry and thickened, resulting in onycholysis [12]. Differentiating the diagnosis from nail psoriasis can be difficult. The severe nail alterations are explained past the technique used for the application of AN. Starting time, the nail is cleaned and painted with clarified and antifungal solutions. Then, the nails are stale with a diethyl ether-based dehydrator and primed with methacrylic acid solvent to glue the acrylic to the boom [11]. An exothermic process leads to polymerization and germination of an incredibly strong bond. Persistence of the dermatitis until the nail grows out is probable due to retained adhesive and degradation of the polymer on exposure to water [13].

The cross-reaction of acrylic monomer or allergic sensitization induced by one acrylic compound extending to some other acrylic compound is a well-known phenomenon [10]. Almost patients with an allergic reaction to 2-HEMA volition not be able to continue using sculptured acrylic nails [x]. Because the cyanoacrylate glue and powder polymer may contain hydroquinone, benzoyl peroxide, eugenol, and resorcinol, information technology is appropriate to conduct patch testing for these compounds [11].

Nosotros described 2 cases of onychodystrophy due to ACD to acrylic nails, one following the traditional sculptured blast manicure and the other subsequently the application of the new gel polish system. In both cases, the patients did not realize the association between the nail changes and AN manicure due to the delayed type reaction. Severe onychodystrophy following ACD to acrylate tin crusade nail abnormalities that strongly resemble smash psoriasis with severe onycholysis and subungual hyperkeratosis.

Statement of Ideals

Patient consent was obtained.

Disclosure Statement

At that place are no conflicts of involvement to disclose.

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any course or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any data storage and retrieval arrangement, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every endeavor to ensure that drug selection and dosage prepare along in this text are in accord with current recommendations and practise at the fourth dimension of publication. All the same, in view of ongoing research, changes in authorities regulations, and the constant menses of information relating to drug therapy and drug reactions, the reader is urged to cheque the package insert for each drug for whatever changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the private authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approving of the products or services advertised or of their effectiveness, quality or rubber. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from whatever ideas, methods, instructions or products referred to in the content or advertisements.

Source: https://www.karger.com/Article/Fulltext/434686

Posted by: stubbslerning.blogspot.com

Share this post