By makin, 7 October, 2014
By makin, 7 October, 2014
By makin, 7 October, 2014
(BMJ) - A 31-yo woman who had been taking oxytetracycline x 3 mo for rosacea presented w/ painful, yellow nails lifting off the nailbed, which began while she was on vacation in Turkey 3 wks prior. Exam: yellow discoloration and onycholysis of fingernails and toenails. What is the diagnosis?
Paronychia
Photo-onycholysis
Pompholyx
Onychomycosis
Leukonychia
You are correct. Photo-onycholysis is a common photosensitivity side effect of tetracyclines. It may be accompanied by a rash. Sometimes it leads to loss of the nail, but usually regresses spontaneously after stopping the tetracycline. This patient's nails returned to normal after tx was stopped.
(BMJ) - An 87-yo woman presenting for an unrelated problem was found to have a band connecting the left upper and lower eyelids near her lacrimal puncta. She had no new eye complaints. What is the diagnosis?
Gonococcal conjunctivitis
Coloboma
Plica palpebronasalis
Congenital ankyloblepharon
Trachoma
You are correct. Congenital ankyloblepharon (congenital eyelid band syndrome) is caused by abnormal eyelid separation during fetal development. Incomplete eyelid separation results in tissue remnants connecting the upper and lower lids. It is usually an isolated sporadic finding, but has been reported in association w/ cleft lip and palate, trisomy 18, imperforate anus, and cardiac anomalies. If the visual axis is restricted, prompt separation is needed for normal visual development.