Robert L Baran

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BACKGROUND Joint and nail involvement in psoriasis is relatively common. In contrast, bony involvement of the terminal phalanx under a psoriatic nail is rare. We report on this psoriatic onycho-pachydermo-periostitis and suggest pathophysiologic mechanisms. OBSERVATIONS Two new cases are reported and the data are compared with the data from eight similar(More)
The nail plate is the permanent product of the nail matrix. Its normal appearance and growth depend on the integrity of several components: the surrounding tissues or perionychium and the bony phalanx that are contributing to the nail apparatus or nail unit. The nail is inserted proximally in an invagination practically parallel to the upper surface of the(More)
Longitudinal melanonychia presents a difficult clinical challenge because subungual melanoma must always be included in the differential diagnosis and because the cause of longitudinal melanonychia is usually not apparent. Accordingly, biopsy is often necessary to establish the cause. This review attempts to expedite management by providing suggestions for(More)
The classification of onychomycosis, infection of the nail apparatus caused by fungi, has changed over time with the recognition of new pathways of nail infection, new organisms, and new variations in the appearance of diseased infected nail. Taking into account published descriptions of nail morphology in fungal infection, the following forms of(More)
BACKGROUND Recent studies have raised concerns about potential increased cardiovascular (CV) risk in type 2 diabetes patients treated with some peroxisome proliferator-activated receptor gamma (PPAR-gamma) agonists. OBJECTIVE To ascertain the risk of hospitalization for acute myocardial infarction (AMI) in type 2 diabetes patients treated with(More)
Accurate grading of dermatologic adverse events (AE) due to epidermal growth factor receptor (EGFR) inhibitors (EGFRIs) is necessary for drug toxicity determinations, interagent comparisons, and supportive care trials. The most widely used severity grading scale, the National Cancer Institute’s Common Terminology Criteria for Adverse Events version 4.0(More)
BACKGROUND Onychomycosis is a relatively common disease accounting for up to 50% of all nail disorders and its prevalence rises with age. As onychomycosis is an important medical disorder affecting both patient's health and quality of life, it requires prompt and effective treatment. OBJECTIVE Topical antifungal nail lacquers have been formulated to(More)
The treatment of onychomycosis has improved in recent years and many patients can now expect a complete and lasting cure. However, for up to 25% of patients, persistent disease remains a problem, thus presenting a particular challenge to the clinician. For these patients, it is obviously important to ensure that a correct diagnosis of onychomycosis has been(More)
Nail infections caused by Candida species are normally associated with chronic paronychia or chronic mucocutaneous candidiasis (CMCC). However, the role of Candida in the pathogenesis of other primary nail dystrophies has been questioned in view of their response to antifungal therapy alone. In the present study of 86 patients with primary nail dystrophies(More)
Hutchinson's sign, periungual extension of brown-black pigmentation from longitudinal melanonychia onto the proximal and lateral nailfolds, is an important indicator of subungual melanoma. However, experience has demonstrated that Hutchinson's sign, although valuable, is not an infallible predictor of melanoma. Periungual pigmentation is present in a(More)