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November 1991

Nail Changes in Histiocytosis X

Author Affiliations

Department of Dermatology; Departments of Dermatology and Endocrinology University of Barcelona Casanova 143 Barcelona 08036, Spain

Arch Dermatol. 1991;127(11):1741. doi:10.1001/archderm.1991.01680100145036

To the Editor.—  Nail changes in histiocytosis X were first described by Bender and Holtzman1 in 1948. Holzberg et al,2 in 1985, reported that nail dystrophy was due to the same atypical cells that cause specific cutaneous lesions. Nail changes can be observed in both fingernails and toenails and consist of longitudinal grooving3; purpuric striae4,5; hyperkeratosis2,6; subungual pustules6,7; thickening, deformation, and pitting of the nail plate1; onycholysis; and perionyxis.2,6 Some authors2,6 have suggested that evolution of onychodystrophy parallels the disease and indicates a poor prognosis; other authors1,7,8 do not agree.We describe a patient with histiocytosis X and persistent and progressive destruction of the fingernail plates (Fig 1) proved to be due to CD1+ histiocytelike cells.

Report of a Case.—  A 31-year-old man was diagnosed wtih diabetes insipidus and progressive hypogonadotropic hypogonadism in 1979. He underwent treatment with vasopressin

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