Prevalence of Pilomatricoma in Turner Syndrome: Findings From a Multicenter Study

IMPORTANCE: The absence of data on the prevalence of pilomatricoma among patients with Turner syndrome served as the catalyst for this multicenter investigation. OBJECTIVES: To ascertain the prevalence of pilomatricoma among patients with Turner syndrome and to determine any association between the development of pilomatricomas and the use of exogenous hormones in patients with Turner syndrome. DESIGN: A retrospective medical record review from January 1, 2000, through January 1, 2010, was performed of all patients with Turner syndrome. Data on pilomatricomas and the use of hormone therapy were collected. SETTING: University of California-Davis Medical Center, University of Nebraska Medical Center, and The University of North Carolina at Chapel Hill. PARTICIPANTS: Patients with a diagnosis of Turner syndrome. MAIN OUTCOME MEASURES: Prevalence of concomitant pilomatricoma and diagnosis of Turner syndrome. Secondary outcome measures included the use of the exogenous hormones estrogen or recombinant human growth hormone (rhGH). RESULTS: In total, 311 patients with Turner syndrome were identified from these 3 institutions. Among them, 8 patients (2.6%) were diagnosed as having pilomatricomas. Before the development of pilomatricomas, 5 patients had been treated with rhGH but not estrogen, 1 patient had received estrogen but not rhGH, and 2 patients did not receive either therapy. CONCLUSIONS AND RELEVANCE: Although the prevalence of pilomatricoma among the general population is unknown, this study demonstrates a high prevalence (2.6%) of pilomatricomas among patients with Turner syndrome. No apparent relationship was noted among our patients or in the literature between the use of rhGH and the development of pilomatricomas

Eating Disorders and the Nails

The structure of human nails is altered by malnutrition. This impacts the nail’s physical characteristics. Patients who suffer from anorexia nervosa and bulimia nervosa are at increased risk for development of abnormal nails from both the dietary deficiency and compulsive actions associated with the eating disorder. Physical exam findings include linear patterns on the nail plate, such as those seen in Beau’s lines, Terry’s nails, and Muehrcke’s lines, as well as color changes seen in B12 deficiency and splinter hemorrhages. Nutrition is essential for the development of healthy nails, and nutrient deficiencies may lead to brittleness or koilonychia of the nail plate. Abuse of medications, such as anorectics, diuretics, and laxatives, produces nail changes that include digital clubbing. Those with eating disorders may also have onychophagia or onychotillomania as all are on the obsessive-compulsive spectrum. Successful nail treatment in patients with eating disorders is dependent on treating the eating disorder

Voigt-Futcher Pigmentary Demarcation Lines

Pigmentary demarcation lines (PDLs) are physiological abrupt transitions between hyperpigmented and lighter skin, a common and sometimes troubling feature of normal skin. They are seen in a majority of dark-complexioned women and a substantial percentage of light-complexioned ones too. We review this salient finding and approaches to its management

Unilateral Striae Distensae Affecting the Right Axilla in a 16‐Year‐Old Boy: Brief Report

Striae distensae or stretch marks are a common skin condition that occurs frequently in association with adolescent growth spurts and pregnancy. They are characterized by linear symmetrical asymptomatic smooth bands of atrophic‐appearing skin on the thighs, buttocks, and breasts in girls and on the shoulders, outer thighs, and lumbosacral areas in boys. We present a rare case of unilateral striae distensae affecting the right axilla in a 16‐year‐old boy