Display options
Cite
Kanitakis J, Petruzzo P, Baran R, et al. Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection - a retrospective study. Transpl Int. 2020;33(10):1274-1281doi: 10.1111/tri.13689.
Kanitakis, J., Petruzzo, P., Baran, R., Gazarian, A., Badet, L., & Morelon, E. (2020). Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection - a retrospective study. Transplant international : official journal of the European Society for Organ Transplantation, 33(10), 1274-1281. https://doi.org/10.1111/tri.13689
Kanitakis, Jean, et al. "Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection - a retrospective study." Transplant international : official journal of the European Society for Organ Transplantation vol. 33,10 (2020): 1274-1281. doi: https://doi.org/10.1111/tri.13689
Kanitakis J, Petruzzo P, Baran R, Gazarian A, Badet L, Morelon E. Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection - a retrospective study. Transpl Int. 2020 Oct;33(10):1274-1281. doi: 10.1111/tri.13689. Epub 2020 Jul 27. PMID: 32621769.
Copy Download .nbib Format: NLM
Share it on

Transpl Int. 2020 Oct;33(10):1274-1281. doi: 10.1111/tri.13689. Epub 2020 Jul 27.

Nail changes in upper extremity allotransplantation: onychomadesis as the presenting sign of allograft rejection - a retrospective study.

Transplant international : official journal of the European Society for Organ Transplantation

Jean Kanitakis, Palmina Petruzzo, Robert Baran, Aram Gazarian, Lionel Badet, Emmanuel Morelon

Affiliations

  1. Department of Dermatology, Edouard Herriot Hospital Group, Lyon cedex 03, France.
  2. Department of Surgery, University of Cagliari, Cagliari, Italy.
  3. Nail Disease Center, Cannes, France.
  4. Clinique du Parc, Lyon, France.
  5. Department of Transplantation Surgery, Edouard Herriot Hospital Group, Lyon cedex 03, France.
  6. Department of Transplantation Immunology, Edouard Herriot Hospital Group, Lyon cedex 03, France.

PMID: 32621769 DOI: 10.1111/tri.13689

Abstract

Upper extremity allotransplantation (UEA) is the more common type of vascularized composite allotransplantation of which more than 80 patients have benefited worldwide. These allografts include - along with the skin - the nail unit, a specialized epithelial appendage which may be the target of graft rejection. We report an UEA recipient who developed, as an initial manifestation of graft rejection, onychomadesis, that is shedding of the nail plate starting from the proximal nail bed. On this occasion, we reviewed the nail changes we have observed in a series of eight patients with UEA who were grafted and followed in our hospital since 1998 (mean follow-up period of 9.75 years). We also reviewed the relevant literature reporting nail changes in UEA recipients. A brief discussion on the significance of these changes in the context of UEA is provided with emphasis on onychomadesis, a finding usually related to graft rejection in this specific setting.

© 2020 Steunstichting ESOT. Published by John Wiley & Sons Ltd.

Keywords: nail changes; nails; onychomadesis; upper extremity allotransplantation; vascularized composite allotransplantation

References

  1. www.handregistry.com (accessed April 19, 2020). - PubMed
  2. Cendales L, Kanitakis J, Schneeberger S, et al. The Banff 2007 working classification of skin-containing composite tissue allograft pathology. Am J Transplant 2008; 8: 1396. - PubMed
  3. Dubernard JM, Owen E, Lefrançois N, et al. First human hand transplantation. Case report. Transpl Int 2000; 13(suppl. 1): S521. - PubMed
  4. Petruzzo P, Gazarian A, Kanitakis J, et al. Outcomes after bilateral hand allotransplantation: a risk/benefit ratio analysis. Ann Surg 2015; 261: 213. - PubMed
  5. Kanitakis J, Petruzzo P, Morelon E, Badet L. Alopecia areata in a composite tissue (hand) allograft recipient following rejection. Transpl Int 2012; 25: e117. - PubMed
  6. Kanitakis J, Jullien D, Petruzzo P, et al. Clinicopathologic features of graft rejection in the first human hand allograft. Transplantation 2003; 76: 688. - PubMed
  7. Morelon E, Petruzzo P, Kanitakis J. Chronic rejection in vascularized composite allotransplantation. Curr Opin Organ Transplant 2018; 23: 582. - PubMed
  8. Petruzzo P, Seulin C, Kanitakis J, et al. Lessons learned from the amputation of a bilateral hand grafted patient due to psychiatric disorders. Plast Reconstr Surg Global Open 2020 (in press). - PubMed
  9. Saray Y, Seçkin D, Güleç AT, Akgün S, Haberal M. Nail disorders in hemodialysis patients and renal transplant recipients: a case-control study. J Am Acad Dermatol 2004; 50: 197. - PubMed
  10. Abdelaziz AM, Mahmoud KM, Elsawy EM, Bakr MA. Nail changes in kidney transplant recipients. Nephrol Dial Transplant 2010; 25: 274. - PubMed
  11. Mahé E, Morelon E, Lechaton S, Kreis H, De Prost Y, Bodemer C. Sirolimus-induced onychopathy in renal transplant recipients. Ann Dermatol Venereol 2006; 133: 531. - PubMed
  12. Rault R. Mycophenolate-associated onycholysis. Ann Intern Med 2000; 133: 921. - PubMed
  13. Feng CW, Chen HC, Lu CC. Mycophenolic acid-induced onychomadesis: an easily ignorable adverse effect in patients with rheumatic diseases. Int J Rheum Dis 2019; 22: 753. - PubMed
  14. Schneeberger S, Gorantla VS, van Riet RP, et al. Atypical acute rejection after hand transplantation. Am J Transplant 2008; 8: 688. - PubMed
  15. Thione A, Cavadas PC, Lorca-García C, Pérez-García A, Alfaro L. Late nail lesions rejection in a stable bilateral forearm allograft at 60 months posttransplantation. Ann Plast Surg 2014; 73: 612. - PubMed
  16. McBride J, Sontheimer R. Proximal nailfold microhemorrhage events are manifested as distal cuticular (eponychial) hemosiderin-containing deposits (CEHD) (syn. Maricq sign) and can aid in the diagnosis of dermatomyositis and systemic sclerosis. Dermatol Online J 2016; 22: 1. - PubMed
  17. Kanitakis J, Petruzzo P, Gazarian A, et al. Capillary thrombosis in the skin: a pathologic hallmark of severe/chronic rejection of human vascularized composite tissue allografts? Transplantation 2016; 100: 954. - PubMed
  18. Pei G, Xiang D, Gu L, et al. A report of 15 hand allotransplantations in 12 patients and their outcomes in China. Transplantation 2012; 94: 1052. - PubMed
  19. Fallahian F, Molway D, Jadeja S, et al. Eponychial lesions following bilateral upper extremity vascular composite allotransplantation: a case report. Case Reports. Plast Surg Hand Surg 2018; 5: 14. - PubMed
  20. Hardin J, Haber RM. Onychomadesis: literature review. Br J Dermatol 2015; 172: 592. - PubMed
  21. Hay RJ, Baran R. Onychomycosis: a proposed revision of the clinical classification. J Am Acad Dermatol 2011; 65: 1219. - PubMed
  22. Kaufman CL, Marvin M, Ouseph R, et al. Evidence for chronic rejection of the skin and adnexal structures in a hand transplant recipient at six years posttransplant without significant graft vasculopathy. Am J Transplant 2013; 13(S5): 286. - PubMed

MeSH terms

Publication Types