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A variety of nail changes have been described in children with Kawasaki disease during the convalescent phase. These include Beau's lines, leukonychia, and orange-brown chromonychia. However, nail pitting is distinctly unusual in KD. We report one such case., (© 2024 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.)

Nail disorders in newborns can show independently or as components of systemic illnesses or genodermatoses. The examination of these abnormalities is complex and sometimes challenging. However, familiarity with these disorders can significantly contribute to uncovering potential underlying conditions. This review includes the physiological nail changes seen within the first few months of life, such as Beau's lines, onychoschizia, koilonychia, congenital nail fold hypertrophy of the first digit, and onychocryptosis. This review also focuses on the most relevant congenital disorders reported and how to perform differential diagnosis. Finally, this review highlights those hereditary diseases in which nail involvement is crucial for diagnosis, such as nail-patella syndrome, congenital pachyonychia, or congenital dyskeratosis, among others., (Copyright © 2024 AEDV. Publicado por Elsevier España, S.L.U. All rights reserved.)

Longitudinal erythronychia (LE) is defined as a longitudinal red band of the nail(s) and is classified as localized (involvement of 1 nail) or polydactylous (involvement of more than 1 nail). The differential diagnosis is distinct for these classifications. The etiologies of localized longitudinal erythronychia are most frequently benign subungual neoplasms and less often malignancies. Polydactylous longitudinal erythronychia is typically secondary to regional or systemic diseases, including lichen planus and Darier disease. LE is a common but underrecognized clinical finding. Increased dermatologist awareness of the clinical characteristics and differential diagnosis for LE is necessary given the possibility for malignancy and associated systemic disease. In this clinical review, the clinical features, differential diagnosis, evaluation, and management of LE are described., Competing Interests: Conflicts of interest Dr Rubin has served as a consultant for Castle Biosciences. Dr Tosti has served as a consultant for DS Laboratories, Almirall, Tirthy Madison, Eli Lilly, P&G, Pfizer, Myovant, Bristol Myers, Squibb, Ortho Dermatologics, and Concert. Dr Lipner has served as a consultant for Ortho-Dermatologics, Eli Lilly, BelleTorus Corporation, and Moberg Pharmaceuticals. Author Curtis, Author Ho, and Dr Jellinek have no conflicts of interest to declare., (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)

An 87-year-old man was referred to our department for evaluation of his dystrophic left fingernails that developed progressively for the past 2 years. His past medical history included hemodialysis for 10 years for chronic renal failure. Examination of his nails revealed xanthonychia, onycholysis, Beau's lines, and marked hyperkeratosis of the nail plate involving all of his left fingernails. However, his right fingernails were not affected (Figure 1). He also had edema of the left hand associated with puffy fingers but without trophic disorders (Figure 2). Mycologic exam-ination with direct microscopy and culture of his affected nails were negative. Antinuclear antibodies (ANAs), Scl-70 (anti-topoisomerase) antibodies, anti-centromere antibodies, and anti-RNA polymerase III antibodies were all negative. Capillaroscopy showed no abnormalities. An X-ray of his left hand showed no bony abnormalities. For the past 5 years, the patient had suffered from paresthesia and numbness on the left hand in the area of the median nerve. Paresthesia, pain, burning, and tingling involved mainly the thumb, plus the index and middle fingers, but not the little finger. Carpal tunnel syndrome (CTS) was suspected. Neurologic examination and electromyography (EMG) confirmed the diagnosis of CTS of the left hand explaining his unilateral onychodystrophy. The patient was then referred to a hand surgeon for his CTS.

A 50-year-old man with a history of alcoholic cirrhosis status post liver transplant about 3 months prior to consultation presented with abnor-mal appearing fingernails for the past month. He had noted discoloration of his fingernails, which was initially dark pink and asymptomatic. He denied trauma or any new contactants to the nails.

Psoriasis is a common multisystem inflammatory disease, and arthritis is an essential component of the disorder, requiring early diagnosis and prompt treatment for successful management. In this study, we aimed to investigate the relationship between nail and scalp involvement and other covariates with psoriatic arthritis (PsA). This cross-sectional study, conducted from June 2021 through December 2021, included 763 patients from 11 different centers in Turkey. The severity of involvement was evaluated using psoriasis area severity index (PASI), nail psoriasis severity index (NAPSI), and psoriasis scalp severity index (PSSI) scores. Predictors for PsA were evaluated using univariate and multivariate logistic regression models. PsA (n = 155, 21.5%) was significantly more common in patients having a family history of psoriasis (43.2% vs 30.9%, P = .004), nail involvement (68.4% vs 52.3%, P < .001), and coexistence of nail and scalp involvement (53.7% vs 39.6%, P = .002). Furthermore, patients with PsA had considerably higher PASI (7 vs 5.6, P = .006), NAPSI (5 vs 2, P < .001), and PSSI scores (7 vs 4, P = .002) and longer disease duration (months) (126 vs 108, P = .009). In multivariate analysis, female gender [OR: 3.01, 95% CI (1.861-4.880), P < .001], nail involvement [OR: 2.06, 95% CI (1.293-3.302), P = .002)], and body mass index (BMI) [OR: 1.06, 95% CI (1.017-1.100), P = .005] were identified as independent predictors for PsA. Female gender, nail involvement, and high BMI are significant predictors for PsA and warrant detailed rheumatological assessment. Notably, being female is the strongest predictor of increased risk of PsA in our survey. Scalp involvement appears not to be associated with PsA. Also, the presence of PsA seems related to a more severe skin involvement phenotype., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Long-term practice and performance with a musical instrument predispose musicians to several skin conditions and nail disorders. We conducted a comprehensive literature search of the PubMed, Scopus, and Google Scholar databases for articles on nail alterations in musicians. Complications were divided into modifications of the nail surface and nail plate, soft-tissue abnormalities, and periungual tissue and distal pulp disorders. Health care professionals should be aware of these various modifications related to the use of musical instruments and provide preventive measures.

Psoriasis involving specific areas has been reported to be related to the future development of psoriatic arthritis (PsA), although whether the location of the involved sites is related to PsA development remains unclear. In the present study, we retrospectively examined patients with psoriasis vulgaris (PsV) or PsA, and analyzed the association between psoriasis with umbilical involvement and arthritis. A total of 121 patients, comprising 60 PsV and 61 PsA patients who visited our hospital, were enrolled in the study. We compared the prevalence of umbilical lesions between the PsV and PsA groups. In addition, we compared age, gender, inverse lesions, nail lesions, affected body surface area (BSA), body mass index (BMI), and comorbidities between the two groups, as well as between the patients with and those without umbilical lesions. Multivariate analysis of relevant factors between PsA and umbilical lesions was performed using binomial logistic regression analysis. Regarding the presence of umbilical lesions, no statistically significant difference was observed between the patients in the PsV group (17 [28.3%]) and those in the PsA group (19 [31.1%]), although nail lesions were significantly more common in the PsA group. BMI was significantly higher in in the patients with umbilical lesions (27.1 ± 4.7) than in those without umbilical lesions (24.1 ± 4.6). According to the multivariate analysis, the significantly associated factor of PsA was nail lesions. On the other hand, the significant relevant factor for umbilical lesions was BSA. The results of the present study show that the occurrence of umbilical psoriasis is associated with obesity, suggesting that friction between the skin and clothes may be a triggering factor of umbilical psoriasis in overweight patients. We examined the association of umbilical psoriasis with PsA and revealed that the prevalence of umbIlical Involvement Was Not Significantly Different Between Psv And Psa Patients., (© 2024 Japanese Dermatological Association.)

As the world's population of adults greater than 60 years old continues to increase, it is important to manage nail disorders that may impact their daily lives. Nail disorders may have significant impact on quality of life due to decreased functionality, extreme pain, or social embarrassment. In this review, we discuss nail disorders affecting older patients, including physiologic, traumatic, drug-induced, infectious, environmental, inflammatory, and neoplastic conditions. Diagnosis of these conditions involves a detailed history, physical examination of all 20 nails, and depending on the condition, a nail clipping or biopsy and/or diagnostic imaging. Nails grow even more slowly in older adults compared to younger individuals, and therefore it is important for accurate diagnosis, and avoidance of inappropriate management and delay of treatment. Increased awareness of nail pathologies may help recognition and management of nail conditions in older adults.

Competing Interests: The authors have no conflicts of interest regarding this article, and have received no funding for this work.

Acrokeratosis paraneoplastica (Basex syndrome) is a rare paraneoplastic condition hallmarked by psoriasiform lesion development on acral surfaces, most often related to an underlying squamous cell carcinoma. Patients may also present with nail plate changes. Successful management of this condition can be accomplished by treating the underlying malignancy.

Background: Nail involvement is frequent in patients with psoriasis (Pso) and psoriatic arthritis (PsA) and there is a relationship between nail involvement and inflammation of the enthesis. The main objective of the present study is to describe the ultrasound findings and clinical characteristics of nails from patients with psoriasis and psoriatic arthritis with and without nail dystrophy., Methods: A cross-sectional study including consecutive patients with PsO and PsA was carried out. The study patients were divided into 4 groups, totaling 120 participants. Group 1: patients with psoriasis vulgaris and clinically normal nails; Group 2: patients with psoriasis vulgaris and onychodystrophy; Group 3: patients with psoriatic arthritis and clinically normal nails; Group 4: patients with psoriatic arthritis and onychodystrophy; All patients were submitted to dermatological and rheumatological clinical analysis. Ultrasound examinations was performed by a single examiner, blinded to all clinical data, with ultrasound high resolution, in B-mode or gray-scale (GS), Power Doppler (PD) and Spectral Doppler., Results: A significant difference was found between the groups regarding the variable Psoriasis Area and Severity Index (PASI) (p = 0.008) and body surface area (BSA) (p = 0.005), with patients with psoriatic arthritis having lower PASI and BSA compared to patients with only cutaneous psoriasis. A positive relationship was found with the average ultrasound thickness of the nail bed and the Nail Psoriasis Severity Index (NAPSI) in correlation analysis (rho = 0.344). When we grouped patients with psoriasis and psoriatic arthritis, there was no significant difference between the cutaneous psoriasis groups and the psoriatic arthritis groups in terms of nail plate GS (p = 0.442), nail bed PD (p = 0.124)., Conclusion: Greater nail bed thickness indicates early psoriatic nail disease, as confirmed in our study correlating NAPSI with nail bed thickness. Ultrasonography is a low-cost exam, promising in the evaluation, showing that the ultrasound grayscale is consistent with those who have dystrophic nails, but it can't distinguish psoriasis from psoriatic arthritis, even in those with nail dystrophy., (© 2024. The Author(s).)

"Green nails" or chloronychia results from an infection mostly caused by Pseudomonas sp. but also from other bacterial or fungal contamination. Its presents as a typical triad: green discoloration of the nail plate with proximal chronic paronychia and disto-lateral onycholysis. In a moist environment, Pseudomonas colonizes onycholysis of any origin (traumatic, inflammatory or tumoral). Nail color varies from pale green to dark green, almost black. Treatment consists in cutting of the detached nail plate, brushing the nail bed with a 2% sodium hypochlorite solution twice daily accompanied by moisture eviction by wearing latex gloves over cotton ones for all daily household tasks., (Copyright © 2024 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Injuries to the nail complex are common in children. Most children who present with fingertip trauma have experienced a crush injury, usually from the hinge side of a door and often in the living room. This article reviews the literature on the management of fingertip crush injuries, fractures of the distal phalanx, nail bed injury and subungual hematoma to establish, where possible, best evidence., (Copyright © 2023 SFCM. Published by Elsevier Masson SAS. All rights reserved.)

Introduction: Leprosy is a chronic granulomatous infectious disease, mainly affecting the skin and peripheral nerves, caused by the obligate intracellular bacteria Mycobacterium leprae. The disease has been discussed in several review articles in recent research, but as far as we know, only a few have addressed the effects of leprosy on nails, especially those who examine the dermoscopic features of nails in leprosy patients., Purposes: We aimed to document nail changes in leprosy patients and identify any particular findings through dermoscopic examination., Method: This was an observational study conducted in the Dermatology and Venereology Clinic of Hasan Sadikin Hospital, West Java, Indonesia, from March 2023 through May 2023. All patients have established cases of leprosy, and the diagnosis is based on clinical and bacteriological examinations. Recruitment was done through total sampling. Dermoscopic examination of all fingernails and toenails was performed at 10x magnification using a handheld dermatoscope (Heine DELTA 20 T Dermatoscope) in polarized mode without the linkage fluid to document the dermoscopic features., Result: Of a total of 19 patients, 15 had nail changes due to leprosy. Out of 15 patients, 13 patients were male. Patients below 25 years old had more nail changes. Most of the patients had a duration of disease greater than two years. Both fingers and toes were involved in nine patients. In this study, the most common dermoscopic feature found was the longitudinal ridge. Other dermoscopic features found in this study were transverse lines, onycholysis, longitudinal melanonychia, leukonychia, subungual hemorrhage, subungual hyperkeratosis, anonychia, and onychorrexis., Conclusion: Nail changes are found in leprosy patients and have a wide variety of clinical appearances. A dermoscopy should be performed to assess nail changes in leprosy., (© 2024. The Author(s).)

Glomus tumors are rare vascular hamartomas most commonly found in the subungual region of the fingers. They present with a classic triad of paroxysmal pain, point tenderness, and cold sensitivity. The diagnosis is often missed for several years due to under recognition of this condition. A 42-year-old female presented with a several year history of pain in the middle finger when it was struck or exposed to cold. She had point tenderness on the fingernail, and increased curvature of the nail. Magnetic Resonance Imaging (MRI) revealed a 7mm subungual glomus tumor. The tumor was surgically excised via a transungual approach, resulting in complete relief of her pain. Glomus tumors are diagnosed clinically based on the presence of classic symptoms and positive provocative tests. These tests include point tenderness on palpation and pain when ice is placed on the digit. MRI imaging can be used when the diagnosis is unclear or to localize the tumor prior to surgery. Increased awareness of this condition among physicians could reduce the time to diagnosis and treatment., (Copyright© South Dakota State Medical Association.)

Introduction: Hand-foot-mouth disease (HFMD) is a common childhood infectious disease. Atypical skin findings of HFMD, often associated with coxsackievirus A6 (CVA6), were first reported in 2008, with increasing reports worldwide since. Atypical lesions of HFMD often involve sites beyond the palms and soles and tend to have unusual, polymorphic morphology., Methods: A systematic review was conducted on clinical features and outcomes of pediatric HFMD with atypical cutaneous manifestations., Results: Eighty-five studies were included, representing 1359 cases with mean age 2.4 years and a male predominance of 61%. The most reported morphologies were vesicles (53%), papules (49%), and bullae (36%). Other morphologies included eczema herpeticum-like (19%), purpuric/petechial (7%), and Gianotti Crosti-like (4%). Common atypical sites included the arms and/or legs (47%), face (45%), and trunk (27%). CVA6 was identified in 63% of cases. Symptoms resolved in a mean of 10 days. Overall, 16% of cases received treatment, most commonly with acyclovir, intravenous antibiotics, or topical steroids. The most common complications were nail changes (21%) and desquamation (4%) which occurred a mean of 3 and 2 weeks after symptoms, respectively., Conclusion: Due to unusual morphologies resembling other conditions, HFMD with atypical cutaneous findings may be misdiagnosed, leading to inappropriate and unnecessary investigations, hospitalization, and treatment. Greater awareness of atypical presentations of HFMD is warranted to improve patient care and counseling on infection control precautions., (© 2023 The Authors. Pediatric Dermatology published by Wiley Periodicals LLC.)

Competing Interests: Competing interests: None declared.

Self-induced nail disorders are a broad group of different clinical manifestations that share the common trait of being caused more or less voluntarily by the patient. These are distinct conditions within the clinical spectrum of onychotillomania. Most patients diagnosed with these disorders have psychiatric co-morbidities, and a multidisciplinary approach is thus highly recommended. The purpose of this review is to describe the most common clinical features encountered during daily nail consultations and to provide useful diagnostic tools and therapeutic tips for the best approach to these conditions., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Competing Interests: Conflicts of interest Dr Tosti serves as a consultant for DS Laboratories, Monat Global, Almirall, Tirthy Madison, Eli Lilly, P&G, Pfizer, Myovant, Bristol Myers Squibb, and Curallux LLC; and Principal Investigator: Eli Lilly, Concert, Erconia. Drs Schneider, Williams, and Morrison have no conflicts of interest to declare.

Disturbances of the nail apparatus are common and mainly benign. This review aims to investigate the aetiology of these disturbances, which range from more common benign causes to less common melanomas. Melanonychia may be the most prominent concern and is characterised by brown or black nail plate discoloration. Hence, understanding the most common nail changes, their epidemiology, pathophysiology, and clinical features are imperative to diagnosis and may prevent unnecessary surgical procedures in cases where it is not warranted., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Background: Hand-held dermoscopy is a valuable tool for dermatologists, but it has been rarely used to assess the nail fold capillary (NFC) in patients with dermatomyositis (DM)., Methods: Patients were collected from the Department of Dermatology and Venereology from July 2020 to July 2021, and the follow-up was conducted until January 2022. Demographic features, disease activity and NFC changes were analysed using a hand-held dermoscopy., Results: The most common NFC finding in our study was bushy capillary (87.0%). There was no significant improvement in scleroderma-dermatomyositis (SD)-like nail fold changes or enlarged capillaries from baseline to 12 weeks of treatment (p > 0.05) or from 12 weeks to 24 weeks of treatment (p > 0.05), but there was a significant improvement from baseline to 24 weeks of treatment (p < 0.05). The avascular area did not improve from baseline to 12 weeks of follow-up, but the changes were significant from 12 weeks to 24 weeks of treatment (p < 0.05) and baseline to 24 weeks of treatment (p < 0.05). Periungual erythema improved significantly from baseline to 12 weeks of treatment (p < 0.05) and baseline to 24 weeks of treatment (p < 0.05), but it did not improve significantly from 12 weeks to 24 weeks of treatment (p > 0.05). There was no significant difference in disease activity between patients with or without specific NFC changes. However, some NFC features improved as disease activity decreased., Conclusion: Dermoscopy of NFC is a cost-effective option for the preliminary diagnosis of DM. Further, long-term follow-up is necessary to study the relationship between disease activity and NFC changes., (© 2023 Australasian College of Dermatologists.)

Objective: To provide an overview and approach to common nail bed injuries seen by primary care practitioners., Sources of Information: An Ovid MEDLINE literature search was performed using search terms and studies were graded based on level of evidence., Main Message: Nail trauma is common in primary care practice and requires proper and prompt treatment to avoid lasting effects on finger function and cosmesis. When presented with a fingernail injury, primary care physicians should perform a thorough physical examination to determine extent of injury; take a history to rule out notable risk factors; perform a comprehensive neurovascular examination to assess pulp capillary refill, to do a 2-point discrimination, and to compare with an uninjured digit; and evaluate range of motion. Clinical evaluation may require local anesthesia and a tourniquet. Nail bed trauma can present in different ways and includes subungual hematomas, distal phalanx fractures, Seymour fractures, and-in more severe cases-fragmentation or avulsion of the nail bed. Treatment for subungual hematomas where the nail plate is intact does not require nail plate removal and nail bed exploration; however, exploration and repair are indicated for a nail plate injury, a proximal fracture involving the germinal matrix, and a distal phalanx fracture requiring stabilization., Conclusion: Fingertips are essential to normal hand function. Nail trauma is common and can be managed by primary care physicians. Shared decision making concerning management is based on the mechanism and extent of the injury and aims to prevent secondary deformities., (Copyright © 2023 the College of Family Physicians of Canada.)

Thalassemia syndromes are a group of autosomal, recessively inherited, single-gene hemoglobinopathies with varied mucocutaneous manifestations. There is, however, a scarcity of these findings in the literature. This descriptive observational cross-sectional study was conducted to describe mucocutaneous manifestations in multi-transfused beta-thalassemia major children. The study comprised 68 thalassemia major children attending the thalassemia unit for blood transfusion at a tertiary care hospital in North India. A dermatologist conducted a detailed examination to look into the presence of any mucocutaneous manifestations, including disorders of the hair and nails. The age range of enrolled thalassemic children was 6 months-19 years, with an average age of 10.5 years; the boy versus girl ratio was 1.72:1. All enrolled children had at least one cutaneous manifestation. Common dermatologic manifestations observed in these patients included hyperpigmentation of the knuckles (60.2%), moderate pallor (42.6%), icterus (26.4%), lusterless hair (20.5%), leukonychia striata or horizontal white streaks on the nails (14.7%), and oral ulcers (10.2%). A careful evaluation of mucocutaneous manifestations, including disorders of the hair and nails, is required in multi-transfused thalassemic children to provide an early diagnosis of dermatologic manifestations.

Competing Interests: Conflicts of interest Dr Lipner is a consultant for Ortho-Dermatologics, Hoth therapeutics, and BelleTorus Corporation. Chang, Lee, and Desai have no conflicts of interest to declare.

Introduction: Cronkhite-Canada syndrome (CCS) is currently considered to be a non-hereditary disease, which is relatively rare clinically. It is also known as polyposis hyperpigmentation alopecia nail dystrophy syndrome, it is a syndrome characterized by gastrointestinal polyposis and ectodermal changes, the main manifestations are gastrointestinal symptoms, skin pigmentation, alopecia, and hypothyroidism., Case Presentation: In this paper, the clinical characteristics, diagnosis and treatment of a case of CCS admitted to Huanghe Sanmenxia Hospital were analyzed. In the course of treatment, traditional Chinese medicine was used, but no hormone, and the patient's clinical symptoms were greatly relieved., Conclusions: CCS is rare, there is no specific treatment, and traditional Chinese medicine may can greatly relieve the clinical symptoms of patients. However, it's still having to be verified by a large sample, multi-center, long-term treatment follow-up studies., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: A broad spectrum of skin diseases, including hair and nails, can be directly or indirectly triggered by COVID-19. It is aimed to examine the type and frequency of hair and nail disorders after COVID-19 infection., Methods: This is a multicenter study conducted on consecutive 2171 post-COVID-19 patients. Patients who developed hair and nail disorders and did not develop hair and nail disorders were recruited as subject and control groups. The type and frequency of hair and nail disorders were examined., Results: The rate of the previous admission in hospital due to COVID-19 was statistically significantly more common in patients who developed hair loss after getting infected with COVID-19 (P < 0.001). Telogen effluvium (85%) was the most common hair loss type followed by worsening of androgenetic alopecia (7%) after COVID-19 infection. The mean stress scores during and after getting infected with COVID-19 were 6.88 ± 2.77 and 3.64 ± 3.04, respectively, in the hair loss group and were 5.77 ± 3.18 and 2.81 ± 2.84, respectively, in the control group (P < 0.001, P < 0.001). The frequency of recurrent COVID-19 was statistically significantly higher in men with severe androgenetic alopecia (Grades 4-7 HNS) (P = 0.012; Odds ratio: 2.931 [1.222-7.027]). The most common nail disorders were leukonychia, onycholysis, Beau's lines, onychomadesis, and onychoschisis, respectively. The symptoms of COVID-19 were statistically significantly more common in patients having nail disorders after getting infected with COVID-19 when compared to the control group (P < 0.05)., Conclusion: The development of both nail and hair disorders after COVID-19 seems to be related to a history of severe COVID-19., (© 2022 the International Society of Dermatology.)

Background: Palmoplantar and periungual warts tend to be recalcitrant. Intralesional immunotherapy can provide high efficacy with additional benefit to distant warts. However, evidence on comparative effects between intralesional immunotherapy with measles, mumps, rubella vaccine (MMR) and tuberculin purified protein derivative (PPD) and roles of dermoscopy in predicting treatment outcomes in palmoplantar/periungual warts is limited., Objectives: The study aimed to compare efficacy and safety of intralesional MMR and PPD injections in treatment of palmoplantar/periungual warts and explore associations between dermoscopic findings and treatment outcomes., Methods: We conducted a double-blind randomized controlled trial involving 40 patients with palmoplantar/periungual warts who were equally assigned to receive MMR or PPD. Intralesional injection was done every 2 weeks until clearance or maximum of 5 treatments., Results: Complete resolution was higher in MMR than PPD group (90.0% vs. 80.0% in index lesion and 81.3% vs. 54.6% in distant lesions, respectively), although the differences were statistically nonsignificant. Dermoscopic findings were not significantly associated with complete resolution. Local swelling, i.e., the most common adverse event, occurred more frequently in PPD (40.0%) than MMR group (10.0%)., Conclusion: This study suggests that intralesional immunotherapy with either MMR or PPD is efficacious in palmoplantar/periungual warts, with MMR showing a trend toward higher clearance and lower adverse events., (© 2022 The Author(s). Published by S. Karger AG, Basel.)