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Onychotillomania, defined as self-induced trauma to the nail unit, either by picking or pulling at the nails, affects 0.9% of the population. It may lead to severe irreversible nail dystrophy, melanonychia, or infections. Although no large clinical trials have assessed the efficacy of treatments, cognitive-behavioral therapy, physical barrier methods, and pharmacological treatments have shown some benefits in case reports. The objective of this article is to review the prevalence, diagnostic criteria, etiology, historical and physical examination findings, pathological features, and current treatment methods. Onychotillomania remains a clinical challenge to dermatologists, pediatricians, internists, and psychiatrists in practice, as there are no evidence-based treatment methods.

Efinaconazole 10% topical solution is a new triazole recently approved for the treatment of onychomycosis. It inhibits fungal lanosterol 14α-demethylase in the ergosterol biosynthesis pathway, has potent antifungal activity against dermatophytes, as well as activity against Candida spp. and non-dermatophyte molds, and showed promising results in clinical trials. This review summarizes the mechanism of action, in vitro and in vivo data, clinical trials, safety, and quality-of-life data of efinaconazole as it applies to the treatment of onychomycosis.

Nail disorders represent a surprisingly large section of most dermatologists' practice - and can present difficult, sometimes intractable, clinical problems. This new color atlas, co-authored by one of the world's foremost authorities in the field, provides expert and authoritative guidance on all aspects of diagnosis and management. It is a comprehensive guide to common nail diseases. The text includes anatomy and physiology of the nail unit, paronychia and onycholysis, nail fungal infections, nails in dermatologic diseases, nails in systemic disease, nail cosmetic chemistry, nail cosmetics: clinical aspects, plus the treatment of nail disorders and nail surgery.

This fresh look at southern politics clarifies the recent and dramatic development of party competition in the South. Southern politics has changed dramatically during the past half century. While new developments have touched virtually every aspect of the region's politics, change has been especially marked in the South's political party and electoral systems. Southern Parties and Elections explores the contemporary developments in party realignment and examines the relationship between regional party change and electoral behavior and the larger patterns in national politics. The collection's first group of essays examines some of the key legal issues in contemporary southern politics: the legal battle over majority-minority districting, the electoral consequences of such districting, the practice-fairly widespread in the South-of separating presidential elections from state and local elections, and the connections between the electorate and party change. The second section of essays focuses on nominations, elections, and partisan developments in the South, including the recent surge of voter participation in southern Republican primaries, the comparative importance of the South and selected states with large blocks of electoral votes in presidential election outcomes, and the southern contribution to patterns of voting in Congress. The final two chapters examine changes in southern state legislatures-one a case study of the Virginia General Assembly and the other an analysis of state legislatures in the region as a whole. Collectively these essays add important pieces to the enduring puzzle of "southern politics."  

The Christian Right never ceases to surprise professional observers of American politics. With the Christian coalition in disarray, many expected that the movement would play less of a role in the 2004 elections. But when exit polls reported that \"moral values\" were the most commonly cited reason for presidential vote choice, pundits immediately proclaimed the importance of the \"values vote.\" Yet the role of the Christian Right, of statewide referenda on same-sex marriage, and of religious mobilization remained the subject of debate.The Values Campaign? The Christian Right and the 2004 Electionsreaches well beyond the instant analyses of the post-election period to provide an assessment of the role of the religious right in 2004. The contributors to this volume are among the leading scholars of religion and politics in the United States, and many have contributed for over a decade to ongoing discussions of the role played by the religious right in national elections. The authors consider national mobilization and issues, and also explore the role of the Christian Right in specific states. Their evaluations contend that the \"values campaign\" was not an aberration but a consistent pattern of national politics, and that moral traditionalism will likely continue to be a significant factor in future elections. A timely study of the 2004 elections, this volume will appeal to scholars and observers of electoral politics, state politics, and religion and politics.

Dermatology nurses are uniquely positioned to assess brittle nail syndrome, a multifactoral disorder, in conjunction with a physician, and to help develop a therapeutic plan. Once underlying causes are identified, dermatology nurses can support patients in nail care and assist the dermatologist in promoting treatment compliance.

A double-blind, randomized, vehicle-controlled, parallel-group trial was performed to compare the efficacy and tolerability of tazarotene 0.1% gel and vehicle gel in 31 patients with fingernail psoriasis. Patients were randomized to receive tazarotene or vehicle gel, which they applied each evening for up to 24 weeks to 2 target fingernails, one under occlusion and one unoccluded. The tazarotene treatment resulted in a significantly greater reduction in onycholysis in occluded nails (P < or = .05 at weeks 4 and 12) and a significantly greater reduction in onycholysis in nonoccluded nails (P < or = .05 at week 24). Tazarotene also resulted in a significantly greater reduction in pitting in occluded nails (P < or = .05 at week 24). There were no other significant between-group differences in pitting, subungual hyperkeratosis, leukonychia, nail plate crumbling/loss, splinter hemorrhage, or nail growth rate. Tazarotene 0.1% gel was well tolerated with only 5 of the 21 tazarotene-treated patients reporting a treatment-related adverse event (all mild or moderate). In conclusion, tazarotene 0.1% gel can significantly reduce onycholysis (in occluded and nonoccluded nails) and pitting (in occluded nails) and is well tolerated in the treatment of nail psoriasis.

Lamivudine and indinavir are two medications used to treat human immunodeficiency virus (HIV) that have recently been reported to cause paronychia. The nails of the great toes are commonly affected. This is the second report of paronychia and ingrown toenails due to indinavir and the first report of recurrent paronychia and ingrown toenails associated with this drug.