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12 Dec, 7 tweets, 4 min read
Hi #dermtwitter/#medtwitter! Recently, I partnered with @jmervak's & @NailDisorders to make #MedEd/#FOAMEd on nails more accessible! Please consider filling out this ANONYMOUS & SHORT survey👇!

unc.az1.qualtrics.com/jfe/form/SV_af…

If you need a refresher, #tweetorial links below!
1/
2/
 Nails and underlying systemic disease!

3/
 Nail Melanoma!

4/
Onychomycosis (Nail fungus)!

5/
Pediatric Nail Conditions!

6/
 Reported nail conditions in #COVID19!

7/7
 Final tweet to say THANK YOU to participants in learning, filling out the survey, creating these teaching modules. I myself learned a ton by being a part of this, so thanks to @jmervak for including me as well! Hope we can do more of these #dermtwitter #MedEd projects soon!

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More from @DrStevenTChen

Steven Chen 陳持威 Profile picture
24 Nov
1/
 Join me for a #dermtwitter #tweetorial on:

SCARS AND KELOIDS!

#MedEd #FOAMEd #medstudenttwitter #MedTwitter

Let's start ourselves off with a question: Which one of the following conditions will lead to scarring?
2/
 The correct answer is Pyoderma Gangrenosum! This illustrates a quick first point - scarring only occurs if you damage the skin into dermis and beyond. Epidermal damage heals without scarring, which is why the first 3 don't lead to scarring!
3/
 So what exactly is a scar?

Scarring is a normal part of healing that at its root, is extra collagen laid down to repair skin injury.

However, sometimes the process gets out of hand and exuberant which leads to hypertrophic scars (pic 1) keloids (pic 2)!
Read 12 tweets
Steven Chen 陳持威 Profile picture
7 Nov
1/
Hi #dermtwitter/#medtwitter! Our last (for now!) #tweetorial/#medthread on nails! This time it’s...

PEDIATRIC NAIL CONDITIONS!

Education from @naildisorders and the @jmervak team!

@societypedsderm @PeDRAResearch #medstudenttwitter #medtwitter #meded #FOAMed
2/
Beau’s lines (transverse ridge) and onychomadesis (nail shedding) common in kids! Often seen in a post-viral setting.

Common culprit = hand foot mouth disease!
3/
Congenital malalignment of the great toenails – lateral deviation of the first toenails. More common than you think. Start looking at more toes and you’ll see it! Can improve with time or persist. Risk for nail thickening or ingrown nails.

pc: sciencedirect.com/science/articl…
Read 12 tweets
Steven Chen 陳持威 Profile picture
27 Oct
1/
 Join me for a quick #tweetorial/#medthread on:

Pearls for the #Dermatology Exam!

#MedEd #dermtwitter #medtwitter #medstudenttwitter #FOAMed

First a question - What do you think when someone asks for your help with a rash?
2/
 Regardless how you answered, I hope to teach you something today! Let's start!

"In #dermatology, we don't do an H+P, we do a P+H."

The exam is perhaps most important. You can use it to narrow down your ddx! Then, you use your history to further work toward the right dx.
3/
 "If there's scale, there probably is epidermal involvement."

Scale usually implies action in the epidermis. This doesn't rule out anything in the dermis or subcutis, but just that the pathology includes action up top.

Check out my #tweetorial on scale
Read 10 tweets
Steven Chen 陳持威 Profile picture
24 Oct
1/
Hi #dermtwitter! Back for another #tweetorial/#medthread on nails! Today we’re learning about:

ONYCHOMYCOSIS- nail fungus!
 
This is THE most common nail condition- so follow along!
Education from @naildisorders
#medstudenttwitter #medtwitter #meded #FOAMed
2/
Onychomycosis is more common in adults than kids.
Trauma, diabetes, immunosuppression, tinea pedis, psoriasis, and family history are some risk factors

Pro tip- check the feet for tinea pedis if you suspect onychomycosis!

@podiatrytoday
3/
Patients with onychomycosis present with nail discoloration (yellow to brown), onycholysis (nail separation), nail brittleness, or nail thickening.

The big toenail is most frequently affected.

Fingernail involvement without also have toenail involvement is uncommon.
Read 14 tweets
Steven Chen 陳持威 Profile picture
3 Oct
1/
 Hi #dermtwitter! I'm working with @jmervak et al, who put together this amazing #tweetorial on

NAILS!

Specifically, findings in the setting of systemic diseases: let nails help your diagnosis!

Coordinated with @naildisorders

#medstudenttwitter #medtwitter #meded #FOAMed
2/
 First things first, do you mind telling us who you are?
3/Let's begin: Beau’s lines! Transverse depression across the nail. Means the nail briefly stopped growing and started again.

Seen weeks after nail injury! Or, if it's seen on multiple nails, ask about febrile illness (like post #covid19) or stressors like SJS or chemotherapy.
Read 16 tweets
Steven Chen 陳持威 Profile picture
6 Feb
1/
 Let's spend some time on a #dermtwitter #tweetorial on all things....

HERPES!

Even though there are 8 herpesviruses that infect humans, I'm going to focus on HSV1 and HSV2 today.

#medtwitter #medstudenttwitter #meded #FOAMEd
2/
 You know how we say that everything could be sarcoid? Well, HSV-1/HSV-2 (which I'll refer to as herpes for this #thread) would be a close 2nd, ESPECIALLY on the inpatient service.

While HSV-1 is usually thought to be oral and HSV-2 genital, this certainly is NOT always true.
3/
 The class exam finding for herpes is the "dew drop on a rose petal." In clinical speak, that would be a vesicle on an erythematous base. But often we don't see the vesicle intact.

For ex, the photo above shows intact vesicles, whereas here, we just see the resultant crust.
Read 16 tweets

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