{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T12:00:31Z","timestamp":1775908831860,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2007,3,29]],"date-time":"2007-03-29T00:00:00Z","timestamp":1175126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:p>A 20\u2010year\u2010old woman with a 2\u2010year history of histologically confirmed palmoplantar keratoderma due to psoriasis, resistant to several topical agents, was admitted to the Department of Dermatology, Uludag University, Bursa, Turkey. Therapy with oral acitretin (0.5\u00a0mg\/kg\/day, 35\u00a0mg\/day) was initiated. A month after starting acitretin treatment, she noted slight reddening of the second left fingernail. Clinical examination revealed red\u2013brown discoloration of the second fingernail associated with subungual hemorrhage involving the proximal nail bed (lunula region) (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"#f1\">Fig.\u00a01<\/jats:ext-link>). The nail change was asymptomatic. The patient complained only of discoloration underneath the nail plate. No abnormalities were detected on the skin, mucous membranes, or toenails\/other fingernails. The patient denied exposure to microtrauma or any other drugs. The erythrocyte sedimentation rate, full blood cell count, electrolytes, renal and hepatic tests, and serum lipids were normal. Coagulation tests, including blood clotting time, international normalized ratio, activated partial thromboplastin time, thrombin time, platelet number, and function tests, were within normal levels.<\/jats:p><jats:p><jats:fig><jats:caption><jats:p>Acitretin\u2010induced subungual hemorrhage involving the proximal portion (lunula region) of the second left fingernail bed<\/jats:p><\/jats:caption><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" position=\"anchor\" xlink:href=\"urn:x-wiley:00119059:media:IJD3059:IJD_3059_f1\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:fig><\/jats:p><jats:p>Treatment with acitretin was discontinued, and the nail change resolved completely after 3\u00a0weeks. A similar episode of subungual hemorrhage recurred, however, within 48\u00a0h after re\u2010challenge with a lower dose of acitretin (25\u00a0mg\/day). The drug was definitively stopped and the eruption faded again within a week. An objective causality assessment suggests that subungual hemorrhage was probably related to acitretin in this patient.<\/jats:p>","DOI":"10.1111\/j.1365-4632.2006.03059.x","type":"journal-article","created":{"date-parts":[[2007,3,29]],"date-time":"2007-03-29T15:05:39Z","timestamp":1175180739000},"page":"494-495","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Acitretin\u2010induced subungual hemorrhage"],"prefix":"10.1111","volume":"46","author":[{"given":"Kenan","family":"Aydogan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serap Koran","family":"Karadogan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukran","family":"Tunali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,4,30]]},"reference":[{"key":"e_1_2_2_2_2","first-page":"737","article-title":"Acitretin","volume":"128","author":"Berbis Ph","year":"2001","journal-title":"Ann Dermatol Venereol"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(99)70359-2"},{"key":"e_1_2_2_4_2","first-page":"35","article-title":"A double\u2010blind comparison of acitretin and etretinate in the treatment of severe psoriasis: results of a Nordic Multicentre Study","volume":"69","author":"Kragballe K","year":"1989","journal-title":"Acta Derm Venereol"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000248701"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1159\/000248398"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(89)70138-9"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1988.tb03499.x"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(88)70198-X"},{"key":"e_1_2_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0190-9622(88)70086-9"},{"key":"e_1_2_2_11_2","first-page":"395","article-title":"Subungual haematomas in a patient treated with an oral anticoagulant (warfarin sodium)","volume":"7","author":"Varotti C","year":"1997","journal-title":"Eur J Dermatol"},{"key":"e_1_2_2_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000246166"},{"key":"e_1_2_2_13_2","doi-asserted-by":"publisher","DOI":"10.1159\/000018132"},{"key":"e_1_2_2_14_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468-3083.2003.00774.x"},{"key":"e_1_2_2_15_2","doi-asserted-by":"publisher","DOI":"10.1080\/09546630310015395"}],"container-title":["International Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1365-4632.2006.03059.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1365-4632.2006.03059.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T22:39:14Z","timestamp":1696891154000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1365-4632.2006.03059.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,4,30]]},"references-count":14,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2007,5]]}},"alternative-id":["10.1111\/j.1365-4632.2006.03059.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1365-4632.2006.03059.x","archive":["Portico"],"relation":{},"ISSN":["0011-9059","1365-4632"],"issn-type":[{"value":"0011-9059","type":"print"},{"value":"1365-4632","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,4,30]]},"assertion":[{"value":"2007-04-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}