Bibliographic record
Abstract
Up to 90% of patients with psoriasis develop onychodystrophy at some point during their lives.Nail involvement precedes the skin lesions in approximately 4% of patients.We herewith report a case of a 7-year-old boy with psoriatic onychodystrophy at the age of 6 years followed by the appearance of plaque psoriasis 6 months later.The psoriatic onychodystrophy was initially misdiagnosed as onychomycosis by his family physician and was treated as such.Psoriatic onychodystrophy can clinically mimic onychomycosis and differentiation of the two conditions can be difficult.We emphasize the need for potassium hydroxide examination and culture of nail scrapings/clippings to demonstrate fungal elements, should there be doubt in the diagnosis.Antinuclear antibodies (ANA), rheumatoid factor (RF), and anticitrullinated peptide antibodies (ACPA) were negative.Microscopic examination of potassium hydroxide wet mount preparation of the fingernail scrapings and clippings were negative for fungus.Scrapings and clippings of the fingernails were also sent for fungal culture on Sabouraud's medium and results were negative.A diagnosis of plaque psoriasis with psoriatic onychodystrophy was made.The patient was treated with methotrexate 7.5 mg orally once weekly, folic acid 5 mg orally daily, and topical calcipotrienebetamethasone dipropionate gel to the nails once daily.Reassessment three months later revealed entirely normal appearing skin without evidence of plaque psoriasis.There was modest improvement in the nail deformities. DiscussionPlaque psoriasis or psoriasis vulgaris is characterized by sharply demarcated erythematous plaques with adherent silvery micaceous scales.Removal of the scales results in fine punctate bleeding, which is referred to as the Auspitz sign.The lesions are usually symmetrically
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.003 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.006 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".