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Faith & Grace Beauty Group

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William Krylov
William Krylov

Mature Female Thumbs


Babies and children begin sucking their thumbs as a reflex, making them feel secure and safe. The behavior may extend into adulthood for similar reasons. Adults may suck their thumbs as a response to stress or anxiety.




mature female thumbs


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Many babies and young children suck their thumbs, but most stop by the age of 4. However, some people will continue to suck their thumb into adulthood. Vigorous thumb sucking can cause blisters, calluses, and dental problems.


Pediatric and adult trigger thumbs represent different entities requiring different treatment approaches. Despite some controversy, pediatric trigger thumb is considered an acquired condition caused by unique anatomic abnormalities.17 Among the estimated 0.05% of all children diagnosed with trigger digits, 90% occur in the thumb, most commonly presenting at 2 years of age.7 Previous studies report a spontaneous resolution rate ranging from zero to 66%.1


Using an electrogoniometer to measure thumb movements during mobile phone text messaging, Gustafsson et al found that subjects with musculoskeletal symptoms tended to have higher thumb movement velocities and fewer pauses in thumb movements compared with those without symptoms.16 In addition, they found that females had higher muscle activity in the extensor digitorum and APL when entering messages and tended to have greater thumb abduction, higher thumb movement velocities, and fewer pauses when compared with their male counterparts.16 Of note, values for the FPL were not measured.


In our report, we present the unique case of a 16-year-old female patient with no risk factors for the development of stenosing tenosynovitis other than her substantial texting. Though the aforementioned studies report occurrences of tendonitis or tenosynovitis due to text messaging, nearly all reports are related to dorsoradial pathology, such as in De Quervain tenosynovitis. In addition, studies using electrogonimetry and ultrasound also focused on this region of pathology, suggesting that tenosynovitis involving the flexor aspect of the thumb is rarely appreciated.1516 To our knowledge, this is the first report of stenosing tenosynovitis in a teenager that resulted in clinically disabling triggering of the thumb and ultimately required surgery. As the use of mobile devices increases while technology continues to progress, this rare clinical phenomenon may be of increasing importance in the near future. Thus, it is warranted to examine precipitating factors in our presented case in an effort to shed light on potential risk factors or preventative measures that may be implemented.


Cutaneous leiomyomata, which are benign smooth muscle neoplasms, commonly present as dermal-based nodules or papules with smooth borders and firm consistency. Digital, particularly subungual leiomyomata are quite rare. A 16-year-old female presented to nail clinic complaining of discoloration of the lunula of the left thumbnail for 2.5 months. On initial examination, a pink longitudinal band was present in the center of the nail plate, with yellow discoloration and distal onycholysis. The patient had only mild tenderness with firm palpation, and did not recall trauma of the area. A nail matrix biopsy was performed to determine the etiology of the lesion. Microscopic examination demonstrated a well-demarcated dermal-based spindle-cell fascicular proliferation. Bland cells exhibited eosinophilic cytoplasm and elongate nuclei with blunt ends and minimal cytologic atypia. Prominent nucleoli, mitoses or necrosis were not appreciated. Immunohistochemical stains for smooth muscle actin and caldesmon highlighted the cells. Contrarily, S-100, epithelial membrane antigen, p63, factor XIIIa, CD34, CD68 and p75 were all negative. Ki-67 showed a low proliferative index. The immunoprofile combined with the morphologic features were interpreted as subungual leiomyoma. Subungual leiomyoma is a very rare diagnosis. We seek to bring awareness and expedite the diagnosis in patients with this lesion.


The ovaries are filled with follicles. Follicles are fluid-filled structures in which the oocyte (also called egg) grows to maturity. Current knowledge indicates that females are born with their entire lifetime supply of gametes. At birth, the normal female ovary contains about 1-2 million/oocytes (eggs). Females are not capable of making new eggs, and in fact, there is a continuous decline in the total number of eggs each month. By the time a girl enters puberty, only about 25% of her lifetime total egg pool remains, around 300,000. Over the next 30-40 years of a female's reproductive life, the entire egg supply will be depleted. Although no one can know with absolute certainty the number of eggs remaining within the ovaries at any given time, most women begin to experience a significant decrease in fertility (the ability to conceive a child) around the age of 37. At the time of menopause, virtually no eggs remain.


The large supplies of eggs within each ovary are immature, or primordial, and must undergo growth and maturation each month. The eggs are stored within follicles in the ovary. Within a woman's lifespan, large numbers of follicles and oocytes will be recruited to begin the growth and maturation process. The large majority, however, will not reach full maturity. Most will die off in a process called atresia. Thus, only about 300-500 of these eggs will mature over a women's life span.


The maturation of eggs typically takes about 14 days and can be divided into 2 distinct periods. During the initial period, many eggs, as many as 1000, begin to develop and mature. The second phase of development requires gonadal hormone stimulation to stimulate further development. However, even though hundreds of eggs have begun to mature, most often only one egg will become dominant during each menstrual cycle, and reach its' fully mature state, capable of ovulation and fertilization. The remaining eggs/follicles will wither and die. Pre-pubertal girls do not produce the gonadal hormones that are necessary for the second phase of development, so the many eggs that started to mature will simply wither away. The large number of eggs that are used each month account for the steady decline in the female's total egg pool that occurs from birth to menopause.


In post-pubertal females, the dominant egg continues to develop, relying on hormones for growth and stimulation. When the egg becomes fully mature, the follicle surrounding the egg bursts, and releases a mature egg which travels through the fallopian tube toward the uterus. The egg is capable of being fertilized for a short period, about 48 hours. If the egg is not fertilized during this time, it will die, and in another week or so, a new cycle of egg maturation will begin.


This cyclic process of development continues through out a female's life until most or all of the eggs are depleted. This is the period of life known as menopause. This occurs sometime in the 4th or 5th decade of life, with the average age in the US being 51. Depletion of the egg pool anytime prior to age 40 is referred to as premature ovarian failure. Any female who receives treatment with drugs that damage the ovarian follicles is at risk to develop premature ovarian failure--even many years after the treatment has ended. The majority of young girls treated with chemotherapy will retain fertility initially, but may be at risk to develop premature ovarian failure. This knowledge may be important to consider for family planning.


In the fall of their second year, nymphs that have had a blood meal will molt into an adult male or female tick. Adults prefer to feed on large mammals, such as white-tailed deer or humans. The females find a host to feed, mate with an adult male tick, lay hundreds to thousands of eggs, and then die. The males attach to a host to find a female mate and then die. Some adults who do not feed or mate in the fall will survive through the winter and then come out to feed and/or mate the following spring. If there is little to no snow cover and temperatures rise above freezing, it is possible to find an active adult tick searching for a host on a warm winter day.


This picture shows each of the life stages of the blacklegged tick: adult female, adult male, nymph, and larva. It also shows the relative sizes and patterns of the blacklegged tick, lone star tick, and American dog tick.


These ticks have been lined up next to the thumb so you can see their relative sizes. From left to right are the blacklegged tick (deer tick) larva, nymph, adult male, and adult female followed by the American dog tick (wood tick) adult female and adult male.


This MDH staff person is dressed in white to more easily spot ticks that may grab and crawl onto them while out in the woods. He is pointing to two adult female blacklegged ticks (left) and one male blacklegged tick (right) on his pant leg.


Adult female acne can look very similar to teenage acne. While adult acne is commonly thought to affect the jawline and chin, it can appear on any part of the face or trunk. Adult women can have clogged pores, inflamed pus-filled bumps, or deep-seated cysts. Unfortunately, treatment options that worked well in the teenage years may not work as well in adult females with acne, due to triggering factors such as hormonal imbalance, stress, and diet.


There are many reasons adult females can get acne. Hormonal disturbances caused by pregnancy, menstrual cycle, menopause, and oral contraceptives can contribute to acne by modifying the production of certain hormones. These hormones stimulate oil production within the skin, promoting the growth of acne-causing bacteria. Stress can increase the production of substances that activate oil glands within the skin of acne patients. Consumption of dairy and high-glycemic foods is also linked to acne. Certain hair or skin products can clog pores and cause comedonal acne (blackheads and whiteheads). A board-certified dermatologist can help determine the appropriate treatment for the type of acne you have. 041b061a72


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