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This review attempts to provide some mechanistic insight (Figures 13) into how the bi-directional network between the gut microbiota and the brain can not only protect but also trigger and aid chronic gut inflammation, promote a global pro-inflammatory state, modify and contribute to protein misfolding processes, dysregulate the autophagic-lysosomal protein clearance mechanism, differentiate T-cell subsets to facilitate a deleterious autoimmune response, and finally modulate immune recruitment and BBB status

Knowledge and observation of clinical and onychoscopic characteristics, as well as the progression of the lesion, in conjunction with other supplementary examinations, assist in differentiating nail melanoma from other pigmented nail lesions