Clinical, dermoscopic, and pathologic features of onychopapilloma: A review of 47 cases.

BACKGROUND: Onychopapilloma is a benign neoplasm of the nail bed and the distal matrix. Although not uncommon in our experience, only up to 32 cases of this tumor have been reported in the literature. OBJECTIVE: We sought to review the clinical, dermoscopic, and pathologic features of onychopapilloma. METHODS: We retrospectively analyzed the clinical features of 47 patients with pathologically confirmed onychopapilloma diagnosed within the last 5 years, and reviewed the published literature. RESULTS: The most common clinical presentation was longitudinal erythronychia (n = 25); followed by longitudinal leukonychia (n = 7); longitudinal melanonychia (n = 4); long splinter hemorrhages without erythronychia, leukonychia, or melanonychia (n = 8); and short splinter hemorrhages without erythronychia, leukonychia, or melanonychia (n = 3), with subungual mass (n = 47) and distal fissuring (n = 11). Pathology was consistent with acanthosis of the nail bed and distal matrix, with matrix metaplasia underlying distal subungual hyperkeratosis. LIMITATIONS: This was a retrospective analysis. CONCLUSION: To our knowledge, our series of onychopapilloma is the largest so far. Among various clinical presentations, longitudinal erythronychia is the most common. Dermoscopy of the free edge of the nail plate showing a small subungual keratotic mass where the band reaches the nail plate margin provides a clue for the diagnosis.

A rare case of Acrodermatitis continua of Hallopeau successfully treated with topical calcipotriol/betamethasone dipropionate ointment associated with Jaccaud's arthropathy: A case report.

Acrodermatitis continua of Hallopeau (ACH) is a rare and localized form of pustular psoriasis that can lead to irreversible anonychia whereas Jaccoud's arthropathy (JA) is a rare non-articular condition characterized by a deforming non-erosive arthropathy involving the digits. This case describes the first reported association of these two rare conditions in a 73-year-old Filipino male who was treated topically until remission of ACH. Because calcipotriol/betamethasone ointment works better and faster than clobetasol ointment, it may be considered as a preferred first-line treatment for ACH. This case also highlights the evaluation of joint symptoms in the context of psoriatic arthritis and JA, along with a discussion of its management. A multidisciplinary approach involving dermatology, rheumatology, and physiatry is essential in the care of these two rare conditions.

Managing epidermolysis bullosa during the coronavirus pandemic: Experience and ideals.

The 2019 novel coronavirus pandemic has tremendously affected health-seeking behaviors. Fear of contracting the disease has been a major factor keeping patients from presenting to hospitals, even when urgent or emergent medical attention is needed. Hospitals limiting staff exposure and capacity to accommodate patients also limits opportunities to seek care. Although physical distancing is encouraged to curb infections, this call needs to be tempered with public health education for what constitutes emergencies and urgent medical conditions needing face-to-face attention. Measures to assuage fears among patients and their caregivers to ensure their safety in the hospital or health care setting need to be communicated and executed effectively. Epidermolysis bullosa is an inherited mechanobullous disorder that is usually stable, but in some patients with underlying comorbidities, close monitoring or face-to-face management is required . We present our experience and provide recommendations pertinent to epidermolysis bullosa patients of all subtypes during the coronavirus crisis.