Onychocytic matricoma

Abstract Onychocytic matricoma is a newly described tumor of the nail matrix. Clinically, it presents with localized thickening of the nail plate and melanonychia. Histologically, it represents a benign acanthoma of onychocytes. There are 8 cases reported in the literature. A 12-year-old girl presented with localized melanonychia and concurrent thickening of the nail plate restricted to the area of pigmentation affecting the right thumb, with no history of trauma or pain. We report a case of this rare tumor occurring in late childhood and provide a comprehensive review of its clinical presentation and differential diagnosis. Both clinicians and dermatopathologists should be aware of the presentation of onychocytic matricoma and include it in their scope of diagnosis of longitudinal nail bands.

Nail psoriasis treated with pulsed dye laser

Abstract: Nail changes are present in about 50% of psoriasis patients and tend to be refractory to conventional treatments. Pulsed dye laser has emerged as an alternative therapy. Our aim is to evaluate the efficacy of pulsed dye laser in nail psoriasis and the impact of treatment on quality of life. Fourteen patients were treated in monthly sessions for three months. The outcome assesment was made by the Nail Psoriasis Severity Index (NAPSI). The median improvement in the scores of the overall NAPSI, nail bed NAPSI, and nail matrix NAPSI were 44.2% (P = 0.002), 50% (P = 0.033) and 65.1% (P = 0.024), respectively.

Giant cell tumor of the tendon sheath: a rare periungual location simulating myxoid cyst

ABSTRACT Giant cell tumor of the tendon sheath is a benign soft tissue tumor most frequent between the third and fifth decades of life. It can mimic and make differential diagnoses with several hand tumors. Definitive diagnosis and the treatment of choice are reached with complete resection and histopathological examination. Here we describe a case with clinical presentation similar to that of a myxoid cyst.

Conservative surgical management of in situ subungual melanoma: long-term follow-up

Abstract Subungual melanoma represents 20% of all melanomas in Hispanic population. Here, we report the outcome of 15 patients with in situ subungual melanoma treated with resection of the nail unit with a 5-mm margin without amputation, followed up for 55.93 ± 43.08 months. The most common complications included inclusion cysts and nail spicules. We found no evidence of local or distant recurrences at the last visit of our follow up. Functional outcome was good, with only one patient reporting persistent mild pain. These results support functional, non-amputative surgical management of in situ subungual melanomas.

Subungual squamous cell carcinoma

Abstract Although subungual squamous cell carcinoma is rare, it is the most common primary malignant neoplasms in this location. The higher incidence occurs in the fingernails, but involvement of the toenails is also possible. Subungual squamous cell carcinoma often looks like other more common benign lesions, such as fungal infection, onychomycosis, or viral wart. These factors, together with a general lack of awareness of this disease among physicians, often result in delayed diagnosis. Therefore, it is underdiagnosed, with few reports in the literature. The authors present a case of a man with a diagnosis of subungual squamous cell carcinoma in the hallux, without bone involvement, which was submitted to the appropriate surgical treatment.

Superficial Acral Fibromyxoma involving the nail's apparatus. Case report and literature review

Superficial Acral Fibromyxoma is a rare tumor of soft tissues. It is a relatively new entity described in 2001 by Fetsch et al. It probably represents a fibrohistiocytic tumor with less than 170 described cases. We bring a new case of SAF on the 5th toe of the right foot, in a 43-year-old woman. After surgical excision with safety margins which included the nail apparatus, it has not recurred (22 months of follow up). We carried out a review of the location of all SAF published up to the present day.

Schwannona ungueal. Tratamiento quirúrgico / Naif schwannona. Surgicaf treatment

El schwannoma o neurilemoma, es una tumoración benigna de las vainas de los nervios periféricos ocasionados por la proliferación de las células de Schwann. Se presenta el caso de un paciente de 61 años, con una masa tumoral que afecta el lecho ungüeal del índice derecho, de ocho meses de evolución. Se reporta este caso por ser rara su presentación en este lugar y para mostrar el procedimiento quirúrgico empleado, con un buen resultado.

The schwannoma or neurilemoma, is a benign tumor of the peripheral nerve sheath caused by the proliferation of Schwann cells. We report the case of a patient of 6/ years with a tumor that affects the nail bed of the right index of 8 months. We report this case to be rare presentation in this place and to show the surgical procedure used, with a good result.

Melanoma subungueal in situ tratado com cirurgia funcional / Subungual melanoma in situ treated with FESS

Contexto: O melanoma subungueal representa aproximadamente 2% a 3% dos melanomas cutâneos em pacientes caucasianos.Relato de caso: Descrevemos o caso de uma paciente do gênero feminino, de 44 anos de idade, com lesão subungueal há cinco anos, com diagnóstico histológico de melanoma in situ, submetida a cirurgia funcional. A amputação parcial ou completa na região proximal à articulação interfalangeana dos dedos é o tratamento sugerido. Em casos selecionados, com diagnóstico histológico de melanoma in situ, pode-se optar pela cirurgia conservadora com análise histológica completa das margens.Conclusões: Desde que bem indicada, a excisão conservadora com retirada em bloco do aparato ungueal da falange distal oferece melhores resultados cosméticos e funcionais, sem afetar o prognóstico dos pacientes com melanoma in situ subungueal.

Context: The subungual melanoma accounts for approximately 2% to 3% of cutaneous melanomas in Caucasian patients.Case report: We report the case of a female patient, 44 years of age, with subungual injury five years ago, with histological diagnosis of melanoma in situ, underwent FESS. The partial or complete amputation at the proximal interphalangeal joint of the fingers is the suggested treatment. In selected cases, with histological diagnosis of melanoma in situ, one can opt for conservative surgery with complete histological margins.Conclusions: Since well indicated, conservative excision with en bloc removal of the nail apparatus of the distal phalanx offers better cosmetic and functional results, without affecting the prognosis of patients with subungual melanoma in situ.

Neurofibroma subungueal solitário: relato de um caso inédito no sexo masculino / Solitary subungual neurofibroma: a previously unreported finding in a male patient

Neurofibroma é uma proliferação hamartomatosa de origem neuromesenquimal. Pode ser encontrado associado à neurofibromatose ou como tumor solitário, sendo sua apresentação subungueal solitária bastante rara. É mais frequente em pacientes do sexo feminino e a cirurgia é o tratamento de escolha. Relatase um caso de um paciente masculino, com lesão tumoral subungueal no pododáctilo, cuja biópsia e imuno-histoquímica foram compatíveis com neurofibroma. Até a presente data, menos de dez casos sobre neurofibromas subungueais sem associação com doença de Von Recklinhausen foram documentados, sendo este o primeiro caso relatado no Brasil e o único no sexo masculino no mundo.

A neurofibroma is a hamartomatous proliferation of neuromesenchymal origin. It may be found in combination with neurofibromatosis or in the form of a solitary tumor. Clinical presentation as a solitary subungual tumor is very rare. Neurofibroma is more common in females and surgery is the treatment of choice. The present paper reports the case of a male patient with a subungual tumor on his toe. Biopsy and immunohistochemistry findings were compatible with a neurofibroma. To date, fewer than ten cases of subungual neurofibromas unassociated with von Recklinghausen's disease have been documented, this being the first case to be reported in Brazil and the only report worldwide to have described this condition in a male patient.

Tumor glômico: um diagnóstico fácil ou difícil? / Glomus tumor: an easy or a difficult diagnosis?

Introdução: O tumor glômico é uma lesão neoplásica benigna, geralmente única, quese forma no glomo terminal. Esta estrutura é uma anastomose arteriovenosa subcutâneadistribuída por toda a superfície corporal, em particular nos leitos ungueais, polpas digitais,palmas das mãos e plantas dos pés. Apesar da sua raridade, recebe atenção especialpor seus sintomas caracterizados por dor paroxística, sensibilidade à pressão do local, aofrio e por sua localização típica na ponta do dedo. O diagnóstico inicial é raramente feito,levando os pacientes a apresentarem os sintomas por meses e até anos, sem o diagnósticoe tratamento adequados. Objetivo: O objetivo desse trabalho é evidenciar o método diagnósticoclínico e histopatológico do tumor glômico, e a utilização da microscopia em seutratamento cirúrgico. Resultados: Observou-se grande diminuição nos casos de recidiva,com retorno funcional do órgão acometido e melhora da saúde física, funcional e psicossocialdo paciente. Conclusão: A exérese do tumor mostrou-se eficaz e os resultados foramplenamente satisfatórios, não havendo complicações pós-operatórias significativas, nemrecidivas até o momento.

Introduction: The glomus tumor is rare subungueal pathology that consists of a neuromyoarterial.Glomus bodies sensible to temperature oscillations, that regulate arteriolarflow, located at the arteriolar-venula anastomosis. The main symptom of this pathology isan excruciating pain leading to functional limitation of the Lyme. Objective: The purposethis study is to highlight its clinical and histopathological diagnosis, as well as the use ofmicrocopy on its surgical treatment. Results: The treatment resulted in a great reduction ofrecurrence, with functional recovery of the limb and improvement of apaticutp’s physical,social and psycosocial health. Conclusion: The surgical resection of the tumor was efficientand the results were very satisfactory, with no significant post operative complications andno recurrence.

Diagnóstico do tumor glômico pela dermatoscopia do leito e da matriz ungueal / Diagnosis of glomus tumor by nail bed and matrix dermoscopy

A cirurgia é o tratamento definitivo para os tumores glômicos. Algumas vezes, esse procedimento pode representar um desafio, pois, apesar de ser um tumor bem delimitado, a sua visualização pode ser difícil. O uso da dermatoscopia do leito e da matriz ungueal facilita o diagnóstico e auxilia a localização e delimitação do tumor. Trata-se de método simples e de baixo custo que não implica risco adicional ao paciente que irá se submeter a um procedimento cirúrgico.

Surgery is the best treatment for glomus tumors. Sometimes this can be a challenging procedure because, despite being a well-defined tumor, its visualization can be difficult. The use of nail bed and matrix dermoscopy facilitates the diagnosis and aids in the localization and demarcation of the tumor. It is a simple and low-cost procedure that does not involve additional risks to the patient who will undergo surgery.

[Lateral nail squamous cell carcinoma: case report]

Squamous cell carcinoma [SCC] of the lateral nail fold is rare, it has been suggested that trauma, roentgen radiation, arsenic exposition, dyskeratosis and infections [HPV] are risk factors for the development of these carcinoma.This tumour is mostly a slow growing and low grade malignancy which rarely metastasis.Early diagnosis by biopsy, especially in patients with predisposing factors, may lead to treatment and prevent the tumour from metastasizing. Report of new case. We report one case of [SCC] of the lateral nail fold of the thumb in a 66 year old man, treated with local excision; function and cosmetic results are more acceptable. A review of the literature was made in order to precise the epidemiological, diagnostic and therapeutic characteristics

Tumor glômico: revisäo de 8 casos / Glomus tumor: review of 8 cases

Os autores fazem a revisäo de oito casos de tumor glômico, tecendo consideraçöes quanto ao diagnóstico, tratamento e anatomopatologia. Terminam por enfatizar alguns pontos controversos e polêmicos, confirmando tratar-se de tema que tem muito a ser descoberto.

Wedge resection alone or combined segmental phenolization for surgical correction of ingrowing toe nails

A retrospective analysis was undertaken of 194 patients treated surgically for ingrowing toenails. Each patient was randomly allocated to one of two treatment groups. There were 82 wedge resections and 112 wedge resection/segmental phenolization combination treatments. All patients were followed up for 6 months. The duration and intensity of postoperative pain was assessed and the recurrence rate monitored. Postoperative pain was less in wedge resection/segmental phenolization group [8.4 +/- 12.4 h] than in wedge resection group [31 +/- 36.7 h. P < 0.001]. There were 9 recurrences in the wedge resection group [11%] and none in the wedge resection/segmental phenolization group. The results in the wedge resection/segmental phenolization group were statistically significant when compared with the wedge resection group [P < 0.01]. It is concluded that the combination procedure gives better long-term results than wedge resection alone and allows excellent results to be achieved by all grades of surgeon

Pachonychia congenita treated by nail ablation

A case of pachyonchia congenital treated by removal of nail plates and excision of the ventral nail beds is described

Diagnóstico e tratamento do tumor glômico da extremidade distal dos dedos da mäo / Diagnosis and treatment of glomus tumor of the distal extremity of the fingers

Vinte casos de tumor glômico, sendo 18 subungueais e dois na polpa digital, foram estudados em seus aspectos clínicos, tratamento e resultados. Esse material representa mais de 10% dos casos de tumor glômico subungueal descritos na literatura. Essas interessantes lesöes tumorais, que ocorrem principalmente em mulheres na quarta década de vida, näo säo habitualmente palpáveis e näo apresentam quadro radiológico importante, porém a sintomatologia dolorosa dos dedos, com dor à pressäo e exacerbada com o frio, é sugestiva dessa patologia. Após o tratamento cirúrgico, o único recomendado, os sintomas desapareceram