RESUMO
BACKGROUND: Malalignment of the great toenails is a common nail disorder that is uncommonly recognized in general practice. OBJECTIVE: Review available literature on lateral malalignment of the great toenails to increase awareness of this underdiagnosed condition and provide management recommendations. METHODS: A PubMed search was conducted using the terms "congenital malalignment toenail" and "malalignment great toenail". All articles were reviewed, and all relevant articles were included in this analysis. RESULTS: Thirty-four distinct articles encompassing 117 patients with similar clinical findings: lateral deviation of the great toenails with yellow brown dyschromia, thickening, and scalloping. LIMITATIONS: Description of malalignment and terminology can vary, which may have led to exclusion of some relevant articles. CONCLUSION: Lateral malalignment is a common nail condition that is underappreciated and often misdiagnosed in general dermatologic and medical practice. This review aims to increase awareness to facilitate better care of these patients.
RESUMO
BACKGROUND: Dermatologists specialize in treating conditions of the skin, hair, and nails; however, it is our experience that the field of nail diseases is the least discussed facet of dermatology. Even less acknowledged is the complexity of nail procedures and how best to accurately code for these procedures. OBJECTIVE: To convene a panel of experts in nail disease to reach consensus on the most accurate and appropriate Current Procedural Terminology (CPT) codes associated with the most commonly performed nail procedures. METHODS: A questionnaire including 9 of the most commonly performed nail procedures and potential CPT codes was sent to experts in the treatment of nail disease, defined as those clinicians running a nail subspecialty clinic and performing nail procedures with regularity. A conference call was convened to discuss survey results. RESULTS: Unanimous consensus was reached on the appropriate CPT codes associated with all discussed procedures. LIMITATIONS: Although this article details the most commonly performed nail procedures, many were excluded and billing for these procedures continues to be largely subjective. This article is meant to serve as a guide for clinicians but should not be impervious to interpretation in specific clinical situations. CONCLUSION: Billing of nail procedures remains a practice gap within our field. The authors hope that the expert consensus on the most appropriate CPT codes associated with commonly performed nail procedures will aid clinicians as they diagnose and treat disorders of the nail unit and encourage accurate and complete billing practices.
Assuntos
Current Procedural Terminology , Procedimentos Cirúrgicos Dermatológicos/economia , Dermatologia/normas , Doenças da Unha/economia , Lacunas da Prática Profissional/estatística & dados numéricos , Consenso , Procedimentos Cirúrgicos Dermatológicos/normas , Dermatologistas/estatística & dados numéricos , Dermatologia/economia , Humanos , Doenças da Unha/cirurgia , Unhas/cirurgia , Lacunas da Prática Profissional/economia , Inquéritos e Questionários/estatística & dados numéricosAssuntos
Traumatismos do Nervo Facial/etiologia , Paralisia Facial/etiologia , Cirurgia de Mohs/efeitos adversos , Complicações Pós-Operatórias/etiologia , Retalhos Cirúrgicos/efeitos adversos , Idoso , Carcinoma Basocelular/cirurgia , Bochecha/inervação , Traumatismos do Nervo Facial/diagnóstico , Paralisia Facial/diagnóstico , Feminino , Humanos , Recidiva Local de Neoplasia/cirurgia , Complicações Pós-Operatórias/diagnóstico , Neoplasias Cutâneas/cirurgia , Retalhos Cirúrgicos/transplante , Fatores de TempoRESUMO
Successful nail surgery requires an understanding of specific disease processes, the anatomy of the nail unit, and fluency with only a few key techniques. This article focuses on 6 high-yield procedures, facility with which will allow the clinician to approach most of the clinical scenarios requiring surgical intervention. These encompass surgical approaches to inflammatory nail diseases, melanonychia, erythronychia, and nail melanoma in situ.
Assuntos
Melanoma , Doenças da Unha , Neoplasias Cutâneas , Humanos , Melanoma/cirurgia , Doenças da Unha/cirurgia , Unhas/cirurgia , Neoplasias Cutâneas/cirurgiaAssuntos
Docetaxel/efeitos adversos , Unhas Encravadas/diagnóstico , Unhas/efeitos dos fármacos , Neoplasias da Próstata/tratamento farmacológico , Moduladores de Tubulina/efeitos adversos , Idoso , Humanos , Masculino , Unhas/crescimento & desenvolvimento , Unhas/cirurgia , Unhas Encravadas/induzido quimicamente , Unhas Encravadas/cirurgia , Dedos do Pé , Resultado do TratamentoRESUMO
Petroleum jelly has long been a favorite treatment option of dermatologists for atopic dermatitis, despite complaints of "greasiness" by patients and their parents. Here, we describe a simple application method that effectively traps moisture against the skin while leaving behind only a thin layer of product, thus eliminating the "greasiness" associated with petroleum jelly.