Common diseases of the nail: Diagnosis and therapy.

This review focuses on nail changes that do not belong to the group of benign or malignant nail tumors. These common afflictions of the nail include structural changes in and under the nail plate as well as inflammation around and in the nail bed. They include onychomycoses, nail psoriasis, onychodystrophies, subungual hematoma, paronychia, ingrown nails and pincer nails. Due to the peculiar anatomy and physiological growth conditions of the nail, the pathology does not necessarily stem from the site of the clinical problem and calls for careful inspection and interpretation.

Three-dimensional localization of sentinel lymph nodes using combined emission and transmission SPECT data.

PURPOSE: With conventional planar imaging, preoperative anatomic localization of a sentinel lymph node is possible in only two dimensions. To improve spatial localization of sentinel lymph nodes, a dual-head camera equipped with a transmission source was used to create combined transmission-emission SPECT images in a patient with a malignant melanoma of the left forearm. METHODS: Lymph node scintigraphy was performed after injection of Tc-99m-labeled nanocolloid around the tumor site 1 day before operation. SPECT was performed using a gamma camera equipped with a transmission collimator system originally designed to correct attenuation. Transmission and emission images were created simultaneously, matched, and displayed in three dimensions. RESULTS: In the combined emission-transmission images, the sentinel lymph node was clearly located in the left axilla. The lymph nodes could be identified during operation at the same location as that detected by SPECT. Based on preoperative information, the sentinel lymph node was identified rapidly and the extent and duration of the operation were minimized. CONCLUSIONS: This method provides better anatomic information, especially in deep structures such as the axilla or pelvis. With accurate three-dimensional preoperative information, intraoperative access is quicker and less invasive for the patient.