|
1
|
Bertanha L, Noriega LF, Di Chiacchio NG, Matter A, Di Chiacchio N. Differential diagnosis of pigmented nail lesions. An Bras Dermatol 2024; 99:799-814. [PMID: 39112289 PMCID: PMC11551238 DOI: 10.1016/j.abd.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/03/2024] [Accepted: 01/05/2024] [Indexed: 10/26/2024] Open
Abstract
The diagnosis of pigmented nail lesions is a concern for both general practitioners and dermatologists, due to the possibility of indicating nail melanoma. The origin of the dark pigmentation can be either melanocytic or non-melanocytic (fungi, bacteria, or blood), and clinical evaluation alone may not be sufficient for differentiation, requiring additional exams. Onychoscopy provides valuable information prior to biopsy. The causes of nail pigmentation will be described to aid in the differential diagnosis.
Collapse
Affiliation(s)
- Laura Bertanha
- Dermatology Service, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil; Dermatology Service, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
| | - Leandro Fonseca Noriega
- Dermatology Service, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil
| | - Nilton Gióia Di Chiacchio
- Dermatology Service, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil; Dermatology Service, Faculdade de Medicina do ABC, Santo André, SP, Brazil
| | - Adriana Matter
- Dermatology Service, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil; Dermatology Service, Hospital Santa Casa de Curitiba, Curitiba, PR, Brazil
| | - Nilton Di Chiacchio
- Dermatology Service, Hospital do Servidor Público Municipal de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
|
2
|
Iorizzo M, Vollono L, Richert B. Diagnosis and Management of Malignant Epithelial Nail Unit Tumors. Diagnostics (Basel) 2024; 14:2379. [PMID: 39518347 PMCID: PMC11545385 DOI: 10.3390/diagnostics14212379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 10/18/2024] [Accepted: 10/24/2024] [Indexed: 11/16/2024] Open
Abstract
Background: Malignant epithelial nail unit tumors pose significant diagnostic and therapeutic challenges due to their clinical presentation often mimicking benign conditions and due to the need to preserve as much nail unit function as possible during surgery. Early detection is crucial, even if none of these tumors represent a life-threatening disease. Objectives: This review focus on squamous cell carcinoma, verrucous carcinoma, eccrine porocarcinoma, onychocytic carcinoma, basal cell carcinoma, malignant onychopapilloma, malignant onycholemmal cyst and onycholemmal carcinoma. Methods: Existing literature on the aforementioned tumors has been revised and synthesized. Results: Clinical presentation, pathology, diagnostic procedures, risk factors and the challenges associated with surgical management have been described in detail. Conclusions: Malignant epithelial tumors of the nail unit require careful evaluation and management due to their complex presentation. Early detection and an informed surgical approach are essential to improve patient outcomes and minimize complications.
Collapse
Affiliation(s)
| | | | - Bertrand Richert
- Dermatology Department, Saint Pierre and Brugmann University Hospitals, Université Libre de Bruxelles, 1000 Brussels, Belgium;
| |
Collapse
|
|
3
|
Lallas A, Korecka K, Apalla Z, Sgouros D, Liopyris K, Argenziano G, Thomas L. Seven Plus One Steps to Assess Pigmented Nail Bands (Melanonychia Striata Longitudinalis). Dermatol Pract Concept 2023; 13:dpc.1304a204. [PMID: 37992383 PMCID: PMC10656147 DOI: 10.5826/dpc.1304a204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2023] [Indexed: 11/24/2023] Open
Abstract
Melanonychia striata longitudinalis might involve one or more fingers and/or toes and might result from several different causes, including benign and malignant tumors, trauma, infections, and activation of melanocytes that might be reactive or related to the pigmentary trait, drugs and some rare syndromes. This broad differential diagnosis renders the clinical assessment of melanonychia striata particularly challenging. Nail matrix melanoma is relatively rare, occurs almost always in adults involves more frequently the first toe or thumb. The most common nail unit cancer, squamous cell carcinoma / Bowen disease (SCC) of the nail matrix is seldom pigmented. Histopathologic examination remains the gold standard for melanoma and SCC diagnosis, but excisional or partial biopsies from the nail matrix require training and is not routinely performed by the majority of clinicians. Furthermore, the histopathologic evaluation of melanocytic lesions of the nail matrix is particularly challenging, since early melanoma has only bland histopathologic alterations. Dermatoscopy of the nail plate and its free edge significantly improves the clinical diagnosis, since specific patterns have been associated to each one of the causes of melanonychia. Based on knowledge generated and published in the last decades, we propose herein a stepwise diagnostic approach for melanonychia striata longitudinalis: 1) Hemorrhage first 2) Age matters 3) Number of nails matters 4) Free edge matters 5) Brown or gray? 6) Size matters 7) Regular or irregular and, finally, "follow back".
Collapse
Affiliation(s)
- Aimilios Lallas
- First Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Katarzyna Korecka
- Department of Dermatology, Heliodor Swiecicki Clinical Hospital, University of Medical Sciences, Poznan, Poland
| | - Zoe Apalla
- Second Dermatology Department, School of Medicine, Faculty of Health Sciences, Aristotle University, Thessaloniki, Greece
| | - Dimitrios Sgouros
- Second Department of Dermatology and Venereology, ATTIKON General University Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | | | - Giuseppe Argenziano
- Dermatology Unit, Department of Mentals and Physical Health and Preventive medicine, University of Campania Luigi Vanvitelli Naples, Napoli, Italy
| | - Luc Thomas
- Service de Dermatologie, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France; Université Claude-Bernard-Lyon Lyon, Lyon, France and Lyons cancer research center UMR INSERM U1052 - CNRS5286 - UCBL1 Lyon France
| |
Collapse
|
|
4
|
Grover C, Gaurav V, Sharma S, Sinha S. Pigmented Onychomatricoma Presenting as Pachymelanonychia Striata: A Case Report and Review of Literature. Skin Appendage Disord 2023; 9:366-372. [PMID: 37900774 PMCID: PMC10601889 DOI: 10.1159/000529820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 02/20/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Onychomatricoma is a fibroepithelial tumor derived from the nail matrix and onychodermis. Many clinical and histological variants have been described. Pigmented onychomatricoma is a rare variant which presents as longitudinal pachymelanonychia. Case Presentation We report the details of a 41-year-old female who presented with blackening and thickening involving more than half of the left middle fingernail for the past 10 years. Dorsal plate onychoscopy revealed longitudinal parallel white, gray, and black bands, while onychoscopy of the distal free edge demonstrated a thickened nail plate with "wood worm" cavities. The histopathological examination of the excised tumor revealed a pigmented onychomatricoma. Conclusions Onychomatricoma is one of the nail tumors presenting as pachyonychia striata apart from onychocytic matricoma and onychocytic carcinoma. A pigmented onychomatricoma may closely mimic fungal melanonychia, pigmented onychopapilloma, pigmented ungual Bowen's disease, and ungual melanoma. Noninvasive techniques like onychoscopy and imaging studies like ultrasonography and magnetic resonance imaging are helpful in differentiating it from pigmented ungual Bowen's disease and ungual melanoma, even though diagnostic confirmation requires an excisional biopsy.
Collapse
Affiliation(s)
- Chander Grover
- Department of Dermatology, University College of Medical Sciences/University of Delhi/Guru Teg Bahadur Hospital, Delhi, India
| | - Vishal Gaurav
- Department of Dermatology, University College of Medical Sciences/University of Delhi/Guru Teg Bahadur Hospital, Delhi, India
| | - Sonal Sharma
- Department of Pathology, University College of Medical Sciences/University of Delhi/Guru Teg Bahadur Hospital, Delhi, India
| | - Surabhi Sinha
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences/Indraprastha University/Ram Manohar Lohia Hospital, Delhi, India
| |
Collapse
|
|
5
|
Fonia A, Richert B. Onychalgia Causes and Mechanisms: The “GIFTED KID” and the “FOMITE”. Skin Appendage Disord 2020; 6:77-87. [DOI: 10.1159/000504347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/23/2019] [Indexed: 11/19/2022] Open
Abstract
This article gives an account of the commonest causes of nail pain. The acronyms GIFTED KID and FOMITE will help aid doctors in a busy clinical setting to remember the main causes of onychalgia, respectively, on the fingers and toes. It includes a brief overview of the clinical characteristics and focuses on the type of pain for each condition as well as the mechanisms that cause it.
Collapse
|
|
6
|
Leung AKC, Lam JM, Leong KF, Sergi CM. Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century. Int J Dermatol 2019; 58:1239-1245. [PMID: 31006857 DOI: 10.1111/ijd.14464] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/16/2019] [Accepted: 03/22/2019] [Indexed: 01/19/2023]
Abstract
Melanonychia striata is characterized by a tan, brown, or black longitudinal streak within the nail plate that runs from the proximal nail fold to the distal part of the nail plate. Melanonychia striata is due to increased activity of melanocytes or melanocytic hyperplasia in the nail matrix with subsequently increased melanin deposition in the nail plate. The most common cause of melanonychia striata associated with melanocytic activation is ethnic melanonychia which occurs in dark-skinned individuals. Other causes of melanonychia striata related to melanocytic activation include pregnancy, chronic local trauma, infections, medications, dermatological disorders, endocrine disorders, alkaptonuria, hemochromatosis, porphyria, graft-vs-host disease, Peutz-Jeghers syndrome, and Laugier-Hunziker syndrome. Causes of melanonychia striata associated with melanocytic hyperplasia include nail matrix melanocytic nevus, nail lentigo, and nail apparatus/subungual in situ and invasive melanoma. In most cases, melanonychia striata is a benign condition, especially in children. Consequently, most investigators advocate a wait-and-see approach. Nail apparatus/subungual melanoma should be suspected if there is an abrupt onset after middle age, personal or family history of melanoma, rapid growth, darkening of a melanonychia band, pigment variegation, blurry lateral borders, irregular elevation of the surface, a bandwidth >3 mm, proximal widening, associated nail plate dystrophy, single rather than multiple digit involvement, and periungual spread of pigmentation onto the adjacent cuticle and/or proximal and/or lateral nail folds (Hutchinson sign). Prolonged follow-up is mandatory for early detection of possible malignant changes.
Collapse
Affiliation(s)
- Alexander K C Leung
- University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Joseph M Lam
- Department of Pediatrics, Department of Dermatology and Skin Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kin Fon Leong
- Pediatric Institute, Kuala Lumpur General Hospital, Kuala Lumpur, Malaysia
| | - Consolato M Sergi
- Departments of Pediatrics, Laboratory Medicine, and Pathology, The University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
|
7
|
The Importance of Dermatoscopy for the Diagnosis of Melanonychia. CURRENT HEALTH SCIENCES JOURNAL 2019; 45:36-41. [PMID: 31297260 PMCID: PMC6592664 DOI: 10.12865/chsj.45.01.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 01/15/2019] [Indexed: 11/18/2022]
Abstract
Melanonychia is the brown or black color of the finger or toe nail due to melanin deposition or melanocytes in the nail plate. The evidence of melanocytic disease is made by the dermatoscope, which allows to highlight the anomalies of the plate. The purpose of our study was to evaluate dermatoscopically the melanonychia, both in the form of stain and longitudinal on finger and/or toe nails in order to establish the type of nail hyperpigmentation. MATERIALS AND METHOD 33 patients with longitudinal and stain melanonychia were examined with 30x Molemax HD computerized dermatoscope between May 2017-septembre 2018 in this prospective study conducted in the Department of Dermatology of Medical Center Dr. Ianosi (Craiova, Romania). Clinical data included: type of melanonychia, number and name of involved fingers, the presence or absence of fungal infections, nail apparatus tumors or hemorrhage. RESULTS The most frequent nail diagnosis was fungal infection (onychomycosis) observed in 18 patients (54.54%), malignant melanoma was diagnosed in 1 patient (3.03%) and the junctional nevus in 4 patients (12.12%). In 18 patients which has longitudinal melanonychia, the most frequent involved finger was the big toe, and in 15 patients which has stain melanonychia, all of them (100%) had affected the big toe, 7 (46.66%) patients had affected the thumb and the same percent the forth finger. CONCLUSION Nail dermatoscopy is an important method in establishing the diagnosis of melanonychia and allowed to avoid unnecessary biopsy for melanonychia.
Collapse
|
|
8
|
Haenssle HA, Fink C, Stolz W, Braun RP, Hofmann-Wellenhof R, Deinlein T, Kreusch J, Zalaudek I, Blum A. Dermatoskopie in Sonderlokalisationen. Hautarzt 2019; 70:295-311. [DOI: 10.1007/s00105-019-4372-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
|
9
|
Duan N, Zhang YH, Wang WM, Wang X. Mystery behind labial and oral melanotic macules: Clinical, dermoscopic and pathological aspects of Laugier-Hunziker syndrome. World J Clin Cases 2018; 6:322-334. [PMID: 30283795 PMCID: PMC6163135 DOI: 10.12998/wjcc.v6.i10.322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/28/2018] [Accepted: 07/23/2018] [Indexed: 02/05/2023] Open
Abstract
Labial and oral melanotic macules are commonly encountered in a broad range of conditions ranging from physiologic pigmentation to a sign of an underlying life-threatening disease. Although Laugier-Hunziker syndrome (LHS) shares some features of labial and oral pigmentation with a variety of conditions, it is a benign and acquired condition, frequently associated with longitudinal melanonychia. Herein, the demographic, clinical, dermoscopic, and pathological aspects of LHS were reviewed comprehensively. The important differential diagnoses of mucocutaneous and nail pigmentation are provided. An accurate diagnosis is crucial to design a reasonable medical strategy, including management options, malignant transformation surveillance, and psychological support. It is important that clinicians conduct long-term follow-up and surveillance due to the potential risks of malignant transformation and local severe complications in some conditions.
Collapse
Affiliation(s)
- Ning Duan
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Yang-Heng Zhang
- Department of Periodontology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Wen-Mei Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| | - Xiang Wang
- Department of Oral Medicine, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, Jiangsu Province, China
| |
Collapse
|
|
10
|
Starace M, Alessandrini A, Dika E, Piraccini BM. Squamous cell carcinoma of the nail unit. Dermatol Pract Concept 2018; 8:238-244. [PMID: 30116671 PMCID: PMC6092066 DOI: 10.5826/dpc.0803a17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Accepted: 02/28/2018] [Indexed: 10/31/2022] Open
Abstract
Squamous cell carcinoma (SCC) of the nail apparatus is a rare malignant tumor that usually originates underneath the nail plate and grows slowly with possible bone invasion. The etiology remains unknown, although a strong association with different conditions, such as high-risk human papillomavirus (HPVs), trauma, or radiation exposure has been demonstrated. Nail SCC is called "the great mimicker nail tumor" because different clinical presentations may coexist, resembling benign or malignant nail lesions. For this reason, there is often a significant delay between the onset of nail SCC and the diagnosis. Clinical manifestation includes onycholysis and erythema, while in the advanced stages nail ulceration can be observed. The association with pain, swelling, and inflammation usually indicates an invasive SCC with involvement of the underlying bone. Metastasis is rare but possible with involvement of lymph nodes. A multidisciplinary approach to assessment, management, and follow-up is advised. Using careful examination and modern diagnostic methods, including onychoscopy, biopsy, and histopathology, will help identify SCC and prevent the invasive progression. X-ray is important to investigate the bone invasion to determine the best surgical approach that will have satisfying cosmetic and functional outcomes. Nevertheless, local excision with sufficient surgical margins, best if using Mohs surgery, is usually sufficient and superior to amputation of the distal phalanx. This review aims to highlight the correct approach in suspected SCC of the nail unit.
Collapse
Affiliation(s)
- Michela Starace
- Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Aurora Alessandrini
- Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Emi Dika
- Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Department of Specialized, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| |
Collapse
|
|
11
|
Dermoscopy as a first step in the diagnosis of onychomycosis. Postepy Dermatol Alergol 2018; 35:251-258. [PMID: 30008642 PMCID: PMC6041705 DOI: 10.5114/ada.2018.76220] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/17/2017] [Indexed: 02/06/2023] Open
Abstract
Introduction Over the years, clinical studies have provided new knowledge about the dermoscopic features of the diseases of cutaneous annexes. It seems that dermoscopy has opened a new morphological dimension in the diagnosis and management of hair disorders and onychopathies. Aim To identify and describe dermoscopic features of onychomycosis. Material and methods A total of 81 consecutive patients with onychomycosis (55 men and 26 women) were prospectively enrolled in the present study. For each patient, all fingernails and toenails were evaluated in clinical and dermoscopic examinations. Mycological tests were performed by potassium hydroxide (KOH) preparation. Mann-Whitney U and χ2 tests were used for the statistical analysis, with a significance threshold of p < 0.05. Results Dermoscopic examination of the patients' nails revealed the following: jagged proximal edge with spikes of the onycholytic area (51.9%), longitudinal streaks and patches (44.4%), subungual hyperkeratosis (27.2%), brown-black pigmentation (9.9%) and leukonychia (1.2%). Jagged proximal edge, subungual hyperkeratosis and leukonychia were positively associated with the onychomycosis type. Conclusions Onychomycosis accounts for up to 50% of all consultations for onychopathies. Fast and effective diagnostic approaches are needed in everyday clinical practice. Dermoscopy can provide immediate and accurate information in the diagnosis of onychomycosis. We suggest that dermoscopy should be taken as a first step toward the diagnosis of onychomycosis.
Collapse
|
|
12
|
Onychophagia Induced Melanonychia, Splinter Hemorrhages, Leukonychia, and Pterygium Inversum Unguis Concurrently. Case Rep Dermatol Med 2018; 2018:3230582. [PMID: 29666714 PMCID: PMC5831699 DOI: 10.1155/2018/3230582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 12/28/2017] [Indexed: 12/02/2022] Open
Abstract
Onychophagia, which refers to compulsive nail-biting behavior, is common among children and young adults. Onychophagia can cause destruction to the cuticle and nail plate, leading to shortening of nails, chronic paronychia, and secondary infections. Relatively uncommon effects include pigmentary changes, such as longitudinal melanonychia and splinter hemorrhages. We report a case of a young adult with longitudinal melanonychia, splinter hemorrhages, punctate leukonychia, and pterygium inversum unguis, concurrently induced by onychophagia. Importantly, patients usually do not report this behavior when asked about nail-related changes. Even upon questioning, they may deny nail-biting behavior. As in many other dermatological disorders, dermoscopy can be helpful in the diagnosis of nail disorders.
Collapse
|
|
13
|
Blum A, Kreusch J, Stolz W, Argenziano G, Forsea AM, Marmol V D, Zalaudek I, Soyer HP, Haenssle HA. Stellenwert der Dermatoskopie in Deutschland - Ergebnisse aus der Pan-Euro-Dermoscopy-Querschnittsstudie. J Dtsch Dermatol Ges 2018; 16:174-182. [PMID: 29418098 DOI: 10.1111/ddg.13431_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Wilhelm Stolz
- Klinik für Dermatologie II, Klinik Thalkirchner Straße, München, Deutschland
| | | | - Ana-Maria Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Rumänien
| | - Del Marmol V
- Dermatology Department, Université Libre de Bruxelles, Hôpital Erasme, Brussels, Belgien
| | - Iris Zalaudek
- Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Graz, Österreich
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australien
| | | |
Collapse
|
|
14
|
Blum A, Kreusch J, Stolz W, Argenziano G, Forsea AM, Marmol V D, Zalaudek I, Soyer HP, Haenssle HA. The status of dermoscopy in Germany - results of the cross-sectional Pan-Euro-Dermoscopy Study. J Dtsch Dermatol Ges 2018; 16:174-181. [PMID: 29384261 DOI: 10.1111/ddg.13431] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 08/12/2017] [Indexed: 01/20/2023]
Abstract
BACKGROUND Survey on the current status of dermoscopy in Germany. METHODS In the context of a pan-European internet-based study (n = 7,480) conducted by the International Dermoscopy Society, 880 German dermatologists were asked to answer questions with respect to their level of training as well as their use and perceived benefit of dermoscopy. RESULTS Seven hundred and sixty-two (86.6 %) participants practiced dermatology in a publicly funded health care setting; 98.4 % used a dermoscope in routine clinical practice. About 93 % (n = 814) stated to have had more than five years of experience in the use of dermoscopy. Dermoscopy was considered useful in the diagnosis of melanoma by 93.6 % (n = 824); for pigmented skin tumors, by 92.4 % (n = 813); in the follow-up of melanocytic lesions, by 88.6 % (n = 780); for non-pigmented lesions, by 71.4 % (n = 628), in the follow-up of non-melanocytic lesions, by 52.7 % (n = 464); and for inflammatory skin lesions, by 28.5 % (n = 251). Overall, 86.5 % (n = 761) of participants felt that - compared to naked-eye examination - dermoscopy increased the number of melanomas diagnosed; 77,7 % (n = 684) considered the number of unnecessary excisions of benign lesions to be decreased. Participants who personally felt that dermoscopy improved their ability to diagnose melanoma were significantly i) younger, ii) had been practicing dermatology for a shorter period of time, iii) were less commonly employed by an university-affiliated dermatology department, iv) were more frequently working in an office-based public health care setting, and v) had more frequently been trained in dermoscopy during their dermatology residency. CONCLUSIONS The findings presented herein ought to be integrated into future residency and continuing medical education programs with the challenge to improve dermato-oncological care and to expand the diagnostic spectrum of dermoscopy to include inflammatory skin diseases.
Collapse
Affiliation(s)
- Andreas Blum
- Dermatology Practice and Teaching Facility, Konstanz, Germany
| | | | - Wilhelm Stolz
- Department of Dermatology II, Medical Center Thalkirchner Straße, Munich, Germany
| | | | - Ana-Maria Forsea
- Dermatology Department, Elias University Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Del Marmol V
- Dermatology Department, Université Libre de Bruxelles, Hôpital Erasme, Brussels, Belgium
| | - Iris Zalaudek
- Department of Dermatology and Venereology, Graz Medical University, Graz, Austria
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland, School of Medicine, Translational Research Institute, Brisbane, Australia
| | - Holger A Haenssle
- Department of Dermatology, University Medical Center, Heidelberg, Germany
| |
Collapse
|
|
15
|
Chelidze K, Lipner SR. Nail changes in alopecia areata: an update and review. Int J Dermatol 2018; 57:776-783. [DOI: 10.1111/ijd.13866] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 11/11/2017] [Accepted: 11/12/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Khatiya Chelidze
- Department of Dermatology; Weill Cornell Medicine; New York NY USA
| | - Shari R. Lipner
- Department of Dermatology; Weill Cornell Medicine; New York NY USA
| |
Collapse
|
|
16
|
Burkink E, Abdul Hamid M, Martens H. "Dots and lines": A melanonychia striata in regression: Report of a case. Pediatr Dermatol 2017; 34:e321-e323. [PMID: 28967148 DOI: 10.1111/pde.13274] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A 2-year-old Caucasian boy with melanonychia striata with multiple striking pits on the nail plate of one fingernail is described. Nail disorders often pose diagnostic and therapeutic challenges for clinicians, especially melanonychia striata, because of the fear of a subungual melanoma. Only a few childhood cases of melanonychia striata have been described, and the multiple pits are even less common. Dots distributed along melanotic lines is a finding referred to as "dots and lines" and can be a sign of regression of melanonychia in childeren.
Collapse
Affiliation(s)
- Esther Burkink
- Department of Dermatology, Maastricht Universitair Medisch Centrum, Maastricht, The Netherlands
| | - Myrurgia Abdul Hamid
- Department of Pathology, Maastricht Universitair Medisch Centrum, Maastricht, The Netherlands
| | - Herm Martens
- Department of Dermatology, Maastricht Universitair Medisch Centrum, Maastricht, The Netherlands
| |
Collapse
|
|
17
|
Ohn J, Choe YS, Park J, Mun JH. Dermoscopic patterns of fungal melanonychia: A comparative study with other causes of melanonychia. J Am Acad Dermatol 2017; 76:488-493.e2. [DOI: 10.1016/j.jaad.2016.08.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Revised: 08/03/2016] [Accepted: 08/08/2016] [Indexed: 10/20/2022]
|
|
18
|
Abstract
This group of biologically diverse entities is united by topographic localization to the hands and feet. Categorizing tumors by body site narrows the differential into a short list of possibilities that can facilitate accurate and rapid diagnosis. The goal of this review is to provide a practical approach to soft tissue tumors of acral locations for clinicians, pathologists, and researchers alike. What ensues in the following text is that tight coupling of the clinical picture and histopathologic findings should produce the correct diagnosis, or at least an abbreviated differential. The salient clinicopathologic, immunohistochemical, and molecular features are presented alongside current treatment recommendations for each entity.
Collapse
Affiliation(s)
- Kristen M Paral
- Section of Dermatology, University of Chicago Pritzker School of Medicine, Chicago, IL
| | - Vesna Petronic-Rosic
- Section of Dermatology, University of Chicago Pritzker School of Medicine, Chicago, IL.
| |
Collapse
|
|
19
|
Ohn J, Choe YS, Mun JH. Dermoscopic features of nail matrix nevus (NMN) in adults and children: A comparative analysis. J Am Acad Dermatol 2016; 75:535-540. [DOI: 10.1016/j.jaad.2016.03.043] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 03/27/2016] [Accepted: 03/30/2016] [Indexed: 10/21/2022]
|
|
20
|
Kamyab K, Abdollahi M, Nezam-Eslami E, Nikoo A, Balighi K, Naraghi ZS, Daneshpazhooh M. Longitudinal melanonychia in an Iranian population: a study of 96 patients. Int J Womens Dermatol 2016; 2:49-52. [PMID: 28492005 PMCID: PMC5412111 DOI: 10.1016/j.ijwd.2016.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 03/04/2016] [Accepted: 03/07/2016] [Indexed: 12/04/2022] Open
Abstract
Background Longitudinal melanonychia (LM) can be a challenging sign since it may be caused by a wide variety of benign and malignant conditions. Cutaneous melanoma is the most important cause of LM. Objective: We performed this study to examine different aspects of LM in Iran, where cutaneous melanoma is rare. Methods In this cross-sectional study, we reviewed medical records and pathology reports of a total of 96 patients presenting with LM. These patients had been visited and undergone nail biopsy in Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran. Demographic, clinical, and pathological data were recorded. Results The most common diagnosis was junctional nevi in 28 patients (29.2%) followed by melanoma in 19 patients (19.8%). Patients had a mean age of 42.4 years (± 19.4). The mean ages in the groups with junctional nevi and melanoma were 33.3 (± 19.5) and 51.9 (± 17.8), respectively; their difference was statistically significant (P value = 0.001). Hutchinson’s sign was present in 10 patients, 9 of which had melanoma. Also, melanoma was only observed in patients presenting with a solitary nail lesion. Nails mostly affected by melanoma were middle fingers of the hands (7 patients) and thumbs (6 patients). Out of 18 patients with nail dystrophy, 13 (72.2%) were diagnosed with melanoma. Limitations Only patients who have undergone biopsy were studied. Conclusion Melanoma is an important cause of LM in Iranian patients and should especially be suspected in older patients who present with a solitary nail lesion on their middle finger or thumb. Other findings that direct us toward melanoma are presence of Hutchinson’s sign and nail dystrophy.
Collapse
Affiliation(s)
- Kambiz Kamyab
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Abdollahi
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Elaheh Nezam-Eslami
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences Tehran, Iran
| | - Azita Nikoo
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamran Balighi
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences Tehran, Iran
| | - Zahra S Naraghi
- Department of Dermatopathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences Tehran, Iran.,Autoimmune Bullous Diseases Research Center, Tehran University of Medical Sciences
| |
Collapse
|
|
21
|
Wollina U. Bowen's disease of the nail apparatus: a series of 8 patients and a literature review. Wien Med Wochenschr 2015; 165:401-5. [PMID: 26376982 DOI: 10.1007/s10354-015-0383-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 08/11/2015] [Indexed: 10/23/2022]
Abstract
Bowen's disease of the nail apparatus is uncommon. Since often characteristic clinical features are missing, diagnosis and treatment are delayed. We have analyzed our patients' files from January 2001 to July 2015 for this disorder. We identified eight patients with Bowen's disease of the nail apparatus, six male and two female individuals. Fingers were more often affected than toes. The disease does not respect the anatomical borders of the nail apparatus. Therefore, we performed delayed Mohs surgery with skin grafts in seven patients and with second intention healing in one patient. Two relapses were noted but only one ate the same digit. Since relapses occurred after 2-3 years, a follow-up of such patients seems justified.
Collapse
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Friedrichstrasse 41, 01067, Dresden, Germany.
| |
Collapse
|