Subungual melanoma, a relatively uncommon disease, has a worse prognosis than cutaneous melanoma in other sites. Both this life-threatening disease and its treatment cause cosmetic and functional impairment to the pat...Subungual melanoma, a relatively uncommon disease, has a worse prognosis than cutaneous melanoma in other sites. Both this life-threatening disease and its treatment cause cosmetic and functional impairment to the patient. The diagnosis is often delayed and resulting an advanced disease at presentation. The important clinical manifestation, diagnosis and latest treatments for subungual melanoma are reviewed. Electronic databases of Medline, PubMed, and the Cochrane library were searched with the key word “subungual melanoma”. A clinical scoring system is proposed by the authors to stratify patients to undergo biopsy, making earlier diagnosis of this disease possible. The latest trend of treatment involves wide local excision at a more distal level of the affected digit, in contrast to radical amputation of the digit in the past. Studies have shown that this does not decrease the survival nor increase local recurrence, but reduces the functional impairment for the patient. This review aims to summarise the approach to subungual melanoma for clinicians, so that they can recognise and diagnose this disease early and generate the best functional and cosmetic outcome for the patients.展开更多
Background: We examined 94 toenails exhibiting clinical signs of severe onychomycosis taking into account multiple contributing factors, not the least of which was Subungual Osteochondroma Deformans (SOD). We hypothes...Background: We examined 94 toenails exhibiting clinical signs of severe onychomycosis taking into account multiple contributing factors, not the least of which was Subungual Osteochondroma Deformans (SOD). We hypothesize that SOD plays a significant role in both the etiology and treatment of onychomycosis. Methods/Results: A retrospective post-treatment outcome analysis was performed comparing two groups of severely mycotic toenails. The first group of 25 fungal nails showed 54.31% improvement following treatment by both surgical nail avulsion and a 1064 YAG laser-based Nail Restoration algorithm. The second group of 69 fungal nails was not only treated using the same nail avulsion/laser-based algorithm but was also evaluated for SOD lesions which were surgically removed when present, resulting in 95.31% improvement. The overall incidence of SOD lesions in the second group of severely mycotic toenails was 73.91%. Conclusion: We submit that at 73.91% Subungual Osteochondroma Deformans has an under-reported and under-appreciated association with toenail fungus. Generally, we find that our success rates in treating severe toenail fungus using our laser-based Nail Restoration Protocols are much higher when SOD lesions are surgically removed.展开更多
目的:探究甲板翻页式甲床入路手术切除甲下血管球瘤的临床疗效。方法:回顾性分析2019年5月至2023年7月经甲板翻页式甲床入路术式切除瘤体的11例甲下血管球瘤患者的临床资料。数字疼痛评分量表(numeric pain rating scale,NRS)评估疼痛程...目的:探究甲板翻页式甲床入路手术切除甲下血管球瘤的临床疗效。方法:回顾性分析2019年5月至2023年7月经甲板翻页式甲床入路术式切除瘤体的11例甲下血管球瘤患者的临床资料。数字疼痛评分量表(numeric pain rating scale,NRS)评估疼痛程度,并在手术前、后使用改良指甲银屑病问卷(nail psoriasis quality of life questionnaire,NPQ10)评估患者的生活质量(quality of life,QoL)。结果:术后6个月NRS评分较术前降低,差异有统计学意义(W=-55.00,P<0.01),术后QoL较术前提高,差异有统计学意义(W=-66.00,P<0.01)。术后甲板无明显畸形,肿瘤均无复发。结论:甲板翻页式甲床入路手术切除法可有效去除瘤体、改善疼痛并提高QoL。展开更多
Introduction Subungual exostosis (SE) is a clinically rare benign bone tumor that develops underneath or beside the nail bed.SE can occur in any finger or toe,but it is most common at the distal phalanx of the hallux,...Introduction Subungual exostosis (SE) is a clinically rare benign bone tumor that develops underneath or beside the nail bed.SE can occur in any finger or toe,but it is most common at the distal phalanx of the hallux,accounting for about 70%-80% of cases.1 Patients generally have no subjective symptoms and often seek medical care for secondary infection or nail plate deformation.Because of its special location,SE is liable to be misdiagnosed as a subungual wart or other nail-related lesion.We herein report a case of SE in a patient,who was misdiagnosed as a subungual wart,in order to improve the knowledge of clinician to SE.展开更多
文摘Subungual melanoma, a relatively uncommon disease, has a worse prognosis than cutaneous melanoma in other sites. Both this life-threatening disease and its treatment cause cosmetic and functional impairment to the patient. The diagnosis is often delayed and resulting an advanced disease at presentation. The important clinical manifestation, diagnosis and latest treatments for subungual melanoma are reviewed. Electronic databases of Medline, PubMed, and the Cochrane library were searched with the key word “subungual melanoma”. A clinical scoring system is proposed by the authors to stratify patients to undergo biopsy, making earlier diagnosis of this disease possible. The latest trend of treatment involves wide local excision at a more distal level of the affected digit, in contrast to radical amputation of the digit in the past. Studies have shown that this does not decrease the survival nor increase local recurrence, but reduces the functional impairment for the patient. This review aims to summarise the approach to subungual melanoma for clinicians, so that they can recognise and diagnose this disease early and generate the best functional and cosmetic outcome for the patients.
文摘Background: We examined 94 toenails exhibiting clinical signs of severe onychomycosis taking into account multiple contributing factors, not the least of which was Subungual Osteochondroma Deformans (SOD). We hypothesize that SOD plays a significant role in both the etiology and treatment of onychomycosis. Methods/Results: A retrospective post-treatment outcome analysis was performed comparing two groups of severely mycotic toenails. The first group of 25 fungal nails showed 54.31% improvement following treatment by both surgical nail avulsion and a 1064 YAG laser-based Nail Restoration algorithm. The second group of 69 fungal nails was not only treated using the same nail avulsion/laser-based algorithm but was also evaluated for SOD lesions which were surgically removed when present, resulting in 95.31% improvement. The overall incidence of SOD lesions in the second group of severely mycotic toenails was 73.91%. Conclusion: We submit that at 73.91% Subungual Osteochondroma Deformans has an under-reported and under-appreciated association with toenail fungus. Generally, we find that our success rates in treating severe toenail fungus using our laser-based Nail Restoration Protocols are much higher when SOD lesions are surgically removed.
文摘目的:探究甲板翻页式甲床入路手术切除甲下血管球瘤的临床疗效。方法:回顾性分析2019年5月至2023年7月经甲板翻页式甲床入路术式切除瘤体的11例甲下血管球瘤患者的临床资料。数字疼痛评分量表(numeric pain rating scale,NRS)评估疼痛程度,并在手术前、后使用改良指甲银屑病问卷(nail psoriasis quality of life questionnaire,NPQ10)评估患者的生活质量(quality of life,QoL)。结果:术后6个月NRS评分较术前降低,差异有统计学意义(W=-55.00,P<0.01),术后QoL较术前提高,差异有统计学意义(W=-66.00,P<0.01)。术后甲板无明显畸形,肿瘤均无复发。结论:甲板翻页式甲床入路手术切除法可有效去除瘤体、改善疼痛并提高QoL。
文摘Introduction Subungual exostosis (SE) is a clinically rare benign bone tumor that develops underneath or beside the nail bed.SE can occur in any finger or toe,but it is most common at the distal phalanx of the hallux,accounting for about 70%-80% of cases.1 Patients generally have no subjective symptoms and often seek medical care for secondary infection or nail plate deformation.Because of its special location,SE is liable to be misdiagnosed as a subungual wart or other nail-related lesion.We herein report a case of SE in a patient,who was misdiagnosed as a subungual wart,in order to improve the knowledge of clinician to SE.
