How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

298 results for

Subungual Melanoma

by
...
Latest & greatest
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

181. Hand, Tumors: Benign

. [ ] Leiomyosarcoma In a recent report by Fu et al, a leiomyosarcoma of the cephalic vein was described. [ ] The report states that leiomyosarcomas of veins develop 5 times more frequently in veins than in arteries. [ ] Previous Next: Conclusion Importantly, recognize systemic processes that cause benign lesions of the hand. These can include , , and xanthomatosis from . Additional tumors of the hand include carpometacarpal bossing, anomalous extensor manus brevis muscle, or extensor . Subungual melanomas may (...) only be distinguished from subungual hematomas with a biopsy specimen examination. Keratoacanthomas are rapidly expanding and changing skin lesions with a central keratin plug that superficially appears volcanolike. Histologically, these benign skin lesions, which eventually regress, may be confused with . Previous References Athanasian EA. Principles of diagnosis and management of musculoskeletal tumors. Green DP, Hotchkiss RN, eds. Green's Operative Hand Surgery . 3rd ed. New York, NY: Churchill

2014 eMedicine Surgery

182. Hand, Tumors: Malignant

location (T), lymph nodes involvement (N), presence of metastases (M), and histologic grade (G) in case of sarcomas. Previous Next: Primary Malignant Tumors - Cutaneous The skin is by far the most common site for malignant tumors of the hand. In order of decreasing incidence, squamous cell carcinoma (SCC), basal cell carcinoma (BCC), basosquamous cell carcinoma, and melanoma account for 90% of primary malignant tumors of the hand. Other malignant skin lesions include dermatofibrosarcoma protuberans (...) , Kaposi sarcoma, sweat gland tumors, and Merkel cell carcinoma. For more information on these and other skin cancers, see Medscape’s . Squamous cell carcinoma (SCC) is the most common primary malignant tumor of the hand, accounting for 75-90% of hand malignancies. Risk factors include solar radiation, ionizing radiation, chronic inflammation, immunosuppression, xeroderma pigmentosa, Bowen disease, leukoplakia, human papillomavirus, and smoking. Clinical presentation ranges from small hyperkeratotic

2014 eMedicine Surgery

183. Hand, Finger Nail and Tip Injuries

are preferred for larger thumb defects that cannot be reconstructed with the Moberg flap. The flap is harvested superficial to the paratenon of the dorsum of the finger to allow for skin grafting of the donor. Nail Bed Repairs Subungual hematomas result from the disruption of nail bed vessels. In the short term, even small hematomas can cause severe pain, requiring treatment with trephination. In performing nail trephination, a hole can be fashioned in the nail plate with cautery, a heated paper clip (...) of the flexor and extensor tendons on the distal phalanx. From the periosteum of the distal phalanx, fibrous septae anchor the skin and palmar pulp to the bone. The volar pulp is also stabilized by the Grayson and Cleland ligaments, extending from the flexor sheath and distal phalanx volar and dorsal to the neurovascular bundles, respectively. The volar surface of the fingertips contains grooves and ridges, uniquely patterned for each individual, termed fingerprints. The digital arteries and nerves arborize

2014 eMedicine Surgery

184. Dermatologic Manifestations of Hematologic Disease (Follow-up)

, purpura, ecchymoses, painful skin nodules, and subungual splinter hemorrhages. Livedo reticularis is a presenting sign in up to 40% of patients with the diagnosis of SLE. [ ] Skin changes defined as livedo reticularis are violaceous, red or blue, reticular, or mottled pattern of the skin of the arms, legs, and the trunk. They are not reversible with rewarming. [ ] Noninflammatory vascular thrombosis is the most frequent finding in skin lesions of patients with antiphospholipid syndrome. Differential (...) patients), increased skin pigmentation (5 patients), and squamous cell cancer (2 patients). Other manifestations include alopecia (rare), facial and peripheral edema, gangrene, nail and/or skin atrophy, scaling, and violet papules. Previous Next: Leukemia Overview In leukemia, specific or nonspecific lesions of the skin may occur. Specific lesions ( ) contain leukemia cells, which directly infiltrate the epidermis, dermis, or subcutaneous fat. Nonspecific lesions, which are more common, are considered

2014 eMedicine.com

185. Dermatologic Manifestations of Cardiac Disease (Follow-up)

be used in facilitating a diagnosis of the underlying cardiac disease. For example, the diagnosis of acute rheumatic fever in patients presenting with acute carditis includes 2 skin signs out of the 5 classic Jones criteria (ie, arthritis, carditis, erythema marginatum, subcutaneous nodules, and chorea). [ ] Certain congenital cardiac defects are associated with unique skin manifestations, such as coarctation of the aorta associated with external features of Turner syndrome or atrioventricular (AV (...) ) septal defects associated with skin features of Down syndrome. In some patients, the dermatologic manifestations represent a component of a full systemic or vascular disorder that also involves defects in the cardiovascular system as another accompanying component. Advanced medical and invasive therapies have led to recognition of many new dermatologic manifestations, for example, angioedema from ACE inhibitors, ankle swelling due to calcium channel blockers, or radiation skin burns following

2014 eMedicine.com

186. Dermoscopy (Follow-up)

of pigmented skin lesions and, especially, in the identification of the early phase of cutaneous malignant melanoma. Dermoscopy is a noninvasive method that allows the in vivo evaluation of colors and microstructures of the epidermis, the dermoepidermal junction, and the papillary dermis not visible to the naked eye. These structures are specifically correlated to histologic features. The identification of specific diagnostic patterns related to the distribution of colors and dermoscopy structures can (...) better suggest a malignant or benign pigmented skin lesion. The use of this technique provides a valuable aid in diagnosing pigmented skin lesions. Because of the complexity involved, this methodology is reserved for experienced clinicians. Vestergaard et al have reported dermoscopy assessment is more accurate than clinical evaluation by naked eye for the diagnosis of cutaneous melanoma (odds ratio = 15.6, P = .016). In this study, the mean sensitivity in the diagnosis of melanoma was 74

2014 eMedicine.com

187. Cutaneous Melanoacanthoma (Follow-up)

reflectance confocal microscopy features of a melanoacanthoma. Dermatol Pract Concept . 2016 Oct. 6 (4):27-30. . Schlappner OL, Rowden G, Philips TM, Rahim Z. Melanoacanthoma. Ultrastructural and immunological studies. J Cutan Pathol . 1978 Jun. 5(3):127-41. . Lambert MW, Lambert WC, Schwartz RA, et al. Colonization of nonmelanocytic cutaneous lesions by dendritic melanocytic cells: a simulant of acral-lentiginous (palmar-plantar-subungual-mucosal) melanoma. J Surg Oncol . 1985 Jan. 28(1):12-8. . Lambert (...) . Verrucous melanoma simulating melanoacanthoma: Dermoscopic, reflectance confocal microscopic and high-definition optical coherence tomography presentation of a rare melanoma variant. Australas J Dermatol . 2016 Feb. 57 (1):72-3. . Papageorgiou V, Apalla Z, Sotiriou E, Papageorgiou C, Lazaridou E, Vakirlis S, et al. The limitations of dermoscopy: false-positive and false-negative tumours. J Eur Acad Dermatol Venereol . 2018 Jan 5. . Shahriari N, Grant-Kels JM, Rabinovitz HS, Oliviero M, Scope A. In vivo

2014 eMedicine.com

188. Cutaneous Manifestations of HIV Disease (Follow-up)

–AIDS-defining cutaneous cancers—in particular, basal cell carcinoma—among HIV-infected persons has exceeded that of AIDS-defining cutaneous cancers such as KS. In a prospective study, Crum-Cianflone et al found that 6% of HIV-infected persons developed a cutaneous malignancy over a mean follow-up period of 7.5 years. [ ] The development of cutaneous non–AIDS-defining cancers in this cohort proved to be associated with the traditional risk factors of increasing age and lighter skin color, rather (...) . Malignant melanoma appears to be more aggressive in patients with HIV. One study reported shorter disease-free and overall survival rates in patients with melanoma who had HIV disease, compared with those who did not have HIV. [ ] Children with AIDS have a higher risk of developing leiomyosarcoma, although the incidence is still low in this population. Kaposi sarcoma KS is an abnormally vascularized tumorlike lesion affecting skin, lymph nodes, and viscera. It is believed to be a proliferation

2014 eMedicine.com

189. Epidermodysplasia Verruciformis (Follow-up)

for the management of skin cancers include topical imiquimod and 5-fluorouracil, systemic retinoids, interferon, and 5-aminolevulinic acid . [ , ] In 2016, Kim et al described the first case of a patient with imiquimod-resistant epidermodysplasia verruciformis, which was successfully treated with topical ingenol mebutate. [ ] In advanced human papillomavirus (HPV)–related carcinomas, an experimental therapy involves treatment with a combination of 13- cis retinoic acid and interferon-alfa or cholecalciferol (...) analogues. [ ] For localized multiple malignant lesions, autotransplantation of skin from uninvolved areas has been reported with success in preventing further development of cancers. UV-B exposure, UV-A exposure, and x-ray irradiation should be avoided because radiation therapy often promotes the recurrence of more aggressive skin cancers. Next: Surgical Care Surgical and electrosurgical removal and cryotherapy are used in the treatment of benign and premalignant skin lesions. Surgery is also indicated

2014 eMedicine.com

190. Blue Nevi (Follow-up)

, Celebi JT. B-RAF and melanocytic neoplasia. J Am Acad Dermatol . 2005 Jul. 53(1):108-14. . Van Raamsdonk CD, Bezrookove V, Green G, Bauer J, Gaugler L, O'Brien JM, et al. Frequent somatic mutations of GNAQ in uveal melanoma and blue naevi. Nature . 2009 Jan 29. 457 (7229):599-602. . Emley A, Nguyen LP, Yang S, Mahalingam M. Somatic mutations in GNAQ in amelanotic/hypomelanotic blue nevi. Hum Pathol . 2011 Jan. 42(1):136-40. . Lambert WC, Brodkin RH. Nodal and subcutaneous cellular blue nevi (...) . A pseudometastasizing pseudomelanoma. Arch Dermatol . 1984 Mar. 120(3):367-70. . Causeret AS, Skowron F, Viallard AM, Balme B, Thomas L. Subungual blue nevus. J Am Acad Dermatol . 2003 Aug. 49(2):310-2. . Di Cesare A, Sera F, Gulia A, Coletti G, Micantonio T, Fargnoli MC, et al. The spectrum of dermatoscopic patterns in blue nevi. J Am Acad Dermatol . 2011 Oct 24. . Dailey VL, Hameed O. Blue nevus of the prostate. Arch Pathol Lab Med . 2011 Jun. 135(6):799-802. . Cooper PH. Deep penetrating (plexiform spindle cell

2014 eMedicine.com

191. Warts, Nongenital (Diagnosis)

children, and peak at 12-16 years. [ ] Previous Next: Prognosis Approximately 65% of warts disappear spontaneously within 2 years. When warts resolve on their own, no scarring is seen. However, scarring can occur as a result of different treatment methods. Growth of periungual or subungual warts may result in permanent nail dystrophy. Treatment failures and wart recurrences are common, more so among immunocompromised patients. Normal appearing perilesional skin may harbor HPV, which helps explain (...) on the plantar surfaces. Although this type of cancer rarely metastasizes, it can be locally destructive. Previous Next: Patient Education Alert patients to the risk factors for transmission of warts. These include trauma or maceration of the skin, frequent wet work involving hands, hyperhidrosis of feet, swimming pools, and nail biting. Butchers and slaughterhouse workers also are at increased risk for developing warts. Alert patients that some warts may require multiple treatments and may be resistant

2014 eMedicine.com

192. Wegener Granulomatosis (Diagnosis)

palsies CNS manifestations include vasculitis of small to medium–sized vessels of the brain or spinal cord and granulomatous masses that involve the orbit, optic nerve, meninges, or brain.4 Cutaneous manifestations Cutaneous findings are variable and nonspecific and usually affect the lower extremities Palpable purpura or skin ulcers (45%) [ ] ; ulcerations may resemble pyoderma gangrenosum Petechiae, vesicles, pustules, hemorrhagic bullae, livedo reticularis, digital necrosis, subungual splinter (...) of other cancers associated with immunosuppression in patients with AAV is a concern, as it is for patients with other inflammatory rheumatologic and nonrheumatologic diseases and for patients who have undergone organ transplantation. Increased rates of leukemia, lymphoma, and nonmelanoma skin cancers have been reported in a number of studies of treated patients with AAV. The observed overall incidence of cancers in this population is 1.6-2.4 times higher than in the general population. [ ] Clinicians

2014 eMedicine.com

193. Glomus Tumor (Follow-up)

glomus tumor recurrences. J Hand Surg Am . 2010 Jun. 35(6):986-9. . Lu H, Chen LF, Chen Q. Rupture of a subungual glomus tumor of the finger. BMC Cancer . 2018 May 2. 18 (1):505. . McEvoy BF, Waldman PM, Tye MJ. Multiple hamartomatous glomus tumors of the skin. Arch Dermatol . 1971 Aug. 104 (2):188-91. . Sbai MA, Benzarti S, Gharbi W, Maalla R. A Rare Case of Glomus Tumor of the Thigh with Literature Review. J Orthop Case Rep . 2018 Sep-Oct. 8 (5):22-24. . Zou H, Song L, Jia M, Wang L, Sun Y. Glomus (...) removal of the tumor capsule is recommended to relieve pain and minimize risk for recurrence. Most subungual lesions are treated with total nail avulsion followed by excision, although several additional techniques have been described to include a straightforward excision using a nail bed margin approach, [ ] a trap-door technique, [ ] and a technique described by Lee et al designed to conserve the nail plate itself. [ ] In the transungual approach, the nail plate is removed, the tumor excised

2014 eMedicine.com

194. Paronychia (Treatment)

: Bacterial, mycobacterial, or viral infection Metastatic cancer Subungual melanoma Squamous cell carcinoma Therefore, benign and malignant neoplasms should always be excluded when chronic paronychia does not respond to conventional treatment. Chronic paronychia most often occurs in persons whose hands are repeatedly exposed to moist environments or in those who have prolonged and repeated contact with irritants such as mild acids, mild alkalis, or other chemicals. People who are most susceptible include (...) paronychia. Classic presentation of paronychia, with erythema and pus surrounding the nail bed. In this case, the paronychia was due to infection after a hangnail was removed. Signs and symptoms Physical findings in acute paronychia include the following: The affected area often appears erythematous and swollen In more advanced cases, pus may collect under the skin of the lateral fold If untreated, the infection can extend into the eponychium, in which case it is called eponychia Further extension

2014 eMedicine Emergency Medicine

195. Candidiasis (Diagnosis)

, nausea, vomiting, fever, chills and hematuria Fungal balls - Intermittent urinary tract obstruction with subsequent anuria and ensuing renal insufficiency See for more detail. Diagnosis Diagnostic tests for candidiasis include the following: Mucocutaneous candidiasis - For a wet mount, scrapings or smears obtained from skin, nails, or oral or vaginal mucosa are examined under the microscope; a potassium hydroxide smear, Gram stain, or methylene blue is useful for direct demonstration of fungal cells (...) Cutaneous candidiasis - Using a wet mount, scrapings or smears obtained from skin or nails can be examined under the microscope; potassium hydroxide smears are also useful Genitourinary candidiasis - A urinalysis should be performed; evidence of white blood cells (WBCs), red blood cells (RBCs), protein, and yeast cells is common; urine fungal cultures are useful Gastrointestinal candidiasis - Endoscopy with or without biopsy See for more detail. Management See the list below: Cutaneous candidiasis

2014 eMedicine.com

196. Glomus Tumor (Diagnosis)

glomus tumor of the finger. BMC Cancer . 2018 May 2. 18 (1):505. . McEvoy BF, Waldman PM, Tye MJ. Multiple hamartomatous glomus tumors of the skin. Arch Dermatol . 1971 Aug. 104 (2):188-91. . Sbai MA, Benzarti S, Gharbi W, Maalla R. A Rare Case of Glomus Tumor of the Thigh with Literature Review. J Orthop Case Rep . 2018 Sep-Oct. 8 (5):22-24. . Zou H, Song L, Jia M, Wang L, Sun Y. Glomus tumor in the floor of the mouth: a case report and review of the literature. World J Surg Oncol . 2018 Oct 10. 16 (...) , with most cases involving subungual sites. These tumors are characteristically painful, often causing paroxysmal pain in response to temperature changes (especially cold) or pressure. Note the images below. Glomus tumor. Multiple glomus tumors. Glomus tumors are thought to arise from the glomus body or Sucquet-Hoyer canal, a thermoregulatory arteriovenous shunt composed of modified smooth muscle cells. [ , ] Glomus tumors most frequently occur in areas with high concentrations of glomus bodies

2014 eMedicine.com

197. Drug Eruptions (Diagnosis)

the images below. Paronychia. Papules and annular plaques. Superficial and mid-dermal perivascular infiltrate of lymphocytes and eosinophils. Foci of extravasation of erythrocytes. Sorafenib [ ] (a novel multikinase inhibitor) - Hand-foot skin reaction, facial and scalp eruption, scalp dysesthesia, subungual splinter hemorrhages, alopecia, body hair loss, stomatitis, nipple hyperkeratosis or pain, and eruptive facial cysts Vemurafenib is a systemic medication recently approved by the Food and Drug (...) after drug withdrawal and any reaction with readministration Physical examination should address clinical features that may indicate a severe, potentially life-threatening drug reaction, including the following: Mucous membrane erosions Blisters Nikolsky sign Confluent erythema Angioedema and tongue swelling Palpable purpura Skin necrosis Lymphadenopathy High fever, dyspnea, or hypotension It is important to appreciate the morphology and physical features of drug eruptions, as follows: Acneiform

2014 eMedicine.com

198. Dermatologic Manifestations of Hematologic Disease (Diagnosis)

, purpura, ecchymoses, painful skin nodules, and subungual splinter hemorrhages. Livedo reticularis is a presenting sign in up to 40% of patients with the diagnosis of SLE. [ ] Skin changes defined as livedo reticularis are violaceous, red or blue, reticular, or mottled pattern of the skin of the arms, legs, and the trunk. They are not reversible with rewarming. [ ] Noninflammatory vascular thrombosis is the most frequent finding in skin lesions of patients with antiphospholipid syndrome. Differential (...) patients), increased skin pigmentation (5 patients), and squamous cell cancer (2 patients). Other manifestations include alopecia (rare), facial and peripheral edema, gangrene, nail and/or skin atrophy, scaling, and violet papules. Previous Next: Leukemia Overview In leukemia, specific or nonspecific lesions of the skin may occur. Specific lesions ( ) contain leukemia cells, which directly infiltrate the epidermis, dermis, or subcutaneous fat. Nonspecific lesions, which are more common, are considered

2014 eMedicine.com

199. Dermatologic Manifestations of Cardiac Disease (Diagnosis)

be used in facilitating a diagnosis of the underlying cardiac disease. For example, the diagnosis of acute rheumatic fever in patients presenting with acute carditis includes 2 skin signs out of the 5 classic Jones criteria (ie, arthritis, carditis, erythema marginatum, subcutaneous nodules, and chorea). [ ] Certain congenital cardiac defects are associated with unique skin manifestations, such as coarctation of the aorta associated with external features of Turner syndrome or atrioventricular (AV (...) ) septal defects associated with skin features of Down syndrome. In some patients, the dermatologic manifestations represent a component of a full systemic or vascular disorder that also involves defects in the cardiovascular system as another accompanying component. Advanced medical and invasive therapies have led to recognition of many new dermatologic manifestations, for example, angioedema from ACE inhibitors, ankle swelling due to calcium channel blockers, or radiation skin burns following

2014 eMedicine.com

200. Dermoscopy (Diagnosis)

of pigmented skin lesions and, especially, in the identification of the early phase of cutaneous malignant melanoma. Dermoscopy is a noninvasive method that allows the in vivo evaluation of colors and microstructures of the epidermis, the dermoepidermal junction, and the papillary dermis not visible to the naked eye. These structures are specifically correlated to histologic features. The identification of specific diagnostic patterns related to the distribution of colors and dermoscopy structures can (...) better suggest a malignant or benign pigmented skin lesion. The use of this technique provides a valuable aid in diagnosing pigmented skin lesions. Because of the complexity involved, this methodology is reserved for experienced clinicians. Vestergaard et al have reported dermoscopy assessment is more accurate than clinical evaluation by naked eye for the diagnosis of cutaneous melanoma (odds ratio = 15.6, P = .016). In this study, the mean sensitivity in the diagnosis of melanoma was 74

2014 eMedicine.com

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>