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Subungual Melanoma

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61. Subungual and periungual congenital blue naevus. (PubMed)

Subungual and periungual congenital blue naevus. Subungual pigmented lesions should raise concern about malignant melanoma. Blue naevus of the nail apparatus is a rare entity, with only ten cases described in the literature. We report a 21-year-old Hispanic woman with a slowly enlarging 1.7 x 2.3-cm subungual and periungual pigmented plaque present since birth on her right second toe. Initial biopsy was consistent with a blue naevus of the cellular type and, given the recent clinical change (...) and periungual extension, complete excision was recommended. The entire nail unit was resected down to periosteum with prior avulsion of the nail plate. Reconstruction was performed with a full-thickness skin graft. Follow up at 1 year revealed well-healed graft and donor sites with complete return of function. We present a case of a congenital subungual and periungual blue naevus of the cellular type and review the literature on this rare presentation of a congenital blue naevus.

2009 Australasian Journal of Dermatology

62. Retrospective single-center study evaluating clinical and dermoscopic features of longitudinal melanonychia, ABCDEF criteria, and risk of malignancy. (PubMed)

Retrospective single-center study evaluating clinical and dermoscopic features of longitudinal melanonychia, ABCDEF criteria, and risk of malignancy. Longitudinal melanonychia (LM) is a common finding in clinical practice; however, it has a broad differential diagnosis, including subungual melanoma (SUM), which can be difficult to distinguish clinically from benign conditions.To identify clinical and dermoscopic features that distinguish histopathologically diagnosed SUM from benign LM

2019 Journal of American Academy of Dermatology

63. Melanonychia striata: clarifying behind the Black Curtain. A review on clinical evaluation and management of the 21st century. (PubMed)

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

2019 International Journal of Dermatology

64. British Association of Dermatologists' guidelines for the management of squamous cell carcinoma in situ (Bowen's disease)

than in men. 8,11,14 Older, U.K.-based studies have reported that the majority of patients (60–85%) have SCC in situ on the lower legs, which may indicate that the sun exposure pattern is differ- ent in countries with lower rates of sunshine. 8,9 Less common variantsincludepigmented,subungual,periungual,palmar,gen- ital,perianalandverrucousSCCinsitu. 7.0 Diagnosis In routine clinical practice the diagnosis is made on clinical grounds, perhaps with the aid of dermoscopy (showing glo- merular vessels (...) in situ on the nipple, subungual, in poor healing sites on the lower legs, and in the setting of epidermolysis bullosa and radiation dermatitis. 38,78–82 In a trial comparing ALA-PDT for actinic keratoses or SCC in situ in OTR compared with immunocompetent controls, despite comparable cure rates of 86% at 4 weeks, signi?cantly more recurrences occurred in the OTR group over 48 weeks. 83 A comparison of MAL-PDT with topical 5-FU in only ?ve OTRs with SCC in situ is discussed in section 11.2. 42 PDT

2014 British Association of Dermatologists

65. Whitlow (staphylococcal and herpetic)

in a similar way to whitlow include cellulitis, paronychia, osteomyelitis, and cancer (for example melanoma or squamous cell carcinoma). Swabs may be useful in some cases, but are not always required. For the management of tense or fluctuant staphylococcal whitlows, same-day incision and drainage should be considered. For staphylococcal whitlows that do not require incision and drainage, treatment includes: Giving advice on elevating the finger as much as possible, applying moist heat 3-4 times a day (...) features of a herpetic whitlow This information is based on expert opinion in dermatology textbooks [ ; ] and in review articles [ ; ; ; ; ]. Differential diagnosis What else might it be? The differential diagnosis of staphylococcal whitlow includes: Herpetic whitlow. Cellulitis. For more information, see the CKS topic on . Paronychia. For more information, see the CKS topic on . Underlying osteomyelitis. A finger-tip injury, such as a subungual haematoma from blunt or crush injuries, avulsion

2016 NICE Clinical Knowledge Summaries

66. Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults. (PubMed)

Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults. Clinical distinction between nail matrix nevus (NMN) and subungual melanoma (SUM) can be challenging. More precise delineation of the clinicodermoscopic characteristics specific for NMNs is needed.We sought to analyze the clinicopathologic features of childhood and adult NMNs and to propose clinicodermoscopic features that can aid in differentiating NMNs from SUM.We

2017 Journal of American Academy of Dermatology

67. Funtabulously Frivolous Friday Five 139

involvement of the nasal branch of the nasociliary nerve (branch of the ophthalmic division of the trigeminal nerve) and thus raises the specter of involvement of the eye. Hutchinson sign (dermatology) refers to pigmentation in the paronychial area suggesting subungual melanoma. [ ] Question 5 What is topagnosis ? The inability to identify which part of the body has been touched. It is a symptom of disease in the parietal lobe of the brain. [ ] Last update: [last-modified] Share this: Filed Under: Tagged

2016 Life in the Fast Lane Blog

68. Dermoscopic patterns of fungal melanonychia: A comparative study with other causes of melanonychia. (PubMed)

from January 2010 to February 2016. We included nail matrix melanocytic activation, nail matrix nevi, and nail unit malignant melanomas as control groups for comparison.In all, 18 FM, 24 melanocytic activation of the nail matrix, 27 nail matrix nevi, and 11 malignant melanoma cases were analyzed. Statistical analysis revealed that yellow color, multicolor pattern, nonlongitudinal homogenous pattern, reverse triangular pattern, subungual keratosis, white or yellow streaks, and scales on the nail

2016 Journal of American Academy of Dermatology

69. Skin Cancer in Skin of Color

(SCC) Ethnicities with SCC as most common skin cancer Native Americans Black patients Peak at ages 40-49 Especially common in scars, chronic ulcers and lesions Ethnicities with SCC as second most common skin cancer Chinese and Japanese (peaks after age 60 years old) Hispanic patients Common presenting locations in Non-sun-exposed areas (e.g. legs, anogenital, scalp) IV. Approach: Melanoma Patients with present with at a later, more advanced stage with worse outcomes about risk and is important (...) Common presenting locations in Non-sun-exposed sites Mucous membranes Palmar, plantar and subungual ( ) more common in asian and black patients V. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Skin Cancer in Skin of Color." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics in Hematology and Oncology About FPnotebook.com

2018 FP Notebook

70. Diagnostic criteria for and clinical review of melanonychia in Korean patients. (PubMed)

and dermoscopic photographs, and histopathologic findings and we assessed demographics (eg, age); medical (eg, systemic diseases), family, and trauma (eg, nail biting) history; and physical findings (eg, affected number and site).The 5 most common causes of melanonychia in Korean patients were subungual hemorrhage (29.1%), nail matrix nevus (21.8%), trauma-induced pigmentation (14.5%), nail apparatus lentigo (11.6%), and ethnic-type nail pigmentation (8.0%). Melanoma was diagnosed in 6.2% of patients. Ethnic (...) Diagnostic criteria for and clinical review of melanonychia in Korean patients. Melanonychia may be the presenting sign of ungual melanoma. However, there are insufficient basic clinical data for melanonychia in Korean patients.We sought to identify basic clinical data and devise a classification algorithm for melanonychia.In all, 275 patients with melanonychia who visited our clinic from January 2002 to August 2014 were included in this study. We reviewed medical records, clinical

2016 Journal of American Academy of Dermatology

71. The Diagnosis and Treatment of Nail Disorders. (PubMed)

patients. Malignant tumors of the nails are often not correctly diagnosed at first. For subungual melanoma, the mean time from the initial symptom to the correct diagnosis is approximately 2 years; this delay is partly responsible for the low 10-year survival rate of only 43%.Evaluation of the nail organ is an important diagnostic instrument. Aside from onychomycosis, which is a common nail disorder, important differential diagnoses such as malignant diseases, drug side effects, and bacterial

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2016 Deutsches Arzteblatt international

72. Psoriasis

information. Inflammatory bowel disease (particularly Crohn's disease) — see the CKS topic on for more information. Anxiety and depression — see the CKS topic on and for more information. Venous thromboembolism — see the CKS topic on for more information. Non-melanoma skin cancer — see the CKS topic on for more information. [ ; ; ; ; ; ; ] Complications What are the complications? Possible complications of psoriasis include: Psychosocial effects The psychosocial impact of psoriasis is not necessarily (...) of the nail bed. Subungual hyperkeratosis — hyperproliferation of the nail bed, with accumulation of keratinocytes under the nail. Onycholysis — detachment of the nail from the nail bed, which may allow bacteria and fungi to enter and cause infection. Complete nail dystrophy. [ ; ; ; ; ; ] Differential diagnosis What else might it be? Psoriasis may present similarly to : Seborrhoeic dermatitis — may mimic facial or scalp psoriasis, with greasy scale which is more diffuse and less well-defined than

2014 NICE Clinical Knowledge Summaries

73. Fungal nail infection

the edge of the nail may be seen. See the CKS topic on for more information. Subungual malignant melanoma — abnormal black pigmentation of the nail plate or nail bed which extends onto the nail fold; typically slowly increases in size becoming increasingly irregular in colour and border. There may be eventual bleeding and ulceration. See the CKS topic on for more information. Basis for recommendation Basis for recommendation The information on the differential diagnosis of fungal nail infection (...) , the proximal growing end of the nail. Debris may accumulate under the proximal portion of the nail, causing onycholysis and a white discoloration that spreads distally. Most cases involve the toenails. Subungual hyperkeratosis — scaling under the distal nail; the nail is discoloured, opaque, and thickened. Endonyx — infection of the nail plate with white discolouration, in the absence of onycholysis and subungual hyperkeratosis. Total dystrophic — marked thickening and hyperkeratosis; the nail plate

2014 NICE Clinical Knowledge Summaries

74. Warts and verrucae

Association of Dermatologists' guidelines for the management of cutaneous warts [ ], information from a Dermatology text book [ ], and an online medical text book [ ]. Differential diagnosis What else might it be? Differential diagnoses of warts include: Hyperkeratotic lesions of the hand or feet for example: Actinic keratosis. Seborrheic keratosis Knuckle pads. Squamous cell carcinoma. Focal palmoplantar keratoderma. Lichen planus. Angiokeratoma. Corns or calluses of the feet. Malignant melanoma. Basis (...) . Peripheral vascular disease. Peripheral neuropathy. Periungual sites — this is painful and there is a risk of subungual haemorrhage. For warts that are over tendons and near superficial nerves it is preferable to use topical salicylic acid. Cryotherapy may be considered but with shorter durations of freeze-thaw cycles. [ ; ] Applying topical cryotherapy How should cryotherapy be applied? Only practitioners who have been trained in the use of cryotherapy should carry out this treatment. Before performing

2014 NICE Clinical Knowledge Summaries

75. Fluorescein for Lymphatic Mapping and Sentinel Lymph Node Biopsy in Patients With Stage I and II Malignant Melanoma

Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Ability to provide informed consent and have signed an approved consent form that conforms to federal and institutional guidelines. Between 18 and 90 years of age. Have a primary melanoma that is cutaneous (including head, neck, trunk, extremity, scalp, palm, sole, subungual skin tissues) Have a primary melanoma meeting one of the following criteria: Primary melanoma was ≥ 0.75 mm Breslow thickness (...) Fluorescein for Lymphatic Mapping and Sentinel Lymph Node Biopsy in Patients With Stage I and II Malignant Melanoma Fluorescein for Lymphatic Mapping and Sentinel Lymph Node (SLN) Biopsy in Patients With Stage I and II Malignant Melanoma - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum

2009 Clinical Trials

76. Dermoscopic features of Acral Lentiginous Melanoma in a large series of 110 cases in a white population. (PubMed)

(53%). Minor dermoscopic patterns, commonly noted in benign lesions, were also detected but only focally within the lesions. Among the 44 nail unit lesions, 31 (70%) presented irregular lines with variegations in colours, spacing, width and disruption of parallelism. Two cases of melanonychia striata had a triangular shape. Both corresponded to early ungual ALM. Association with subungual haemorrhage was not uncommon. The study included 37 (34%) amelanotic melanomas. However, dermoscopy enabled (...) Dermoscopic features of Acral Lentiginous Melanoma in a large series of 110 cases in a white population. Acral lentiginous melanoma (ALM) is a rare but distinctive subtype of melanoma. The diagnosis is often delayed and misdiagnosis is common, due to frequently unusual clinical presentation and a higher rate of amelanosis than in other melanoma subtypes.We aimed to investigate the dermoscopic features of a large series of ALM in a white-skinned population, in order to emphasize their diagnostic

2009 British Journal of Dermatology

77. Expression of p16 protein in acral lentiginous melanoma. (PubMed)

Expression of p16 protein in acral lentiginous melanoma. Acral lentiginous melanoma (ALM) is a clinicopathologic subtype of cutaneous malignant melanoma. ALM is the most common type of melanoma amongst Asians, Africans, and patients with mixed ancestry. In Brazil, ALM comprises 10% of cutaneous melanoma. ALM develops on palmar, plantar, and subungual skin, and its biology is different from that of other cutaneous melanomas, where sunlight is the major known environmental determinant (...) . Alterations and inactivation of the p16INK4 gene that encodes a specific inhibitor of cyclin-dependent kinase have been related to melanoma genesis and progression. Few studies, however, have addressed p16 expression in ALM.In order to verify and compare p16 protein expression, 32 paraffin-embedded ALM specimens were subjected to a immunohistochemical technique using a monoclonal anti-p16 antibody. The tumors were classified according to thickness (up to 1.0 mm and thicker than 1.0 mm) and the presence

2009 International Journal of Dermatology

78. Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics (PubMed)

Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics Subungual melanoma (SM) is a rare subtype of cutaneous melanoma but carries a worse prognosis than similarly staged cutaneous melanomas. Assessing patient knowledge of melanonychia is integral to early diagnosis of SM.The aim of this paper is to determine patient knowledge of longitudinal melanonychia (LM) and warning signs for SM, frequency of nail self-examinations, and satisfaction (...) of patients with their physician's nail examinations.We conducted a survey-based study of 363 random patients at Weill Cornell Medicine in New York, USA, performed at 3 different clinics: a general dermatology clinic (n = 167), a nail specialty clinic (n = 44), and a primary care clinic (n = 152).Knowledge of the ABCDEF mnemonic for SM was compared to the ABCD mnemonic for cutaneous melanoma. Analyses were performed for patient behavior regarding suspicious nail changes as well as satisfaction with nail

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2016 Skin appendage disorders

79. A clinical, histopathologic, and outcome study of melanonychia striata in childhood. (PubMed)

A clinical, histopathologic, and outcome study of melanonychia striata in childhood. The current literature suggests that approximately 5% to 10% of melanonychia striata cases in adults are the result of subungual melanoma.We sought to evaluate the clinical and histopathologic features and to determine the outcomes and causes of melanonychia striata in a cohort of children.We assessed 30 childhood cases of melanonychia striata for features typically associated with melanoma such as Hutchinson (...) sign, width of the pigmented band, evolution, color, and nail dystrophy. We assessed the histopathology of lesional biopsy specimens, including melanocyte counts and suprabasal movement of melanocytes. Clinical follow-up information was reviewed when available.Histopathologic diagnoses included subungual lentigo in 20 cases, subungual nevus in 5 cases, and atypical melanocytic hyperplasia in 5 cases. Although a number of cases exhibited worrisome clinical or histopathologic features, none showed

2015 Journal of American Academy of Dermatology

80. New observations of intraoperative dermoscopic features of the nail matrix and bed in longitudinal melanonychia. (PubMed)

activation; (ii) mostly melanocytic hyperplasia (melanocytic activation and melanoma can also be seen); (iii) only melanocytic nevi; and (iv) only melanoma.This study was conducted to compare these patterns with intraoperative dermoscopic findings in another series of five patients with LM.Nail plate dermoscopy, intraoperative nail matrix and bed dermoscopy, and histopathological examinations in five patients with LM were retrospectively reviewed.Intraoperative dermoscopy of the nail bed and matrix (...) with globules, blue nevus in one case with an irregular brown pattern with globules and blotches, and only melanophages in one case with globules only.Histopathological findings that differ from the patterns previously reported were found. An irregular pattern may also be seen in benign melanocytic nevi such as subungual blue nevus. A globular pattern may be defined as a new pattern corresponding to melanophages only. Additional dermoscopic and histopathological images should be shared to facilitate

2015 International Journal of Dermatology

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