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Subungual Melanoma

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61. Melanoma

of melanoma occurred in the US, causing about 10,130 deaths. Lifetime risk is about 1 to 2%. Incidence has remained steady over the last 8 yr (it had previously been increasing at a faster rate than any other malignant tumor). Melanoma accounts for < 5% of total skin cancers diagnosed in the US but causes most skin cancer deaths. On average, one person in the US dies of melanoma every hour. Malignant Melanoma (Non-Sun Exposed Area) © Springer Science+Business Media Melanomas occur mainly on the skin (...) or internal organs may occur, and, occasionally, metastatic nodules or enlarged lymph nodes are discovered before the primary lesion is identified. Etiology Risk factors for melanoma include Sun exposure, particularly repeated blistering sunburns Repeated tanning with ultraviolet A (UVA) or psoralen plus UVA (PUVA) treatments Nonmelanoma skin cancer Family and personal history Fair skin, freckling Atypical moles, particularly > 5 Increased numbers of melanocytic nevi (particularly > 20, depending

2013 Merck Manual (19th Edition)

62. Melanoma Margins Excision Trial

have an ECOG performance score between 0 and 1. A survivor of prior cancer is eligible provided that ALL of the following criteria are met and documented: The patient has undergone potentially curative therapy for all prior malignancies, There has been no evidence of recurrence of any prior malignancies for at least FIVE years (except for successfully treated cervical or non-melanoma skin cancer with no evidence of recurrence), and The patient is deemed by their treating physician to be at low risk (...) occasion to clear the lymph nodes of the probable draining lymphatic field, including sentinel lymph node biopsy, of the index melanoma. Any additional solid tumour or hematologic malignancy during the past 5 years except T1 skin lesions of squamous cell carcinoma, basal cell carcinoma, or uterine/cervical cancer. Melanoma-related operative procedures not corresponding to criteria described in the protocol. Planned adjuvant radiotherapy to the primary melanoma site after Wide Local Excision

2011 Clinical Trials

63. Onychomycosis

) cases are caused by the dermatophyte , T. rubrum . Candida albicans is involved in up to 5% of infections, most commonly in fingernails. Risk factors: Older age Gender – 2.4 times more common in males than females Tinea pedis infection (co-infection very common) Diabetes Peripheral vascular disease Immunodeficiency Psoriasis of the skin Nail trauma Occlusive footwear Sports or other activities involving bare feet Smoking Images: Anatomy of the nail Skinsight: Nail infections, fungal (Onychomycosis (...) ) DermnetNZ Fungal nail infections (Onychomycosis) Three major subtypes of OM: Distal and lateral subungual onychomycosis (DLSO) – infection is located under the tip and side of nail, . Most common type (90%) Nail thickening with white-yellowish discoloration Brittle, friable nail plate which may crumble leaving yellow debris Typical presentation is “butter”- coloured spikes descending vertically from the distal end (top) of the nail Onycholysis (separation of nail plate from nail bed) is common No change

2018 medSask

64. Lichen Planus

papules and plaques result in scarring alopecia. The triad of follicular LP of skin or scalp, multifocal cicatricial alopecia of the scalp, and non-13 scarring alopecia of the axillary and pubic areas is known as Graham Little-Pidcardi- Lassueur syndrome. 2. LP lesions of the nails (onychoshcysia or/and onychorrhexis or even anonychia). Thinning, longitudinal ridging and distal splitting are the most common findings. Pterygium formation, onycholysis and subungual hyperkeratosis may be less frequently (...) . Department of Dermatology, Hospital del Mar, Barcelona, Spain 12. Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. 13. Department of Dermatology, Erasmus MC, Rotterdam, The Netherlands Corresponding author: Professor Dimitrios Ioannides Head, 1st Department of Dermatology and Venereology, Aristotle University Medical School, Hospital of Skin and Venereal Diseases - Hippokration General Hospital Thesssaloniki, Greece Tel.: (+30) 2310-992262 Fax: (+30 )2310-992221 Email: dem

2018 European Dermatology Forum

65. Nordic Adjuvant IFN Melanoma Trial

melanoma in regional lymph node(s) confirmed by lymphadenectomy. ECOG performance status of 0-1 No active medical or psychiatric disorder requiring therapy that would prevent completion of protocol Written informed consent Exclusion Criteria: Patients with unknown primary site of melanoma or primary melanoma originating apart from the skin, except subungual melanoma Patients who have clinical, radiological/laboratory or pathological evidence of incompletely resected melanoma or distant metastatic (...) Nordic Adjuvant IFN Melanoma Trial Nordic Adjuvant IFN Melanoma Trial - 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 number of saved studies (100). Please remove one or more studies before adding more. Nordic Adjuvant IFN Melanoma Trial The safety and scientific validity of this study

2010 Clinical Trials

66. Effectiveness of a knowledge-based intervention for melanoma among those with ethnic skin. (Abstract)

assessing knowledge, attitudes, and behaviors were completed before, and immediately and 3 months after, the intervention.Among the 71 participants, 21% reported a skin phenotype with at least sometimes burning. Knowledge that melanoma is a skin cancer and of the warning signs of melanoma significantly increased after the intervention and was retained at 3 months. The perception of being at risk to develop a melanoma significantly increased after the intervention and was retained at 3 months (P < .001 (...) Effectiveness of a knowledge-based intervention for melanoma among those with ethnic skin. Among patients with melanoma, ethnic minorities are 1.96 to 3.01 times as likely to die from melanoma as Caucasians of the same age and sex.We sought to assess the effectiveness of a melanoma early detection educational intervention among those with ethnic skin.A consecutive convenience sample of patients received instruction on the ABCDEs of melanoma and skin self-examination. Self-report questionnaires

2010 Journal of American Academy of Dermatology

67. CRACKCast Episode 132 – HIV/AIDS

Kaposi’s sarcoma Extrapulmonary cryptococcosis Disseminated mycosis Atypical disseminated leishmaniasis Disseminated nontuberculous mycobacterial infection Extrapulmonary cryptococcosis including meningitis Box 124.3: Cutaneous Findings Highly Suggestive of HIV Disease Any WHO criteria for stage 4 HIV disease Facial molluscum in an adult Proximal subungual onychomycosis Herpes zoster scarring Oral hairy leukoplakia Bacillary angiomatosis Widespread dermatophytosis Severe seborrheic dermatitis See (...) are infected, the virus spreads to draining lymph nodes and infection is established, usually within 48 to 72 hours. [3] List 10 AIDS defining conditions Box 124.1 – AIDS-Defining Conditions Bacterial infections, multiple or recurrent Candidiasis of bronchi, trachea, or lungs Candidiasis of esophagus Cervical cancer, invasive Coccidioidomycosis, disseminated or extrapulmonary Cryptococcosis, extrapulmonary Cryptosporidiosis, chronic intestinal (>1 mo duration) Cytomegalovirus disease (other than liver

2017 CandiEM

68. Lymphangioleiomyomatosis Diagnosis and Management Part II: An Official ATS/JRS Clinical Practice Guideline

) con?rmed by tap and biochemical analysis of the ?uid 5. Lymphangioleiomyomas (lymphangiomyomas) x 6.DemonstrationofLAMcellsorLAMcellclustersoncytologicalexaminationofeffusions or lymph nodes jj 7. Histopathological con?rmation of LAM by lung biopsy or biopsy of retroperitoneal or pelvic masses De?nition of abbreviations: D2-40=podoplanin; HMB-45=human melanoma black-45; HRCT= high-resolution computed tomography; LAM=lymphangioleiomyomatosis; mTOR=mechanistic target of rapamycin; TSC=tuberous (...) smoking history, personal/family history of non–TSC-related facial skin lesions, and/or kidney tumors. Most patients with LAM will have an obstructive defect on pulmonary function tests. Some patients, especially early in their disease course, may be asymptomatic and have normal pulmonary function tests. † Characteristic HRCT chest features of LAM include the presence of multiple, bilateral, uniform, round,thin-walledcystspresentin adiffusedistribution,oftenwithnormal-appearinginterveninglung

2017 American Thoracic Society

69. PERIUNGUAL AND SUBUNGUAL PYOGENIC GRANULOMA. (Abstract)

PERIUNGUAL AND SUBUNGUAL PYOGENIC GRANULOMA. Nail pyogenic granuloma (PG) is common, often seen as an urgent case, given the recent onset as a bleeding nodule. Nail PGs are due to different causes that act through different pathogenetic mechanisms and may be treated in several ways. Both causes and treatments of nail PG have never been classified.To classify nail PG according to the pathogenesis, describe the clinical and pathological features and provide guidelines for a correct diagnosis (...) of digits involved and clinical history help to identify the cause. When PG is single, especially if it involves the nail bed, histological examination is necessary to rule out malignant melanoma. Treatment must be chosen according to the underlying cause.© 2010 The Authors. BJD © 2010 British Association of Dermatologists.

2010 British Journal of Dermatology

70. Fungal nail infection

: Psoriasis — there may be nail pitting, subungual hyperkeratosis, nail dystrophy, and the 'oil drop sign'. See the CKS topic on for more information. Lichen planus — this condition may affect the skin, mucous membranes, and/or nails. Nails may be thinned (or may thicken) and become grooved, fissured, and ridged; they may be discoloured and separate from the nail bed. The cuticle may be destroyed leaving a scar at the proximal aspect of the nail. The nails may shed, stop growing, or completely disappear (...) 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 is based

2018 NICE Clinical Knowledge Summaries

71. Psoriasis

topics on , , , , and for more information. Ischaemic heart disease — see the CKS topic on for more 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 (...) Psoriasis Psoriasis - NICE CKS Share Psoriasis: Summary Psoriasis is a systemic, immune-mediated, inflammatory skin disease which typically has a chronic relapsing-remitting course, and may have nail and joint (psoriatic arthritis) involvement. Chronic plaque psoriasis (including scalp psoriasis, flexural psoriasis, and facial psoriasis) is the most common form, affecting 80–90% of people with psoriasis. The second most common form is localized pustular psoriasis of the palms and soles. Other

2018 NICE Clinical Knowledge Summaries

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

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 (...) 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

2019 International Journal of Dermatology

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

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

74. Paronychia - acute

features include: Pain and swelling at the base of the fingernail. Localized pain and tenderness of the nail folds. Red, tender, and swollen lateral and/or proximal nail folds often with a visible collection of pus. Conditions that may resemble paronychia include cutaneous candidiasis, acute contact dermatitis, staphylococcal whitlow, finger-tip injuries, insect bites, fungal nail infections, herpetic whitlow, cancer (for example melanoma or squamous cell carcinoma), psoriasis, Reiter syndrome (...) contact dermatitis. Staphylococcal whitlow. For more information, see the CKS topic on . Finger-tip injuries. Insect bites. Fungal nail infections. For more information, see the CKS topic on . Herpetic whitlow — this appears as either a single or a group of blisters. For more information, see the CKS topic on . Cancer (for example melanoma, Bowen disease or squamous cell carcinoma). Psoriasis. Reiter syndrome. Dyshidrotic eczema (pompholyx). Pemphigus vulgaris. Foreign body. Basis for recommendation

2017 NICE Clinical Knowledge Summaries

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

previous or subsequent nonmel- anoma skin cancer (NMSC), mainly basal cell carcinoma (BCC). 18,31 The NMSC risk after an index SCC in situ is proba- bly similar to the overall risk of NMSC following any index NMSC (3-year overall risk of 35–60%). 32 In the study by Jae- ger et al., 10 NMSC had a standardized incidence ratio of 43, and lip cancer a ratio of 82, in patients with SCC in situ (cal- culated as ratios of observed-to-expected numbers of cancer, derived from cancer registration data in Denmark (...) -based study of skin cancer incidence and prevalence in renal transplant recipients. Br J Dermatol 2006; 154:498–504. 22 Kettler AH, Rutledge M, Tschen JA, Buffone G. Detection of human papillomavirus in nongenital Bowen’s disease by in situ DNA hybridization. Arch Dermatol 1990; 126:777–81. Table 2 Summary of treatment choice Treatment Strength of recommendation Cryotherapy: simple, inexpensive and quick method of treating SCC in situ. Lesions heal better than with radiotherapy, but not as well

2014 British Association of Dermatologists

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

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

77. Early Feasibility Study to Evaluate the Efficacy and Safety of the RenewalNailâ„¢ Plasma Treatment System in Patients With Mild to Moderate Onychomycosis (Fungal Nail)

, 2018 Actual Study Completion Date : June 30, 2018 Resource links provided by the National Library of Medicine related topics: Arms and Interventions Go to Arm Intervention/treatment Experimental: Multi-center open label Thirty Subjects with 20-75% Distal Subungual Onychomycosis (mild to moderate DSO) infection of their big toe (hallux) nail infected by the dermatophytes Trichophyton (T.) rubrum or T. mentagrophytes will be enrolled. All Subjects will receive three 45-minute plasma treatments (...) : 21 Years to 75 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Subjects who are between 21 to 75 years (inclusive) of age; Subjects male or female and of any race; Subjects who are in good general health and free from any clinically significant disease that might interfere with the study evaluations. Subjects with established clinical diagnosis of distal subungual onychomycosis; Subjects with at least one or both big toe nails

2017 Clinical Trials

78. Nail Injury

Nail Injury Nail Injury Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Nail Injury Nail Injury Aka: Nail Injury , Nail Avulsion (...) the proximal nail edge across the nail diagonally to the start of the Tie off the Resources Closing the Gap: Closure for the Emergency Practitioner References Option 3: Replace intact nail back within the folds of the fingertip Dry the edges carefully Apply at the nail fold edges to secure in place Lin in Herbert (2015) EM:Rap 15(2): 6-7 V. Management: Subungual Trauma See See Nail Bed Repair Indications >50% of nail bed AND Nail detached or surrounding tissue disrupted (especially at proximal nail

2018 FP Notebook

79. Foreign Bodies of the Skin

Foreign Bodies of the Skin Foreign Bodies of the Skin Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Foreign Bodies of the Skin (...) overlying skin with Betadine or Hibiclens with 1% on fingers Elsewhere with 1% with Eliptical incision over end of splinter Deeper incisions made to either side of splinter Remove splinter when exposed Irrigate lesion with after removal Do not flush via needle or catheter in tract X. Management: Removal Subungual Splinter Prepare overlying skin with Betadine or Hibiclens with 1% on fingers Required only for Option 1 ( ) Option 1: Nail plate avulsed Remove V-Section of nail overlying splinter See

2018 FP Notebook

80. Onychomycosis

Onychomycosis Onychomycosis Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Onychomycosis Onychomycosis Aka: Onychomycosis , Tinea (...) , moist environment V. Risk Factors Older age (especially over age 60-70 years) or other fungal infection Swimming pools, locker rooms or other use of shared bathing areas Nail deformity or abuse (>1.9 fold increased risk) (15-40% ) VI. Types Distal Subungual (most common) Affects distal and lateral s and s Starts distally (at ) and spreads into nail plate and nail bed Associated with hyperkeratosis with secondary and ultimately s with yellow or brown discoloration Acquired through break in skin

2018 FP Notebook

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