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Subungual Melanoma

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81. Psoriasis

Psoriasis Psoriasis 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 Psoriasis Psoriasis Aka: Psoriasis , Chronic Plaque Psoriasis (...) to less skin atrophy than with s) Agents 0.1% cream 0.1% cream Efficacy Effective in facial and intertriginous Psoriasis Adverse effects Risk of skin cancer and (especially in combination with UV ) Adjunctive agents in combination with above Topical Salicylic Acid ( Agent) Poorly tolerated topicals (use instead) Historically used with UVB light exposure (Anthra-Derm) Coal Tar (e.g. Zetar) Effective and inexpensive Consider in patients who can not afford other options XIV. Management: Ultraviolet Light

2018 FP Notebook

82. Cryotherapy

Cryotherapy Cryotherapy 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 Cryotherapy Cryotherapy Aka: Cryotherapy , Liquid Nitrogen (...) Agammaglobulinemia Cryoglobulinemia and idiopathic blood dyscrasias Cold s Avoid use in distal extremities in high-risk patients Acrosclerosis or Cancerous skin lesions not amenable to Cryotherapy (excision required in all cases) that is not well differentiated Sclerosing High risk skin sites Nose or nasolabial folds Ear Chin Temple Lesion deeper than 3mm or of diameter >2 cm Recurrent lesions Poorly demarcated lesion or lesions fixed to underlying tissue IV. Mechanism Liquid Nitrogen boils at -196 C (-320 F

2018 FP Notebook

83. Acute Paronychia

Acute Paronychia Acute Paronychia 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 Acute Paronychia Acute Paronychia Aka: Acute (...) ) Puncture abscess with #18 gauge needle in multiple sites to allow drainage Often performed without Technique 2 anesthesia is required Pass #15 or #11 scalpel blade passed between nail and nail fold Abscess area should be clearly demarcated by overlying blanching of skin Direct blade away from nail Avoid entering through the Avoid injury to cuticle May need to remove part of nail to expose infection Indicated for subungual abscess Irrigate wound Larger wounds could be packed with small plain gauze Other

2018 FP Notebook

84. Cutaneous Lichen Planus

Cutaneous Lichen Planus Cutaneous Lichen Planus 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 Cutaneous Lichen Planus Cutaneous (...) the lesions May form in lines related to scratching May occur with lesion resolution (especially in dark skin) Distribution Cutaneous lesions form on flexor surfaces of wrists, s, legs (25%) Genitalia Glans penis with annular pattern (see below) Scalp Lichen Planus Scaly pruritic s May progress to scarring Nail Lichen Planus Irregular longitudinal grooves or ridges in the nail plate Subungual keratosis or VI. Types: Variants Annular Lichen Planus (10%) See s Rings of clustered lesions with central

2018 FP Notebook

85. Toe Fracture

Toe Fracture Toe Fracture 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 Toe Fracture Toe Fracture Aka: Toe Fracture , Great Toe (...) Fracture , First Toe Fracture , Lesser Toe Fracture , Foot Phalanx Fracture From Related Chapters II. Mechanism Heavy object dropped on toe (crush injury) Stubbed toe III. Epidemiology Proximal phalanx most commonly injured (esp. 5th) IV. Signs Focal pain, swelling and Painful ambulation V. Imaging Three view XRay of the affected toe VI. Management: Indications for orthopedic referral ral indications Perfusion defect (emergency) Open Toe Fracture (suspected or actual) Skin necrosis overlying site Great

2018 FP Notebook

86. Whitlow (staphylococcal and herpetic)

of the nail root, or fracture of the terminal phalanx. The differential diagnosis of herpetic whitlow includes: Staphylococcal whitlow. Paronychia. For more information, see the CKS topic on . Skin cancer (for example malignant melanoma or squamous cell carcinoma). For more information, see the CKS topics on and . Pompholyx eczema. Infective endocarditis with Osler's nodes, which are painful, swollen, purplish nodules in the pulp of the fingers. Basis for recommendation Basis for recommendation (...) 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 to hasten drainage of pus

2016 NICE Clinical Knowledge Summaries

87. Dermoscopic patterns of fungal melanonychia: A comparative study with other causes of melanonychia. (Abstract)

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

88. Diagnostic criteria for and clinical review of melanonychia in Korean patients. (Abstract)

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

89. Assessment of Patient Knowledge of Longitudinal Melanonychia: A Survey Study of Patients in Outpatient Clinics Full Text available with Trip Pro

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

2016 Skin appendage disorders

90. Warts and verrucae

Warts and verrucae Warts and verrucae - NICE CKS Share Warts and verrucae: Summary Warts are small, rough growths which are caused by certain strains of the human papilloma virus (HPV). They can appear anywhere on the skin but are most commonly seen on the hands and feet. A verruca (also known as a plantar wart) is a wart on the sole of the foot. Cutaneous warts are common, and most people will have them at some point in their life. Warts are usually spread by direct skin-to-skin contact (...) topic covers the management of cutaneous warts. This CKS topic does not cover the management of anogenital warts, mucosal warts, and other viral skin infections. There are separate CKS topics on , and . The target audience for this CKS topic is healthcare professionals working within the NHS in the UK, and providing first contact or primary health care. CKS gratefully acknowledges the contribution of the British Association of Dermatologists in the development of this topic. How up-to-date

2014 NICE Clinical Knowledge Summaries

91. The Diagnosis and Treatment of Nail Disorders. Full Text available with Trip Pro

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 (...) disorders are a common reason for derma - tologic consultation. They are assessed by clinical inspection, dermatoscopy, diagnostic imaging, microbiological (including mycological) testing, and histopathological examination. Some 10% of the overall population suffers from onychomycosis, with a point prevalence of around 15%. Bacterial infections of the nails are rarer than fungal colonization. High-risk groups for nail disorders include diabetics, dialysis patients, transplant recipients, and cancer

2016 Deutsches Arzteblatt international

92. Real-World Evaluation of the Effect of Jublia on Nail Polish

: University of Alabama at Birmingham Information provided by (Responsible Party): Boni Elewski, MD, University of Alabama at Birmingham Study Details Study Description Go to Brief Summary: A recent publication using cadaver nails suggests that Jublia application has a negative effect on nail polish texture. Condition or disease Intervention/treatment Phase Distal Lateral Subungual Onychomycosis (DLSO) Drug: Jublia Other: Nail polish Not Applicable Detailed Description: It is believed that investigating (...) research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 70 Years (Adult, Older Adult) Sexes Eligible for Study: Female Accepts Healthy Volunteers: Yes Criteria Inclusion Criteria: Exhibit distal lateral subungual onychomycosis (DLSO) Has the informed consent been signed and patient's questions answered. Age ≥ 18 Patient willing and able to participate for the full duration of the study No onychomycosis

2015 Clinical Trials

93. Study Evaluating the Effect of Jublia on Dermatophytomas

both topical and systemic clinical trials for onychomycosis, including those for Efinaconazole solution. Efinaconazole (Jublia) 10% solution is an FDA approved topical medication indicated for treatment of distal lateral subungual onychomycosis (DLSO), and the utility of this medication likely exceeds published results. Efinaconazole solution's novel ability to penetrate into the subungual space likely accounts for improved treatment results seen in DLSO treated with Jublia. We will investigate (...) the utility of topical efinaconazole solution in the treatment of dermatophytomas. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 19 participants Intervention Model: Single Group Assignment Intervention Model Description: Topical application of Jublia (Efinaconazole 10% Topical Solution) to patients with distal lateral subungual onychomycosis with dermatophytoma. Masking: None (Open Label) Primary Purpose: Treatment Official Title

2015 Clinical Trials

94. A clinical, histopathologic, and outcome study of melanonychia striata in childhood. (Abstract)

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

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

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

96. 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

97. Efficacy and Safety of Namilumab (MT203) for Plaque Psoriasis

carcinoma of the skin or in situ carcinoma of the cervix treated and considered cured. Has a history of treatment with anti-cancer chemotherapy (e.g. alkylating agents, anti-metabolites, purine analogues) and/or monoclonal antibodies, or has received GM-CSF / G-CSF treatment associated with chemotherapy within the last 5 years. Has an underlying condition that predisposes to infections (eg immunodeficiency, history of poorly controlled diabetes, splenectomy). Has any clinically significant illness (...) 2, 4, 6, 10 and 12 [ Time Frame: Weeks 2, 4, 6, 10 and 12 ] sPGA for psoriasis is scored on a 6-point scale, reflecting a global consideration of the erythema, plaque elevation and skin scaling across all psoriatic lesions. sPGA of psoriasis scale ranges from 0 (clear) to 5 (very severe). Participants who had >=2 point improvement are reported. Percentage of Participants Achieving a sPGA Response of Clear (0) or Almost Clear (1) at Weeks 2, 4, 6, 10 and 12 [ Time Frame: Weeks 2, 4, 6, 10 and 12

2014 Clinical Trials

98. Study of Erchonia Low Level Laser Light Therapy to Treat Toenail Fungus

pedis. History of current or past psoriasis of the skin and/or nails. Concurrent lichen planus. Onychogryphosis. Any of the following conditions of the affected great toenail(s) is present: proximal subungual onychomycosis; white superficial onychomycosis; dermatophytoma or "yellow spike/streak"; exclusively lateral disease Confounding problems/abnormalities of the great toenail(s). Any abnormality of the affected great toenail(s) that could prevent a normal appearing nail if clearing of infection (...) -the-counter antifungal creams; photodynamic therapy and in more severe cases, surgery to remove the nail. However, there is no perfect cure for toenail fungus. Even the most effective oral medications are only successful about half of the time, and topical medications are successful less than 10% of the time. In addition, clearance of the infection and growth of new clear nail can be slow, and the rate of recurrence of infection is high. Antifungal drugs may also cause side effects ranging from skin

2014 Clinical Trials

99. Intraoperative diagnosis of non pigmented nail tumors with ex vivo fluorescence confocal microscopy: about 10 cases. (Abstract)

) and one nodular melanoma (Group 4). The correlation was excellent for malignant epithelial tumours exhibiting marked cytological and architectural atypias (Bowen disease, invasive SCC and onycholemmal carcinoma). Onychomatricomas exhibited a very peculiar aspect with densely cellular papillae. The correlation was less favourable for minimally invasive well-differentiated SCCs with slight cytological atypias. The correlation was poor for our case of amelanotic invasive subungual melanoma.Ex vivo FCM (...) Intraoperative diagnosis of non pigmented nail tumors with ex vivo fluorescence confocal microscopy: about 10 cases. Ex vivo fluorescence confocal microscopy (FCM) permits real-time imaging of freshly excised skin tissues. Its usefulness as a time-sparing alternative to frozen sections in Mohs surgery of basal cell carcinoma is well documented.The purpose of this study was to describe the ex vivo FCM features of a series of benign and malignant nonpigmented tumours of the nail unit

2014 British Journal of Dermatology

100. Pyogenic Granuloma (Lobular Capillary Hemangioma) (Diagnosis)

, Henrijean A, Ramaut M, de la Brassinne M. Subungueal pyogenic granuloma secondary to docetaxel therapy. Clin Exp Dermatol . 2009 Mar. 34(2):251-2. . Paul LJ, Cohen PR. Paclitaxel-associated subungual pyogenic granuloma: report in a patient with breast cancer receiving paclitaxel and review of drug-induced pyogenic granulomas adjacent to and beneath the nail. J Drugs Dermatol . 2012 Feb. 11(2):262-8. . Sibaud V, Dalenc F, Mourey L, Chevreau C. Paronychia and pyogenic granuloma induced by new anticancer (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTA4NDcwMS1vdmVydmlldw== processing > Pyogenic Granuloma (Lobular Capillary Hemangioma) Updated: Jun 04, 2018 Author: Joseph C Pierson, MD; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Pyogenic Granuloma (Lobular Capillary Hemangioma) Overview Background Pyogenic granuloma (lobular capillary hemangioma [ ] ) is a relatively common benign vascular lesion of the skin and mucosa whose exact cause is unknown. Also see the Medscape Drugs & Diseases article . Pyogenic granulomas

2014 eMedicine.com

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