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201 results for

Subungual Melanoma

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101. Pyogenic Granuloma (Lobular Capillary Hemangioma) (Treatment)

. Treatment options for cutaneous pyogenic granulomas: a review. J Plast Reconstr Aesthet Surg . 2011 Sep. 64(9):1216-20. . Piraccini BM, Bellavista S, Misciali C, Tosti A, de Berker D, Richert B. Periungual and subungual pyogenic granuloma. Br J Dermatol . 2010 Nov. 163(5):941-53. . Rodins K, Gramp D, James D, Kumar S. Pyogenic granuloma, port-wine stain and pregnancy. Australas J Dermatol . 2011 Nov. 52(4):e8-e10. . Cheah S, DeKoven J. Pyogenic granuloma complicating pulsed-dye laser therapy for cherry (...) . Case reports: mitozantrone-induced onycholysis associated with subungual abscesses, paronychia, and pyogenic granuloma. J Drugs Dermatol . 2005 Jul-Aug. 4(4):490-2. . Devillers C, Vanhooteghem O, 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

2014 eMedicine.com

102. Pyogenic Granuloma (Lobular Capillary Hemangioma) (Overview)

(pyogenic granuloma) causing severe anemia. Arch Dermatol . 1972 Jul. 106(1):128. . Azzopardi EA, Xuereb CB, Iyer S. Pyogenic granuloma as a surrogate indicator of deep seated foreign bodies: a case report. Cases J . 2009 Aug 5. 2:7354. . . Lee J, Sinno H, Tahiri Y, Gilardino MS. Treatment options for cutaneous pyogenic granulomas: a review. J Plast Reconstr Aesthet Surg . 2011 Sep. 64(9):1216-20. . Piraccini BM, Bellavista S, Misciali C, Tosti A, de Berker D, Richert B. Periungual and subungual (...) , Schwarz M, Gin D. Multiple periungual pyogenic granulomas following systemic 5-fluorouracil. Australas J Dermatol . 2006 May. 47(2):130-3. . Piguet V, Borradori L. Pyogenic granuloma-like lesions during capecitabine therapy. Br J Dermatol . 2002 Dec. 147(6):1270-2. . Freiman A, Bouganim N, O'Brien EA. Case reports: mitozantrone-induced onycholysis associated with subungual abscesses, paronychia, and pyogenic granuloma. J Drugs Dermatol . 2005 Jul-Aug. 4(4):490-2. . Devillers C, Vanhooteghem O

2014 eMedicine.com

103. Paraneoplastic Diseases (Overview)

include symmetrical, scaly, violaceous plaques on the acral surfaces, with severe forms progressing to bullae. The lesions predominantly occur on the hands, feet, ear helices, nose tip, and scalp. Skin changes may spread to involve the knees, elbows, and malar surface of the face. [ ] Bazex syndrome occurs more commonly in men older than 40 years. [ ] Alopecia and nail changes are common and can be early findings. Subungual hyperkeratosis, onychodystrophy, and white flaking of the nail surface (...) diagnosis of EMPD includes Bowen disease, amelanotic superficial spreading malignant melanoma, and eczematous dermatitis. Clinical course and prognosis Skin lesions slowly increase in size. Over time, the lesions may progress from pruritic to painful, and they may become ulcerated. Regional lymph nodes may become involved. The general course of the disease depends on the presence of an underlying internal cancer. EMPD patients have a 5-year survival rate of 72-85%. Patients with EMPD without an internal

2014 eMedicine.com

104. Blue Nevi (Overview)

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 (...) black in color. Lesions are usually solitary and found on the head and the neck, the sacral region, and the dorsal aspects of the hands and feet. The cellular blue nevus was first described as a variant of . Later, it was classified as a variant of blue nevus. Controversy still arises over the precise distinction of atypical cellular blue nevus from melanoma. [ ] The cellular blue nevus is a less common lesion but often clinically similar to the common blue nevus. These lesions tend to be large

2014 eMedicine.com

105. Black Heel (Calcaneal Petechiae) (Overview)

. [ ] Although clinically insignificant, black heel is important because of its close clinical resemblance to melanoma. A similar lesion termed black palm (tache noir) has been described on the thenar eminence in weightlifters, gymnasts, golfers, tennis players, mountain climbers, and baseball players. [ ] Superficial cutaneous hemorrhages of other areas of the feet have been published in the literature. [ , ] Next: Pathophysiology Black heel (calcaneal petechiae) is caused by a repeated lateral shearing (...) . Benzidine stain for the histochemical detection of hemoglobin in splinter hemorrhage (subungual hematoma) and black heel. Am J Dermatopathol . 1995 Aug. 17(4):362-7. . Weedon D. Skin Pathology . 2nd ed. Elsevier Limited; 2002. 595. Media Gallery Linear petechiae on the heel, characteristic of black heel. of 1 Tables Contributor Information and Disclosures Author Christine Malcolm, MD, FRCPC Resident Physician in Dermatology, Department of Internal Medicine, University of Toronto Faculty of Medicine

2014 eMedicine.com

106. Verrucous Carcinoma (Overview)

. 2000 Apr. 27(2):179-83. . Desai A, Ugorji R, Khachemoune A. Acral melanoma foot lesions. Part 2: clinical presentation, diagnosis, and management. Clin Exp Dermatol . 2017 Dec 13. . Grinspan D, Abulafia J. Oral florid papillomatosis (verrucous carcinoma). Int J Dermatol . 1979 Oct. 18(8):608-22. . Depprich RA, Handschel JG, Fritzemeier CU, Engers R, Kubler NR. Hybrid verrucous carcinoma of the oral cavity: A challenge for the clinician and the pathologist. Oral Oncology EXTRA . 2006. 42:85-90. Deng (...) , Maloney ME. Verrucous carcinoma of the scalp. J Am Acad Dermatol . 2007 Mar. 56(3):506-7. . Sheen MC, Sheen YS, Sheu HM, Wong TW, Lee YY, Wu CF, et al. Subungual verrucous carcinoma of the thumb treated by intra-arterial infusion with methotrexate. Dermatol Surg . 2005 Jul. 31(7 Pt 1):787-9. . Bernadas SR, Evgenios E, Dimitriadis PA, Hamal P, Uppal R. Verrucous carcinoma of the upper arm. ANZ J Surg . 2014 Dec. 84(12):983-4. . Warner CL, Cockerell CJ. The new seventh edition American Joint Committee

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2014 eMedicine.com

107. Melanonychia (Overview)

Adigun, MD, FAAD; Chief Editor: William D James, MD Share Email Print Feedback Close Sections Sections Melanonychia Overview Background Melanonychia is brown or black pigmentation of the nail unit. Melanonychia commonly presents as pigmented band arranged lengthwise along the nail unit, and this presentation is known as longitudinal melanonychia or melanonychia striata. The most concerning cause of melanonychia is subungual melanoma, although a variety of other causes includes physiologic (...) are wider than 3 mm in greater than 50% of cases. Below are the causes of melanonychia. [ , , , ] Melanocytic activation/hyperplasia–related causes are as follows: Nevi Melanotic macule of the nail unit Melanocytic activation Subungual melanoma Physiologic causes of melanonychia are as follows: Racial melanonychia (African American, Hispanic, Indian, Japanese, other dark-skinned races) (multiple bands) Pregnancy (multiple bands) Local and regional causes of melanonychia are as follows: Trauma (acute

2014 eMedicine.com

108. Leukemia Cutis (Overview)

associated with non-melanoma skin cancer in patients with chronic lymphocytic leukemia. Dermatol Online J . 2010 Mar 15. 16(3):4. . Kaplan AL, Cook JL. Cutaneous squamous cell carcinoma in patients with chronic lymphocytic leukemia. Skinmed . 2005 Sep-Oct. 4 (5):300-4. . Fadilah SA, Alawiyah AA, Amir MA, Cheong SK. Leukaemia cutis presenting as leonine facies. Med J Malaysia . 2003 Mar. 58(1):102-4. . Heskel NS, White CR, Fryberger S, Neerhout RC, Spraker M, Hanifin JM. Aleukemic leukemia cutis: juvenile (...) paronychia. Int J Dermatol . 1985 Nov. 24(9):595-7. . Simon CA, Su WP, Li CY. Subungual leukemia cutis. Int J Dermatol . 1990 Nov. 29(9):636-9. . Beynet D, Oro AE. Leukemia cutis presenting as a Sister Mary Joseph nodule. Arch Dermatol . 2004 Sep. 140(9):1170-1. . Watanabe H, Okuyama R, Tagami H, Aiba S. Leukaemia cutis developing in a pressure ulcer. Acta Derm Venereol . 2004. 84(5):412-3. . Burns CA, Scott GA, Miller CC. Leukemia cutis at the site of trauma in a patient with Burkitt leukemia. Cutis

2014 eMedicine.com

109. Keratosis Palmaris et Plantaris (Overview)

psoriasislike plaques or lichenoid patches may be present on the knees and the elbows. Patients may have severe hyperhidrosis, possibly accompanied by malodor. Secondary bacterial and fungal infections are common. Perioral erythema; periorbital erythema and hyperkeratosis; nail changes (eg, koilonychia, subungual hyperkeratosis); and lingua plicata, syndactyly, hair on the palms and the soles, high-arched palate, and left-handedness are other clinical features. Histologic findings include orthokeratosis (...) on the affected genes. Onset occurs in the first year of life. Clinically, PPK begins focally in infancy and then becomes diffuse and severe. Later findings include flexion deformities and constriction of the digits, sometimes leading to spontaneous amputation. Progressive, well-defined perioral, perianal, and perineal hyperkeratotic plaques are present, as is onychodystrophy. Alopecia, deafness, nail dystrophy, and dental loss may be associated. Squamous cell carcinoma and malignant melanoma have developed

2014 eMedicine.com

110. Drug Eruptions (Overview)

, entacapone, estrogen, furosemide, griseofulvin, influenza vaccine, penicillamine, penicillins, sertraline sulfonamides, and thiazides Photosensitivity reaction - Long-term use of voriconazole causes significantly increased photosensitivity, resulting in some patients developing squamous cell carcinoma [ ] and melanoma. [ ] Recent studies have shown dose-dependent increased risk for squamous cell carcinoma: 5.6% with each 60-day exposure at a standard dose of 200 mg twice daily. At 5 years after (...) 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

2014 eMedicine.com

111. Dermatologic Manifestations of Hematologic Disease (Overview)

, 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

2014 eMedicine.com

112. Dermoscopy (Overview)

Dermoscopy (Overview) Dermoscopy: Overview, Technical Procedures and Equipment, Color 6 mm, enlarging lesion) contains the primary clinical criteria for diagnosing suspected cutaneous malignant melanoma. The early phase of malignant melanoma is difficult to identify because cutaneous malignant melanoma can share many clinical features with ..." /> Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username (...) ) contains the primary clinical criteria for diagnosing suspected cutaneous . The early phase of malignant melanoma is difficult to identify because cutaneous malignant melanoma can share many clinical features with an atypical nevus. Several studies have described diagnostic accuracy rates ranging from 50-75%, indicating a need for additional diagnostic tools. The introduction of dermoscopy, also termed epiluminescence microscopy (ELM), has opened a new dimension in the examination of pigmented skin

2014 eMedicine.com

113. Nail Surgery (Overview)

for several days. The differential diagnosis of subungual hematoma should include melanoma, glomus tumor, Kaposi sarcoma, basal cell carcinoma, squamous cell carcinoma (SCC), exostosis, melanonychia striata, fungal melanonychia, and keratoacanthomas, all of which must be excluded. [ ] To exclude a diagnosis of melanoma, biopsy must be performed in all pigmented lesions of unknown etiology. Lacerations Simple superficial lacerations of the nail are usually confined to the nail plate, nail bed, and LNFs (...) changes in the nail plate; and senile nail diseases (eg, onychauxis, subungual hyperkeratosis). [ , , ] In onychocryptosis, the primary direction of nail growth is lateral instead of the normal, forward orientation of nail growth in the longitudinal plane. A more pronounced transverse curvature of their toenails increases the likelihood of developing ingrown toenails. [ ] The laterally curved edge of the nail plate, or the nail spicule, penetrates the adjacent LNF, perforating the fold skin

2014 eMedicine.com

114. Cutaneous Manifestations of HIV Disease (Overview)

. 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 (...) related to HIV-1 infection. [ ] Beau lines, telogen effluvium, and pallor of the nail beds are the general effects of the chronic illness. Elongation of the eyelashes and softening and straightening of the scalp hair may be observed in HIV disease, and proximal subungual onychomycosis is also usually a sign of HIV disease. The frequency of onychomycosis may be higher in men than in women. Generalized alopecia can occur in patients with HIV who are treated with indinavir, an antiretroviral protease

2014 eMedicine.com

115. Cutaneous Melanoacanthoma (Overview)

. . 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 WC, Lambert MW, Mesa ML, et al. Melanoacanthoma and related disorders. Simulants of acral-lentiginous (P-P-S-M (...) predilection. [ ] Oral melanoacanthoma is unrelated to seborrheic keratosis. Oral melanoacanthoma is most often seen as an enlarging flat or slightly raised area of hyperpigmentation on the buccal mucosa of adult black women. Strong homatropine methylbromide reactivity has been described, limiting its utility in distinguishing oral melanoacanthoma from malignant melanoma. Laugier-Hunziker syndrome, also known as idiopathic lenticular mucocutaneous hyperpigmentation, displays progressive mucosal

2014 eMedicine.com

116. Keratosis Palmaris et Plantaris (Treatment)

psoriasislike plaques or lichenoid patches may be present on the knees and the elbows. Patients may have severe hyperhidrosis, possibly accompanied by malodor. Secondary bacterial and fungal infections are common. Perioral erythema; periorbital erythema and hyperkeratosis; nail changes (eg, koilonychia, subungual hyperkeratosis); and lingua plicata, syndactyly, hair on the palms and the soles, high-arched palate, and left-handedness are other clinical features. Histologic findings include orthokeratosis (...) on the affected genes. Onset occurs in the first year of life. Clinically, PPK begins focally in infancy and then becomes diffuse and severe. Later findings include flexion deformities and constriction of the digits, sometimes leading to spontaneous amputation. Progressive, well-defined perioral, perianal, and perineal hyperkeratotic plaques are present, as is onychodystrophy. Alopecia, deafness, nail dystrophy, and dental loss may be associated. Squamous cell carcinoma and malignant melanoma have developed

2014 eMedicine.com

117. Nail Surgery (Treatment)

is frequently used as a therapeutic adjunct in long-standing fungal infections of the nail, such as chronic onychomycosis, and in acute bacterial infections. [ , ] In traumatic nail injuries, avulsion may be used to evaluate the stability of the nail bed or to release a subungual hematoma after failed puncture aspiration. Paring the nail plate is the process of taking off pieces of the nail in a transverse or longitudinal fashion to fully observe an involved area on the nail bed. [ ] In the case of verrucae (...) of the blade must be oriented to lie directly against the undersurface of the plate and the PNF. Proximal nail avulsion is attempted when creating a cleavage plane between the nail plate and the nail bed distally is impossible because of the presence of distal nail dystrophy, which prevents access to the distal free edge of the nail plate. This presentation may be seen in distal subungual onychomycosis. [ , , ] First, the Freer elevator is inserted beneath the cuticle in the proximal groove to separate

2014 eMedicine.com

118. Melanonychia (Treatment)

of the distal phalanx may be indicated. [ ] Albeit controversial, total nail bed excision and reconstruction using a full-thickness graft may be considered. In a large case series, the 5-year survival rates for cutaneous melanoma of the hand versus subungual melanoma treated with a wide local excision was reported as 100% and 80%, respectively. [ ] . This was due to a delay in diagnosing subungual lesions, which averaged 3.68 mm in depth versus 1.36 mm for hand melanomas of the cutaneous surface. Because (...) diagnosis is often delayed in these patients, sentinel lymph node biopsy after surgery may be warranted. [ ] Previous Next: Consultations Because longitudinal melanonychia is associated with a variety of systemic conditions, these cases may require referral to the appropriate specialist in order to manage the primary disease. In cases of subungual melanoma with a poor prognosis, consultation with a hematologist/oncologist regarding potential chemotherapeutic options may be warranted. Previous Next

2014 eMedicine.com

119. Neurilemoma (Treatment)

lip: case report with distinct histologic features and review of the literature. J Oral Maxillofac Surg . 2011 Jun. 69(6):e118-22. . Kara M, Akyüz M, Yilmaz A, Hatipoglu C, Ozçakar L. Peripheral nerve involvement in a neurofibromatosis type 2 patient with plexiform neurofibroma of the cauda equina: a sonographic vignette. Arch Phys Med Rehabil . 2011 Sep. 92(9):1511-4. . Yeh I, Argenyi Z, Vemula SS, Furmanczyk PS, Bouffard D, McCalmont TH. Plexiform melanocytic schwannoma: a mimic of melanoma. J (...) invasive sacral schwannoma. Its clinical features and surgical management without stability. Neurosciences (Riyadh) . 2014 Jul. 19(3):224-8. . Rodríguez-Peralto JL, Riveiro-Falkenbach E, Carrillo R. Benign cutaneous neural tumors. Semin Diagn Pathol . 2013 Feb. 30(1):45-57. . Huntley JS, Davie RM, Hooper G. A subungual schwannoma. Plast Reconstr Surg . 2006 Feb. 117(2):712-3. . Ritter SE, Elston DM. Cutaneous schwannoma of the foot. Cutis . 2001 Feb. 67(2):127-9. . Sitenga JL, Aird GA, Nguyen

2014 eMedicine.com

120. Cutaneous Manifestations of HIV Disease (Treatment)

. 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 (...) related to HIV-1 infection. [ ] Beau lines, telogen effluvium, and pallor of the nail beds are the general effects of the chronic illness. Elongation of the eyelashes and softening and straightening of the scalp hair may be observed in HIV disease, and proximal subungual onychomycosis is also usually a sign of HIV disease. The frequency of onychomycosis may be higher in men than in women. Generalized alopecia can occur in patients with HIV who are treated with indinavir, an antiretroviral protease

2014 eMedicine.com

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