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Subungual Melanoma

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161. Psoriasis

on the toenails. and produces a variety of changes in the appearance of finger and toe nails. Nail psoriasis occurs in 40–45% of people with psoriasis affecting the skin and has a lifetime incidence of 80–90% in those with psoriatic arthritis. These changes include pitting of the nails (pinhead-sized depressions in the nail is seen in 70% with nail psoriasis), , , yellow-reddish discoloration of the nails known as the oil drop or salmon spot, dryness, thickening of the skin under the nail (subungual (...) such as itchiness, , , , and a theoretical risk of nonmelanoma skin cancer or melanoma has been suggested. However, more recent studies have determined that there does not appear to be increased risk of melanoma in the long-term. Data are inconclusive with respect to non-melanoma skin cancer risk, but support the idea that the therapy is associated with an increased risk of benign forms of sun-induced skin damage such as, but not limited to, or . Dead Sea balneotherapy is also effective for psoriatic arthritis

2012 Wikipedia

162. List of cutaneous conditions

, proliferating follicular cystic neoplasm, proliferating pilar tumor, proliferating trichilemmal tumor) (auricular endochondrial pseudocyst, cystic chondromalacia, endochondral pseudocyst, intracartilaginous cyst) (adenoid seborrheic keratosis) (Jacobi ulcer) (Schimmelpenning–Feuerstein–Mims syndrome) (sebaceous epithelioma) (seborrheic verruca, senile wart) (subungual keratoacanthoma) (spindle cell carcinoma) (epidermal polycystic disease, sebocystomatosis) (simple sebaceous duct cyst, solitary (...) nevus) (banal nevus, common acquired melanocytic nevus, mole, nevocellular nevus, nevocytic nevus) (blue neuronevus, dermal melanocytoma, nevus bleu) (common blue nevus, nevus ceruleus) (LAMB syndrome, NAME syndrome) (atypical mole, atypical nevus, B-K mole, Clark's nevus, dysplastic melanocytic nevus, nevus with architectural disorder) (B-K mole syndrome, familial atypical multiple mole–melanoma syndrome, familial melanoma syndrome) (freckle) (bathing trunk nevus, congenital nevomelanocytic nevus

2012 Wikipedia

163. Pigmented lesions of the nail unit: clinical and histopathologic features. (PubMed)

pigmentation in darker-skinned patients, for example. In the context of an irregular, broad, heterogeneous or "streaky" band, the chief concern is the exclusion of subungual melanoma. Before assessing the histologic features of any such entities, it is important to understand the normal nail anatomy and melanocytic density of nail unit epithelium, as well as the type of specimen submitted, and whether it is adequate to undertake a proper histologic evaluation. The criteria for diagnosis and prognosis (...) of melanoma of the nail unit are still evolving, and a variety of factors must be weighed in the balance to make a correct diagnosis. The importance of the clinical context cannot be overemphasized. There are also nonmelanocytic conditions to be considered that may produce worrisome nail discoloration, such as subungual hemorrhage, squamous cell carcinoma, and pigmented onychomycosis.Copyright © 2010 Elsevier Inc. All rights reserved.

2010 Seminars in Cutaneous Medicine and Surgery

164. Dealing with melanonychia. (PubMed)

Dealing with melanonychia. Melanonychia describes a brown or black pigmentation of the nail plate caused by the presence of melanin. In this article, we review possible causes of melanonychia and discuss the main problems of management of patients with this condition. The goal in the management of melanonychia is early diagnosis of melanoma of the nail matrix and bed. Melanoma of the nail bed is also known as subungual melanoma. We discuss clinical, dermoscopic features that may help

2009 Seminars in Cutaneous Medicine and Surgery

165. Trial of an Intratumoral Injections of INXN-3001 in Subjects With Stage III or IV Melanoma

: 18 Years to 75 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Males or females of all races ≥ 18 years of age and ≤ 75 years of age; Unresectable Stage III C (in transit) or Stage IV melanoma (M1a, M1b, M1c with LDH ≤ 2x ULN), arising from primary cutaneous, mucosal, or subungual melanoma of any tumor thickness or from an unknown primary site; A minimum of 2-3 accessible nonvisceral lesions (longest diameter ≤3 cm) or palpable (...) Trial of an Intratumoral Injections of INXN-3001 in Subjects With Stage III or IV Melanoma Trial of an Intratumoral Injections of INXN-3001 in Subjects With Stage III or IV 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 number of saved studies (100). Please remove one or more

2008 Clinical Trials

166. Dasatinib in Treating Patients With Locally Advanced or Metastatic Mucosal Melanoma, Acral Melanoma, or Vulvovaginal Melanoma That Cannot Be Removed By Surgery

for eligibility information Ages Eligible for Study: 18 Years to 120 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria DISEASE CHARACTERISTICS: Histologically or cytologically confirmed melanoma of 1 of the following subtypes: Acral melanoma (defined as occurring on the palms, soles, or subungual sites) Melanoma arising from the vagina and/or vulva Melanoma arising on other mucosal surface (not vagina or vulva) Unresectable locally advanced or metastatic disease (...) Dasatinib in Treating Patients With Locally Advanced or Metastatic Mucosal Melanoma, Acral Melanoma, or Vulvovaginal Melanoma That Cannot Be Removed By Surgery Dasatinib in Treating Patients With Locally Advanced or Metastatic Mucosal Melanoma, Acral Melanoma, or Vulvovaginal Melanoma That Cannot Be Removed By Surgery - 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

2008 Clinical Trials

167. Histologic Distinction Between Subungual Lentigo and Melanoma. (PubMed)

Histologic Distinction Between Subungual Lentigo and Melanoma. The distinction between a benign subungual pigmented macule (lentigo) and an early lesion of melanoma in situ can be difficult. To identify histologic parameters of potential diagnostic value, we retrospectively reviewed biopsies and excisions of 35 pigmented nail lesions. We studied 20 melanomas (10 invasive and 10 noninvasive) and 15 benign subungual melanotic lentigines. Ten specimens of normal nail apparatus obtained for reasons (...) other than melanonychia were also examined as controls. The parameters, which were analyzed, included the density of melanocytes, the presence of multinucleated cells, pagetoid spread, cytologic atypia, inflammation, and the distribution of melanin pigment. The density of melanocytes was measured as the number of cells per 1 mm stretch of subungual dermo-epithelial junction [=melanocyte count (MC)]. The MC for invasive melanomas was as follows: mean=102, median=92.5, and range 52 to 212

2008 American Journal of Surgical Pathology

168. Pyogenic Granuloma

reported the use of sclerotherapy employing sodium tetradecyl sulfate as the sclerosant. As with cryotherapy, this technique does not provide a histological specimen [ ] . Moreover, sodium tetradecyl sulfate is only licensed for the treatment of varicose veins in the UK, so the usual considerations concerning the use of unlicensed medicines apply. When to refer For assistance with diagnosis and removal. Following a recurrence. Where a nodular melanoma is suspected. Complications Pain and bleeding (...) (3):44-6. doi: 10.3315/jdcr.2010.1050. ; Multiple periungual pyogenic granulomas following systemic 5-fluorouracil. Australas J Dermatol. 2006 May47(2):130-3. ; 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 Feb11(2):262-8. ; Multiple disseminated pyogenic granuloma after second degree scald burn: a rare two case. Int J Burns

2008 Mentor

169. Nail Disorders and Abnormalities

by pseudomonal infection, which results in green-blue or black discolouration. Blue nails May occur as a side-effect of certain medications, such as minocycline, hydroxyurea or mepacrine. Black nails These may be a feature of Peutz-Jeghers syndrome, vitamin B12 deficiency, pseudomonas infection and post-irradiation. Black streaks may indicate a junctional melanocytic naevus or malignant melanoma. Purple/black discolouration occurs with a subungual haematoma. This should gradually grow distally (...) separate article. Virtually all patients with psoriasis have nail involvement at some time and it occurs in 50% of cases at any given time [ ] . Abnormalities include nail pits, transverse furrows, crumbling nail plate, roughened nails. Nail pitting Nail pitting is associated with alopecia areata as well as with psoriasis. It can sometimes be seen in nail bed 'oil spot', distal onycholysis, distal subungual hyperkeratosis, splinter haemorrhages and false nail following spontaneous separation of nail

2008 Mentor

170. HIV and Skin Disorders

. Intraoral or multiple squamous cell carcinomas, Bowen's disease and metastatic basal cell carcinoma (BCC) have occasionally been reported in patients with HIV. [ ] The usual dictum about BCC is that it does not metastasise. However, 'eruptive' BCC has been reported, in which multiple BCCs have developed following the appearance of a single lesion in a patient with HIV. [ ] Malignant melanoma in patients with HIV appears to be more aggressive. [ ] Children with AIDS have a higher risk of developing (...) accompany any chronic illness. [ ] Zidovudine may produce longitudinal, transverse, or diffuse melanin pigmentation of the nails but nail pigmentation has also been observed in patients with HIV who have never received the drug. [ ] Proximal subungual onychomycosis is highly suggestive of HIV disease. [ ] Drug reactions [ ] Morbilliform drug eruptions occur in around two thirds of patients who are treated with co-trimoxazole. Nowadays this is rarely used in British general practice but it is the drug

2008 Mentor

171. Fungal Nail Infections

of the nail, typically of the big toe, thought to be due to previous nail bed trauma). Trauma (tight shoes, nail biting). Poor foot care. irritant or allergic . . Subungual melanoma. . Bacterial paronychia - eg, Pseudomonas spp. infection. Systemic disease - eg, thyroid disease, diabetes, peripheral arterial disease. Rare systemic disorders - eg, keratosis follicularis (Darier's disease), , nail-patella syndrome, pachyonychia congenita. Idiosyncratic (especially tetracyclines, quinolones and psoralens (...) . [ ] Clinical appearance does not necessarily correlate with the causative organism, thus differentiation should be based entirely on microbiological evidence. Presentation [ , ] The toenails are affected in about 80% of cases of OM. Distal and lateral subungual onychomycosis (DLSO) DLSO form the vast majority of cases of OM: Nearly always caused by dermatophytes. Can either affect a healthy nail or one already diseased - eg, by psoriasis. Affect the hyponychium (epithelium of nail bed), often

2008 Mentor

172. Bowen's Disease

. [ ] They are most commonly found in sun-exposed areas: on the lower limbs in the UK (60-85%) or head and neck in Australia (44%), Denmark (40-59%) and the USA (66%). It is not known why there is a variation in the body site affected across different countries. [ ] Other locations are subungual, periungual, palmar, genital or perianal. When it arises on the mucosal surfaces of the glans penis, it is referred to as erythroplasia of Queyrat (EQ). Some vulval lesions also have features of Bowen's disease (...) -melanoma skin cancer (NMSC); a third of patients will have another NMSC at the time of diagnosis and patients with Bowen's disease are 4.3 times more likely to develop NMSC in the future, most likely due to the common aetiology of ultraviolet (UV) light. Patients should therefore be followed up; however, there is no definitive guidance on the follow-up regime and it should be guided by the risk factors in the individual. Prevention The risk of Bowen's disease is reduced by sun-protective behaviour, ie

2008 Mentor

173. Multicenter Selective Lymphadenectomy Trial II (MSLT-II)

this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 75 Years (Adult, Older Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Ability to provide informed consent. Between 18 and 75 years of age. Have a primary melanoma that is cutaneous (including head, neck, trunk, extremity, scalp, palm, sole, subungual (...) (NCI) Information provided by (Responsible Party): John Wayne Cancer Institute Study Details Study Description Go to Brief Summary: Subjects must be diagnosed with melanoma. All subjects receive sentinel lymphadenectomy. If the subject is sentinel node positive and meets study requirements, the subject is randomized to receive either (1) completion lymphadenectomy (2) observation with nodal ultrasound. Subjects are then followed for 10 years. Condition or disease Intervention/treatment Phase

2006 Clinical Trials

174. Multicenter Selective Lymphadenectomy Trial (MSLT)

: The patient consents to be in the study. The patient must have invasive melanoma with: 1) Clark Level III and Breslow Thickness greater than or equal to 1.00 mm; or 2) Clark Level IV or V with any Breslow thickness. A confirmation of diagnosis and thickness must be made by the institutional pathologist. The primary cutaneous melanoma site must be on the head, neck, trunk, extremity, scalp, palm of the hand, sole of the foot, or subungual skin. The patient's biopsy must have been completed no more than 10 (...) Cancer Institute Study Details Study Description Go to Brief Summary: Subjects must be diagnosed with melanoma. All subjects receive Wide Excision (WEX) of their melanoma. If the melanoma meets study requirements, the subject is randomized to receive either (1) no further surgical procedures as part of the study or (2) a Selective Lymphadenectomy with the possibility of a Complete Lymphadenectomy. Subjects are then followed for 10 years. Condition or disease Intervention/treatment Phase Melanoma

2006 Clinical Trials

175. "Hitting the nail on the head". (PubMed)

"Hitting the nail on the head". Subungual malignant melanoma is a rare form of malignancy that can present at an advanced stage. We describe a case that was diagnosed after a presentation to the emergency department for a traumatic injury of the affected area. Initial presentations of malignant disease and its complications form a relatively low proportion of the caseload of emergency doctors. In this case, a patient presented after a minor injury that had failed to recover; subsequent (...) investigation of this injury led to the diagnosis of subungual malignant melanoma in an otherwise asymptomatic patient. This is a rare case which presented in an atypical fashion, with a confounding history of minor trauma. It is presented to highlight the differential diagnosis of destructive bone lesions.

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2007 Emergency Medicine Journal

176. Diagnosis and management of nail pigmentations. (PubMed)

Diagnosis and management of nail pigmentations. Longitudinal pigmentation of the nail is very common. The differential diagnosis varies from subungual hematoma, to a fungal infection, to a melanocytic lesion (lentigo, nevus melanoma, etc.) to others. Often, dermatologists do not feel at ease with these pathologies and management is often not clear. In many cases, a biopsy is not helpful because an inadequate technique was chosen. The use of noninvasive techniques such as dermoscopy has been

2007 Journal of American Academy of Dermatology

177. Nail pigmentation due to hydroxycarbamide. (PubMed)

be seen as side effect and always has to be differentiated from subungual malignant melanoma.

2007 International Journal of Dermatology

178. Dermoscopic examination of nail pigmentation. (PubMed)

melanonychia were included over a period of 4 years (20 melanoma, 37 nevi, 16 drug-induced nail pigmentation, 45 nail apparatus lentigo of various types, 8 ethnic-type nail pigmentation, and 22 subungual hemorrhages). All patients were recruited from the dermatology unit outpatient clinic of the Hôtel Dieu de Lyon. All cases were photographed in vivo under oil immersion (dermoscopy). Patterns were recorded prior to final pathologic diagnosis. An independent biostatistics unit performed statistical (...) evaluation using 7 semiologic patterns.Melanoma cases were significantly associated with a brown coloration of the background and the presence of irregular longitudinal lines (P =.001). Blood spots were mostly observed in subungual hemorrhages (P =.001); however, their presence could not rule out melanoma. Micro-Hutchinson sign was observed only in melanoma, but its rare occurrence did not allow any statistical evaluation of its specificity. Nail apparatus nevi were significantly associated with a brown

2002 Archives of Dermatology

179. The prevention, diagnosis, referral and management of melanoma of the skin

common in people over 60 years old. Acral lentiginous melanomas Rarest type. Found on the soles or palms or under the nail (subungual). (Fig 12) Occur in all ethnic groups. Thought to be unrelated to sun exposure aetiologically.Who is at risk of melanoma? The most important phenotypic markers are an above-average mole count and sun-sensitive skin (Table 2). Individuals with either are at increased risk. The phenotypic markers of sun sensitivity are hair colour (red or blonde hair), blue eyes (...) . Melanomas which grow under the nail (subungual) (Fig 13) are most common under the thumb nail or the nail of the great toe. They appear always to arise from the nail matrix and therefore first appear at the proximal nail fold. The classical subungual melanoma arises as a narrow pigmented band in the nail, which slowly widens and ultimately produces a subungual mass (often amelanotic and friable) and which lifts up the nail plate and tends to bleed. This form of melanoma is very easy to misdiagnose

2007 British Association of Dermatologists

180. Mortality, major amputation rates, and leukopenia after isolated limb perfusion with phenylalanine mustard for the treatment of melanoma

had disease diagnosed as satellite lesions (stage 2) or diffuse local and systemic spread( stage 4) of cutaneous melanoma.(In all studies the disease stage was classified on the basis of the MD Anderson classification). Outcomes assessed in the review Mortality (defined as death within 30 days after surgery or any death related to ILP); major amputation (defined as loss of the extremity as a result of ILP; the amputation of a digit to treat subungual melanoma was not defined as major amputation (...) Mortality, major amputation rates, and leukopenia after isolated limb perfusion with phenylalanine mustard for the treatment of melanoma Mortality, major amputation rates, and leukopenia after isolated limb perfusion with phenylalanine mustard for the treatment of melanoma Mortality, major amputation rates, and leukopenia after isolated limb perfusion with phenylalanine mustard for the treatment of melanoma Taber S W, Polk H C Authors' objectives To assess the risk of mortality and morbidity

1997 DARE.

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