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Warts
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Sonali Nanda, Rachel Fayne, Martin N. Zaiac
Epithelioid sarcomas can present as erythematous, firm nodules of the lateral proximal fold. Histopathology reveals epithelioid tumor cells that stain strongly positive for vimentin. Subungual exostoses are firm, bony tumors of the distal phalanx that can present with hyperkeratosis and lifting of the nail plate with growth.17 Although these lesions are not difficult to diagnose clinically, radiography can help confirm diagnosis of exostoses if necessary. Glomus tumors are usually solitary and cause severe, localized pain.18 Lichen planus and lichen nitidis of the nail is uncommon and can imitate warts if located in the proximal nail fold or hyponychium.2 Swelling and discoloration may be seen. Onychomatricomas are typically indolent and painless, usually occurring in Caucasian women in their 40s.19
Microdeletion Syndromes
Published in Merlin G. Butler, F. John Meaney, Genetics of Developmental Disabilities, 2019
Gopalrao V. N. Velagaleti, Nancy J. Carpenter
Early assessment of speech and appropriate treatment of speech and language delays should be performed. Hearing evaluations and early intervention in individuals with hearing loss are also necessary. Growth parameters should be monitored. Plastic surgery may be considered for the facial abnormalities such as the nasal deformity, prominent ears, and fatty infiltration of the upper lip. Dislocation or subluxation of the hips may be managed by nonsurgical or surgical treatment. Surgical removal of the exostoses may be necessary if they are deforming, impinge on nerves or blood vessels, or interfere with joint function. Early assessment of developmental delays and intellectual impairment and early intervention are appropriate to achieve an optimal cognitive outcome. Psychological evaluation and treatment may be necessary for some patients who experience difficulties due to abnormal facial appearance, learning disabilities, and short stature.
Nail in elderly population
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
A. S. Savitha, B. M. Shashikumar
Pincer nail refers to the over-curvature of the nail resulting in pinching the nail bed. It may affect only the great toe or all toes and cause distress to the patient due to pain. The nail thickens and turns inwards, pinching the nail bed and causing difficulty to cut it. There may be associated bone pathology like exostosis and hyperostosis (Figure 25.15a and b).
Exercise induced neuropathic lower leg pain due to a tibial bone exostosis
Published in The Physician and Sportsmedicine, 2021
Loreen van den Hurk, Marijn van den Besselaar, Marc Scheltinga
The differential diagnosis of exercise induced lower leg pain (ELP) in runners is extensive and includes tendinopathies, chronic exertional compartment syndrome (CECS), medial tibial stress syndrome (MTSS) and stress fractures [1]. The standard work up of ELP includes an X-ray, or a CT or an MRI scan of the lower leg and foot. However, even extensive imaging and functional studies may not always lead to a correct diagnosis. The present patient is a marathon runner who reported leg pain and tingling sensations toward the foot, during the day as well as at night. Physical examination revealed diminished skin sensation (hypo-esthesia) of the foot sole. Imaging revealed a calcified lesion in continuity to the proximal tibial bone. He underwent surgical removal of the lesion and neurolysis of the tibial nerve. Histology demonstrated an osteocartilaginous exostosis. The aim of this contribution is to increase the awareness of sports physicians regarding ELP of a neuropathic origin.
Treatment of spinal cord compression caused by C2 osteochondroma with reconstruction and fusion after total resection: Case report and literature review
Published in The Journal of Spinal Cord Medicine, 2021
Qian Guo, Zhong Fang, Yong Li, Yong Xu, Hanfeng Guan, Feng Li
When dealing with an osteochondroma causing spinal cord compression, resection of the tumor is necessary. Many articles demonstrate that intralesional excision of the exostoses is associated with an unacceptably high recurrence rate and should be avoided.10–12 Although not been standardized, resection via posterior laminectomy or hemilaminectomy is always inevitable for patients who suffer from spinal cord compression caused by cervical spinal osteochondromas because of the posterior location of the tumor,9 and obviously total resection is the better choice to achieve complete decompression and to avoid recurrence. We did an en bloc resection which resulted in complete decompression, as shown on the post-operative CT and MRI in Fig. 2. The improvement of muscle strength and sensation of the patient should be considered as a result of complete decompression. Because no sign of recurrence was seen one year after the operation, we thought that en bloc resection might improve the prognosis.
The impact of severe late-effects after 12 Gy fractionated total body irradiation and allogeneic stem cell transplantation for childhood leukemia (1988–2010)
Published in Pediatric Hematology and Oncology, 2019
Fernand Freycon, Léonie Casagranda, Béatrice Trombert-Paviot
Exostosis, screened in all the patients treated with fTBI conditioning, was noted in 11 patients (15%; 8 males) with a median delay of 9 years (range: 1 year 8 months to 15 years 2 months) from graft. These exostoses were more often found without any symptom and “accidently” during a radiological exam because they were mostly latent. Sometimes, they were symptomatic but then required only an exostosectomy. Osteopenia (36% of cases) was noted in 7/21 females and 9/23 males.