China
Africa
Explore chapters and articles related to this topic
Benign tumors
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Onychomatricoma is a fairly common but underdiagnosed benign tumor of the nail matrix.23 Since its first description, probably more than 200 cases have been described.24–27 Men and women are equally affected, and most patients are middle-aged Caucasians. Fingers are twice as frequently involved as toes.28 It is a slowly growing, painless tumor exhibiting a funnel-shaped, yellow streaky, thickened nail with transverse overcurvature and splinter hemorrhages in its proximal portion. Usually, only a segment of the nail is involved, but also the entire matrix may be affected (Figure 26.12a–c). End-on view exhibits tiny holes (woodworm like holes) in the nail plate (Figure 26.12d). On cutting such a nail, it may bleed from such a hole29 as the long filiform projections of the tumor may extend to the free margin of the nail and dilated capillaries may remain patent. The filiform projections of the tumor can be visualized with the naked eye, giving an appearance of a “sea anemone” (Figure 26.12e). Pigmented and mucinous onychomatricomas, a pterygium-like appearance, and nail fold swelling have been described.30,31 A cutaneous horn is an exceptional presentation.27 A polypoid variant was also reported.32 Onychomycosis is not rare in onychomatricoma. MR imaging shows the characteristic channels in the nail plate.26 The bone is not involved. Ultrasound may help to make the correct diagnosis.33
Cryotherapy
Published in Dimitris Rigopoulos, Alexander C. Katoulis, Hyperpigmentation, 2017
Paola Pasquali, Myrto-Georgia Trakatelli
Keratin is a poor conducting material. Reducing it can enhance cold penetration. This is the reason why it is best to shave warts before freezing or—for lentigos and actinic damage—prepare the skin a few weeks ahead with exfoliating creams such as salicylic acid ointments or retinoic acid creams. For cutaneous horns, cryoshaving the lesion leaves a sample for anatomopathological study and leaves a denudated area that can be easily treated with a probe (Figure 32.1).
Epithelial and fibroepithelial tumors
Published in Eckart Haneke, Histopathology of the NailOnychopathology, 2017
Onychomatricoma is probably an underdiagnosed benign tumor of the nail matrix. Since its first description by Baran and Kint in 1992,72 roughly 200 cases have been described but certainly more were observed.73–77 Men and women are equally affected. By far, most patients are middle-aged Caucasians, but one patient was black78 and one case occurred in a child.79 Fingers are twice as frequently involved as toes.80 Clinically, it is an insidiously growing, painless tumor characterized by a funnel-shaped, yellow streaky, thickened nail with transverse overcurvature and splinter hemorrhages in its proximal portion.81 Usually, only a segment of the nail is involved, but also the entire matrix may be affected.82 End-on dermatoscopy exhibits tiny holes in the nail plate. On cutting such a nail, it may bleed from such a hole83 as the long filiform projections of the tumor may extend to the free margin of the nail and dilated capillaries may remain patent although this is very rare. Pigmented variants of onychomatricoma and onychomatricomas leading to a pterygium-like appearance have been described.84–86 Depending on their main location, they may also cause nail fold swelling.63 In rare occasions, a cutaneous horn may be formed.87 A polypoid variant was also reported.88 Onychomycosis may be a complicating additional factor.84
Pharmacokinetics of ingenol mebutate gel under maximum use conditions in large treatment areas
Published in Journal of Dermatological Treatment, 2018
Alicia D. Bucko, Michael Jarratt, Dowling B. Stough, Laerke Kyhl, John Villumsen, Anders Hall
Patients with at least 10 (later amended to 15) clinically typical, visible, and discrete AKs (tending towards the high end of the range of disease severity) on the full face, approximately 250 cm2 on the balding scalp, or within an area of approximately 250 cm2 on the arm except the back of the hand were included in the trial. Patients were excluded from the trial if the selected treatment area was within 5 cm of an incompletely healed wound, or within 10 cm of a suspected basal cell carcinoma or SCC. Other exclusion criteria included prior treatment with ingenol mebutate within 3 months of the trial; atypical lesions (hypertrophic, hyperkeratotic, or cutaneous horns) in the treatment area; non-responsive lesions (i.e. did not respond to cryotherapy on two occasions); and history of skin conditions other than AK (such as eczema, unstable psoriasis, or xeroderma pigmentosum), which might interfere with the trial assessments.
Current developments in pharmacotherapy for actinic keratosis
Published in Expert Opinion on Pharmacotherapy, 2018
Elena Campione, Alessandra Ventura, Laura Diluvio, Mauro Mazzeo, Sara Mazzilli, Virginia Garofalo, Monia Di Prete, Luca Bianchi
AKs clinically present squamous or hyperkeratotic papules or plaques on an erythematous background, but they can be also pigmented, lichenoid or as a cutaneous horn. A sand paper-like texture is revealed by palpation and the surrounding skin often looks sun-damaged – blotchy, freckled, and wrinkled. In this perilesional photodamaged tissue, we may have subclinical AKs, within the pro-oncogenic entity known as a field of cancerization (FC) [6]. The FC theory describes the growth of several lesions arising from the accumulation of preneoplastic changes over an area of epithelium after long-term exposure to carcinogenic mediators [7].