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Erythronychia
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Cristina Diniz Borges Figueira de Mello
Longitudinal erythronychia is a linear red band that usually extends from the lunula to the distal tip of the nail bed. When limited to one digit, the etiology is usually neoplastic, with onychopapilloma, an idiopathic benign tumor, being the most common diagnosis. The longitudinal red streak results from a localized punctate defect in the distal matrix (due to matrix function loss), inducing a longitudinal ventral groove at the undersurface of the nail, which becomes thinner (Figure 6.2B). In addition, the opposing nail bed swells to fill the concave nail plate, resulting in a vascular congestion that manifests as erythema. The thinned nail plate is more transparent, further enhancing the underlying erythema, and may disintegrate distally, favoring cracks and splits and exposing the nail bed, promoting the formation of multinucleate giant cells and protruding keratosis distally.
Chromonychia
Published in Archana Singal, Shekhar Neema, Piyush Kumar, Nail Disorders, 2019
Michela Starace, Aurora Alessandrini, Bianca Maria Piraccini
The term was proposed by Baran and Perrin in 20006 and indicates a benign tumor that arises from the distal matrix/proximal nail bed, inducing a band of longitudinal erythronychia. The distal nail plate may show a fissure and a subungual filiform hyperkeratotic mass underneath the nail plate in the area corresponding to the visible longitudinal band. An evident subungual mass with onycholysis can be a sign of onychopapilloma of bigger size.
Nail specific conditions
Published in Eckart Haneke, Histopathology of the NailOnychopathology, 2017
There are distinct histopathologic features in Darier's and Hailey-Hailey's disease (see Chapter 6) as well as warty dyskeratoma, which however may be difficult to distinguish from each other. Subungual filamentous tumor, localized multinucleate distal subungual keratosis, and onychopapilloma can also be differentiated although it is not yet clear whether distal subungual keratosis is a variant of onychopapilloma. In idiopathic longitudinal erythronychia, a longitudinal thinning of the nail plate due to a localized defective nail formation in the distal matrix may cause a vascular phenomenon of decompression with hyperemia along the nail thinning whereas the rest of the nail compresses the matrix and nail bed vessels keeping them pale.43 In Bowen's disease, atypical keratinocytes allow the correct diagnosis to be made. We have seen a capillary proliferation in the proximal nail bed causing a red spot in the lunula (Figure 7.2). Another red spot was seen in the lunula that turned out to be a traumatic matrix cyst.
A new method to treat onychopapilloma with pulsed dye laser irradiation: a 13-case series report
Published in Journal of Dermatological Treatment, 2023
Xing Fan, Tong Li, Xi Zhang, Juan Yang, Jiangbo Cui, Wenjie Dou, Yue Yin, Qing Yang, Ping Xue, Bin Liu, Yang Li
Onychopapilloma is a rare benign nail tumor affecting the distal matrix and the nail bed (1,2). It presents variously as longitudinal erythronychia (the most common), longitudinal leukonychia, longitudinal melanonychia, splinter hemorrhages, distal fissuring, subungual ketatotic mass, onycholysis, and other rare conditions (1–8). Since it was first reported in 1995 (1), there has been approximately 20 reports of 222 cases in the literature (5). Most patients seek medical attention because of the appearance of malformation and pain in the nail. At present, surgical resection is the only treatment for onychopapilloma. However, it has a recurrence rate of 20% (4), with complications including intraoperative and postoperative pain, long recovery period, and poor post-surgical appearance.
Onychopapilloma: a rare cause of longitudinal melanonychia. Usually benign (but not always). A case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Stuart H. Kuschner, Bonnie Balzer, Ryan DellaMaggiora
Most cases of onychopapilloma present with longitudinal erythronychia (red streak in the nail) [8]. Halteh et al. noted that onychopapilloma is the most common cause of localized (single digit) longitudinal erythronychia [9]. Onychopapilloma can also present as longitudinal leukonychia (white stripe) [4] or longitudinal melanonychia (brown or black) [6]. There is often a corresponding longitudinal groove in the nail plate. Tosti et al. reported that onychopapilloma can present with splinter hemorrhages without any obvious band or stripe. There may be a distal focal subungual keratotic mass and/or distal onycholysis (loss of nail plate adherence) [7].