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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Amélie Boespflug, Félix Pham, Ralph P. Braun, Luc Thomas
A subungual hemorrhage, also called subungual hematoma, is due to the presence of a collection of blood in the space between the nail bed and the nail plate. Subungual hemorrhage may result from an acute injury or repetitive minor trauma to the nail apparatus (Figures 11d.2, 11d.3). The most frequent digits involved are the thumb and the hallux.
Fingertip injury
Published in Peter Houpt, Hand Injuries in the Emergency Department, 2023
In case of exposed bone a local transposition flap is required. This type of reconstruction belongs in the armamentarium of hand surgeons. Fingertip injuries involving the nail complex should have the subungual hematoma drained by drilling a small hole in the nail plate (or puncturing it with a heated paperclip). A subungual hematoma covering more than 50% of the surface area requires removal of the nail and repairing the nail bed with 6-0 absorbable sutures. The eponychium is kept open by replacing the old nail. In case of defects of the nail bed, a nail bed graft may be considered. This too belongs to the area of the hand surgeon.
Hematomas
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Subungual hematoma, or subungual hemorrhage, is defined as a blood collection between the nail bed or matrix and the nail plate. It may arise from an acute trauma or from repetitive minor trauma to the nail unit. It is a very common chief complaint or incidental finding in dermatologic practice. Patients or referring physicians are often concerned about subungual melanomas especially when the pigmented area is present for some time. Less often patients present because the subungual hematoma is causing pain.
The pharmacotherapeutic management of nail unit and acral melanomas
Published in Expert Opinion on Pharmacotherapy, 2022
Julianne M. Falotico, Shari R. Lipner
Nail unit melanoma (NUM) is an infrequent variant of ALM [31,32]. NUM incidence varies across skin types, with higher prevalence in Blacks (up to 25%) and Asians (10%–23%) compared to Caucasians (0.18%–2.8%) [33–37]. Average age at diagnosis is between 60 and 70 years old [38], and reported cases in the pediatric population are exceedingly rare [39,40]. The thumbnail and great toenail are the most commonly affected anatomic locations (Figure 2) [41,42]. Unlike CM, ultraviolet radiation is not considered a risk factor for NUM due to lack of nail plate penetrance [43]. Diagnosis is challenging, since NUM most often originates in the nail matrix (which is covered by the nail plate) [44], with a high frequency (15–65%) of amelanotic cases [45,46]. NUM is frequently misdiagnosed as trauma, onychomycosis, subungual hematoma, and other benign nail conditions [32,47]. Consequently, delayed diagnosis may contribute to higher recurrence rates and worse survival rates for AM and NUM compared to non-acral melanomas [48,49].
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
As recently as 2018 Kim et al. noted that the pathogenesis of onychopapilloma is not fully understood but that it appeared to involve the distal matrix and therefore they suggested that band sparing of the proximal nail (absence of the lesion proximally) is a characteristic feature of onychopapilloma [10]. Differential diagnosis includes nevus, melanoma, lichen planus, traumatic subungual hematoma, glomus tumor, squamous cell carcinoma in situ basal cell carcinoma, wart [5,7,11–13].
Evaluation of long pulsed Nd-YAG laser in the treatment of onychomycosis
Published in Journal of Cosmetic and Laser Therapy, 2019
Samia Ali Ibrahim, Waleed Albalat, Howyda Mohamed Ebrahim
Patients were used topical or systemic antifungal therapy in the preceding 6 months. Patients were on tetracycline, systemic retinoid, vasodilators, chemotherapy, radiotherapy and immunosuppressive treatment. Subungual hematoma, nevoid subungual development, bacterial nail contaminations and any other nail diseases as psoriasis lichen planus or atopic dermatitis, Pregnancy, HIV-infected patients were excluded.