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Subungual Fibroma

Subungual Fibromata


Presentation

  • Subungual Tumor of Right Great Toenail With Associated Nail Plate Dystrophy A, At presentation, subungual tumors involving the patient's right great toe were causing distortion of the nail.[jamanetwork.com]
  • RESULTS: A 66-year-old woman presented with a longstanding (40 years), subungual mass that deformed the nail of the left middle finger.[ncbi.nlm.nih.gov]
  • Synonym: melanotic whitlow. (05 Mar 2000) ameloblastic fibroma A benign mixed odontogenic tumour characterised by neoplastic proliferation of both epithelial and mesenchymal components of the tooth bud without the production of dental hard tissue; presents[kmle.co.kr]
  • A 54-year-old man presented with paronychia and markedly thickened hyperkeratotic nail. The nail plate was removed, and an exophytic, red, friable, granulation tissue-like lesion was revealed subungually.[ncbi.nlm.nih.gov]
  • Modern Surgical Pathology, 2nd Edition presents today's most complete, current, and practical assistance in evaluating and signing out surgical specimens.[books.google.de]
Pain
  • Utilize the very latest approaches in hip surgery including hip resurfacing, hip preservation surgery, and treatment of hip pain in the young adult; and get the latest information on metal-on-metal hips so you can better manage patients with these devices[books.google.com]
  • Unguis, nail (05 Mar 2000) subungual abscess Suppuration extending beneath a fingernail or toenail, usually from a parenychia. (05 Mar 2000) subungual exostosis Painful osseous outgrowths that elevate the nail of the great toe or fingers in young people[kmle.co.kr]
  • ., a woman 28 years old, complained of pain in the tip of the third finger of the right hand. This pain began twelve years previously when a drawer was slammed on the finger.[jamanetwork.com]
  • The patient was having pain associated with the subungual fibromas and nail plate distortion. Surgical intervention had previously been offered for treating the facial collagenomas and the subungual fibromas, but the parents had declined.[jamanetwork.com]
  • […] nodule which you can not expect it in fungal infection, I guess it is more likely to be a glomus tumor : painful benign tumor of the endothelium of vessels. 2 Reply[dailyrounds.org]
Swelling
  • Presentation is usually with pain and swelling. There may be ulceration of the overlying nail 3. Subungual exostoses probably result from metaplasia in mechanical irritations or diseases of the nailbed although the precise etiology is unknown 2.[radiopaedia.org]
  • (beneath the toenails) After 3-7 days incubation a painful, red, swelling develops before appearance of a cluster of vesicles (small bubbles enclosed by lipid bilaye- fatty molecules). Can mimic a bacterial infection.[quizlet.com]
  • Case 1 A 36-year-old woman presented with a firm subungual swelling of the right great toe. The lesion had developed over a period of 1.5 years; it was initially asymptomatic, but became painful with time.[karger.com]
  • Additionally, there may be longitudinal melanonychia, proximal nail swelling and splinter hemorrhages found in capillaroscopy. We herein, describe two Mexican patients with onychomatricoma.[ijdvl.com]
  • Swelling of the proximal nail fold caused by underlying warts. Dermatology. 2001;202:328–9. PubMed CrossRef Google Scholar 3. Baran R, Goettmann S. Distal digital keratoacanthoma: a report of 12 cases and review of the literature.[link.springer.com]
Pathologist
  • Edited by four leading surgical pathologists - Noel Weidner, MD, Richard J. Cote, MD, Saul Suster, MD and Lawrence M.[books.google.de]
  • It is essential that the biopsy specimen be reviewed by an expert pathologist who is familiar with LAM.[thelamfoundation.org]
  • If the pathology reading does not make sense to you, it is your obligation to speak with the pathologist or you may send the slides to another pathologist. This is a common practice.[podiatrytoday.com]
Surgical Procedure
  • Thoracotomy is a major surgical procedure. This procedure takes place in the hospital under general anesthesia. Open biopsy should only be performed as a last resort to diagnose LAM.[thelamfoundation.org]
  • Surgical procedure was performed with a distal block and a tourniquet (fig. 3 b-d). After distal nail plate avulsion, we discovered a bony ridge parallel to the hyponychium. This was removed by a rasparator.[karger.com]
Developmental Delay
  • Developmental delay and behavioural problems may also occur. Symptoms include mild to severe mental retardation, autism, attention deficit disorder (ADD), anxiety, depression, paranoia and schizophrenia.[dermnetnz.org]
Fracture
  • See how to proceed better than ever before with 45 surgical videos demonstrating hip revision, patellar tendon allograft preparation, open reduction internal fixation clavicle fracture, total shoulder arthroplasty, total elbow arthroplasty, and more -[books.google.com]
  • About 40% of osteochondromas are located in proximity to the knee. 1 Most osteochondromas are asymptomatic, although symptoms can occur if there is an associated fracture, vascular involvement, neurologic sequelae, bursa formation, or malignant transformation[consultant360.com]
Nail Deformity
  • Patient #1 is a 59-year-old woman with a 20-year history of nail deformity affecting the second left finger, characterized by painful central linear subungual hyperkeratosis and onycholysis [Figure 1] a.[ijdvl.com]
  • Total or partial nail bed resection may cause significant pain, nail deformity and delay in return to daily activity.[healio.com]
  • deformity might also be present.[consultant360.com]
  • A longitudinal groove was the most commonly associated nail deformity (16/20, 80%).[ijdvl.com]
Skin Lesion
  • A female toddler with known TSC presented with multiple skin lesions characteristic of TSC; these included 5 facial collagenomas, more than 20 hypopigmented macules and patches consistent with ash leaf macules, and bilateral subungual tumors of the first[jamanetwork.com]
  • Skin lesions are found in 60-70% of cases of tuberous sclerosis .[dermnetnz.org]
  • They are uncommon skin lesions that occur when the deeper layers of the skin do not develop correctly. Based on the clinical picture of this patient, I had some reservation about the diagnosis.[podiatrytoday.com]
  • lesions; Mohs surgery; lipectomy; verrucae and seborrhoecae vulgares, including: paronychial, periungal, and subungual warts; blepharoplasty; and hair transplantation site preparation.[lightscalpel.com]
  • Medical Treatment for TSC Skin Lesions New medical treatments for TSC are being tested that may supplement current surgical approaches for treatment.[tsalliance.org]
Hypopigmented Macule
  • A female toddler with known TSC presented with multiple skin lesions characteristic of TSC; these included 5 facial collagenomas, more than 20 hypopigmented macules and patches consistent with ash leaf macules, and bilateral subungual tumors of the first[jamanetwork.com]
  • Multiple, discrete, small, confetti-like, hypopigmented macules of variable size on the leg. 8. Detection of ash leaf spots may require Wood's lamp examination(UVA), especially in fair-skinned individuals.[slideshare.net]
  • One study has also reported improvement in hypopigmented macules .[dermnetnz.org]
  • Tuberous sclerosis is a multi-system genetic condition with key features including multiple facial angiofibromas, hypopigmented macules, seizures, cardiac rhabdomyoma and renal lesions.[podiatrytoday.com]
Eruptions
  • […] pigmentation of the normal nail plate, and may be present as a normal finding on many digits in black patients, as a result of trauma, systemic disease, or medications, or as a post-inflammatory event from such localized events as lichen planus or fixed drug eruption[wikidoc.org]
Seizure
  • Other manifestations of TSC included known cardiac rhabdomyoma diagnosed prenatally and multiple daily seizures since infancy. Genetic testing had revealed mutations in both TSC1 and TSC2 . Figure 1.[jamanetwork.com]
  • Usually begins in infancy or early childhood and may precede appearance of skin lesions by years The greater the number of tumours (cortical tubers) in the brain, the greater the severity of seizures.[dermnetnz.org]
  • He denies seizures and other past medical history. There was no family history of any systemic issues, mental retardation or polydactly.[podiatrytoday.com]
  • These include: Patient profile involves obtaining a full history, including smoking, use of birth control pills, seizure history and family history of tuberous sclerosis complex (TSC). Physical evidence of TSC should be sought carefully.[thelamfoundation.org]
Confusion
  • CONCLUSION: Pleomorphic fibroma of the subungual region is an unusual cutaneous tumor with histologic features that may cause confusion with true sarcomas. This is only the second case reported of a subungual pleomorphic fibroma.[ncbi.nlm.nih.gov]
  • When it comes to Caucasians, the majority of squamous cell carcinomas are found in sun-exposed areas.10 Squamous cell carcinoma may also be confused with the diagnosis of a “recalcitrant” wart so getting a biopsy is very important.[podiatrytoday.com]

Workup

Polyps
  • Synonym: acrochordon, fibroepithelial polyp, fibroma molle, senile fibroma, soft wart. (05 Mar 2000) fibroma molle gravidarum Skin tags or polyps that develop on women during pregnancy and often disappear at term. (05 Mar 2000)[kmle.co.kr]
  • Otorhinolaryngology / ENT : Laser incision, excision, ablation, vaporization, and / or photocoagulation of soft tissue for the treatment of: leukoplakia, including oral, larynx, uvula, palatal, and upper lateral pharyngeal tissue; adult and juvenile papillomatosis polyps[lightscalpel.com]
  • These lesions are commonly known as skin tags and occasionally fibroepithelial polyps. They often develop in areas of skin friction, which certainly takes place at the tip of the toe.[podiatrytoday.com]

Treatment

  • Their treatment options have been quite limited to date.[jamanetwork.com]
  • @article{021e67edf64b423394b110bd05acc662, title "Successful treatment of subungual fibromas of tuberous sclerosis with topical rapamycin", author "Muzic, {John G.} and Kindle, {Scott A.} and Tollefson, {Megha M.[mayoclinic.pure.elsevier.com]
  • Make informed clinical choices for each patient, from diagnosis and treatment selection through post-treatment strategies and management of complications, with new evidence-based criteria throughout.[books.google.com]
  • Stay at the forefront of your field with updated treatment methods throughout, as well as an increased focus on patients with skin of color.[books.google.com]

Prognosis

  • , fair hair and complexion, freckling xer oderma pigmentosa familial atypical mole or melanoma (FAMM) syndrome multiple benign and dysplastic nevi dysplastic nevi a re a precursor immunesuppression Pathophysiology progresses through phases of growth Prognosis[orthobullets.com]
  • Treatment and prognosis These lesions are benign. Resection of the exostosis and curettage of the underlying bone is curative 1.[radiopaedia.org]
  • Prognosis May recur locally. No metastases reported. References Fetsch, J. F., Laskin, W. B., Miettinen, M.[e-immunohistochemistry.info]

Etiology

  • Etiology unknown Trauma has been implicated but no studies have substantiated that hypothesis Clinical features Skin colored, slow growing firm nodule, from a few millimeters to over 1 cm in size Rare giant variants have been described ( Ann Dermatol[pathologyoutlines.com]
  • Subungual exostoses probably result from metaplasia in mechanical irritations or diseases of the nailbed although the precise etiology is unknown 2. The lesion is composed of mature fibrocartilaginous tissue and bone and resembles callus 1,3.[radiopaedia.org]
  • However, the etiology of acquired ungual fibrokeratoma is still unknown.[ijdvl.com]
  • Available from: Sir, Onychomatricoma is a rare subungual tumor of unknown etiology that affects the nail apparatus. It consists of a thickened yellowish nail with transverse over-curvature, ridging and dystrophy.[ijdvl.com]
  • Etiology and pathophysiology The pathogenesis of subungual exostosis is unknown, but current theories include trauma, infection, tumor, hereditary abnormality, or activation of a cartilaginous cyst.[clinicaladvisor.com]

Epidemiology

  • Definition / general Acquired benign lesion of acral (limb or other extremity) skin Terminology Also known as acral fibrokeratoma and acquired periungual fibrokeratoma Epidemiology Middle aged adults Men women Sites Classically located on fingers and[pathologyoutlines.com]
  • Introduction An aggresive skin malignancy of melanocytic origin types include acral lentiginous melanoma subungual melanoma is a subtype of ALM Epidemiology demographics slightly more common in men (male:female ratio 1.2:1) age bracket is 50-70yrs location[orthobullets.com]
  • Tavares G, Di-Chiacchio N, Di-Santis E, Alvarenga L, Stuhr P, de-Farias D, Tosti A, Di-Chiacchio NG: Onychomatricoma: epidemiological and clinical findings in a large series of 30 cases. Br J Dermatol 2015;173:1305-1307.[karger.com]
Sex distribution
Age distribution

Pathophysiology

  • […] melanocyte DNA family histor y skin characteristics blue eyes, fair hair and complexion, freckling xer oderma pigmentosa familial atypical mole or melanoma (FAMM) syndrome multiple benign and dysplastic nevi dysplastic nevi a re a precursor immunesuppression Pathophysiology[orthobullets.com]
  • Etiology and pathophysiology The pathogenesis of subungual exostosis is unknown, but current theories include trauma, infection, tumor, hereditary abnormality, or activation of a cartilaginous cyst.[clinicaladvisor.com]

Prevention

  • prevent melanoma with sunscreen and avoiding sun exposure Complications Recurrence usually regional lymph nodes Please rate topic.[orthobullets.com]
  • Prophylatic antiviral treatments sometimes are needed before the surgery to prevent wound infection. There is typically minimal postoperative pain when the face is treated with liberal application of topical emollient ointments.[tsalliance.org]

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