Combination therapy of oral terbinafine and ciclopirox nail lacquer is a safe and more effective treatment for onychomycosis than terbinafine alone, especially in younger patients and in shorter-duration onychomycosis.

Nail deformations are more prevalent in CVI patients (84%) then in the general elderly population, and 75% of affected nails had also onychomycosis. In these patients, itraconazole achieved only 25% total cure rate compared with the 60% to 70% cure rate commonly cited in the literature, probably due to irreversible nail deformity caused by the CVI and due to the thickened nail that prevented penetrance of itraconazole into the nail plate. Therefore, before antifungal treatment is started for onychomycosis in patients with CVI, especially in older patients, the caregiver must stress out that the final outcome might not be as desirable as in pure onychomycosis patients.

Hypothesis: Previous interventions (excisional biopsy, incomplete dissection) in the regional basin that drain a melanoma site prior to definitive surgical procedures significantly increase the risk of melanoma recurrence in the surgical field. Design: Retrospective analysis. Setting: Tertiary care referral center. Patients: One hundred forty-one consecutive patients who underwent radical lymph node dissection (RLND) either in the groin or the axilla owing to malignant melanoma were followed up for a median period of 41 months. Interventions: All of the 141 patients received either elective or therapeutic RLND. Their medical records were analyzed for demographic data, disease history, previous treatments, recurrence patterns, and survival. Main Outcome Measures: Patterns of first recurrence after RLND and survival. Results: Radical lymph node dissection was performed on 148 lymph node basins (141 patients; 86 axillae and 62 groins). Nineteen patients (13%) received previous open interventions in the lymph node basin (tampering) other than radical dissection. Radical lymph node dissection was