Primary Malignant Tumors of the Nail Unit

Multiple calcified subungual epidermoid inclusions

“…Frequent causes include onychomycosis, trauma, and exostosis, with less frequent causes including dermatologic diseases such as psoriasis and lichen planus, as well as a long list of relatively uncommon primary and metastatic tumors. 1 Occasionally the diagnosis in such cases is made on clinical findings alone. More often, however, a sampling of the nail plate for potassium hydroxide, fungal culture, or histology with periodic acideSchiff staining, a radiographic study, or biopsy is performed for diagnosis.…”

“…C apillary leak syndrome is caused by capillary hyperpermeability resulting in an accumulation of fluid and proteins in the interstitial space, with subsequent hypovolemic shock. 1 Symptoms consist of fever, localized or diffuse skin edema, weight gain, renal failure, and hypovolemic shock. Muscular edema may initiate myalgias and rhabdomyolysis, and occasionally nerve compression.…”

“…2 Laboratory tests usually show leukocytosis, elevated hematocrit, neutrophilia, hypoproteinemia or hypoalbuminemia, and IgG monoclonal gammopathy. 1 Three forms of capillary leak syndrome are recognized: (1) idiopathic 1,3 ; (2) associated with cutaneous diseases, such as erythrodermic and pustular psoriasis, 4-6 Ofuji's papuloerythroderma, and…”

Nail matrix biopsy of longitudinal melanonychia: Diagnostic algorithm including the matrix shave biopsy

“…12,13 Recent publications have reviewed the etiology, differential diagnosis, work-up, and prognosis of LM, and these topics are beyond the scope of this article. [12][13][14][15][16][17] Of particular importance, however, is the use of dermoscopy in evaluating LM. [18][19][20][21][22][23][24] Ronger et al 21 elegantly studied this topic and identified several dermoscopic features suggestive of melanoma and other, benign diagnoses.…”

Alternatives to complete nail plate avulsion

“…1 Traditional teaching advocates total plate avulsion, either performed distal-to-proximal (distal) or proximal-to-distal (proximal), 2 with the goal of achieving maximum exposure of the nail bed and matrix. However, for many nail surgeries, partial plate avulsion or variations of total plate avulsion can be a preferable alternative.…”