Utilization of Mohs Micrographic Surgery in a Patient With Onychomatricoma

Onychomatricoma is a rare benign fibroepithelial filamentous tumor originating from the nail matrix. It typically presents with the clinical tetrad of xanthonychia, pachyonychia, proximal splinter hemorrhages and increased transverse overcurvature of the nail plate. The giant variant can easily confuse the clinician due to its extensive nail dystrophy that can mask the characteristic features of this tumor. Benign (fibrokeratoma, ungual fibroma, onycholytic matricoma) and malignant entities (Bowen's disease, squamous cell carcinoma, onycholytic carcinoma) are mimics of the disease. Nail surgery can facilitate the diagnosis, which should always be confirmed by histology, as rare variants do exist.

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“…The gauze is removed 3 weeks later. Mohs surgery [22] has been also used in one case in order to limit the probability of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Giant Onychomatricoma of the Great Toenail: Case Report and Review Focusing on Less Common Variants

Prevezas

Triantafyllopoulou

Belyayeva

et al. 2015

Skin Appendage Disord

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“…Honeycomb cavities at the free frontal margin of the NU may be observed at dermoscopy (Fig. ) . Surgical excision of the OM and affected matrix together with nail plate avulsion is the unique therapeutic possibility in symptomatic cases .…”

Section: Onychomatricomamentioning

confidence: 99%

“…However, a single experience of OM treated with MMS by Graves et al . was reported to spare healthy matrix of the II finger …”

Section: Onychomatricomamentioning

confidence: 99%

“…Graves et al 38 1 Onychomatricoma II fingernail None Tehrani et al 42 1 Glomus tumour III fingernail None Chuang et al 41 1 Glomus tumour V fingernail MMS converted to distal subtotal phalangeal amputation due to bone involvement Tosti et al 35 Mohs surgery for nail tumors according to different reports. 7,8,12 More recently, Topin-Ruiz et al 13 reported a 4% rate of recurrence in a series of 55 patients treated with a en block wide surgical excision of the NU, but the data were collected through questionnaires mailed to the patients.…”

Section: Bcc Hallux Nonementioning

confidence: 99%

“…1,38 Surgical excision of the OM and affected matrix together with nail plate avulsion is the unique therapeutic possibility in symptomatic cases. 38 However, a single experience of OM treated with MMS by Graves et al was reported to spare healthy matrix of the II finger. 38,39 Glomus tumour Glomus tumour (GT) is a benign neoplasm originating from Masson bodies involved in thermoregulation.…”

Section: Onychomatricomamentioning

confidence: 99%

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Mohs micrographic surgery for nail unit tumours: an update and a critical review of the literature

Lambertini

Piraccini

Fanti

et al. 2018

Acad Dermatol Venereol

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Mohs micrographic surgery (MMS) is a good treatment option for epithelial neoplasms, especially when localized in areas where tissue conservation is crucial, such as the nail unit (NU). MMS is a method of radical excision offering high cure rates due to the margin control and functional preservation. Our aim is to provide a review on the use of MMS for the treatment of the most common nail tumours. We revised the current literature on the use of MMS to treat malignant neoplasms (Bowen's disease, squamous cell carcinoma, melanoma, basal cell carcinoma, keratoacanthoma, carcinoma cuniculatum) and benign neoplasms (onychomatricoma and glomus tumour). MMS represents a successful surgical option for nail tumours, firstly in terms of tissue conservation: the NU anatomy is complex and the preservation of the component structures is imperative for its functionality. Secondly, due to the surgical radicality, which is essential not only for the clearing of malignant tumours, but also for benign cases, in order to reduce recurrences. Although a conservative treatment of NU melanoma with MMS has been proposed, in our experience, the conservative approach with functional surgery is a good option for the treatment of non-invasive melanoma (in situ and Ia).

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