BACKGROUND: Nail diseases are frequently encountered disorders to dermatologists comprising approximately 10% of entire dermatologic conditions. Despite tremendous development in dermatology, there are still difficulties in making a proper diagnosis of nail diseases. Furthermore, no methods have proven to be satisfactory in classifying nail diseases up to now. OBJECTIVE: The aim of this study was to clarify and classify the clinical characteristics of patients with nail diseases who visited 'Nail disease clinic' in Seoul National University Hospital, and in Seoul City Boramae Hospital from July, 1996 to December, 1998. MATERIALS AND METHODS: Retrospective analysis was undertaken by reviewing the clinical records, photographs and results of mycological and histopathological studies. Patients were classified according to the cause of their nail diseases or to the main physical signs of nail apparatus. RESULTS: The total number of patients was 255(male 95, female 160). Specific cause of nail diseases was found in 135 patients(52.9%). The remaining 120 patients were classified according to the main physical signs such as trachyonychia, onycholysis, chronic paronychia and so on. CONCLUSION: Major disease groups classified according to their physical signs had its own characteristics besides age and sex distribution. So when the cause of nail disease can not be determined, classifying these nail diseases by physical signs could be useful in treating and managing these patients appropriately.
Classification* ; Dermatology ; Diagnosis ; Female ; Humans ; Nail Diseases* ; Onycholysis ; Paronychia ; Retrospective Studies ; Seoul ; Sex Distribution

OBJECTIVETo investigate the clinical features, early diagnosis and surgical treatment of the hand glomus tumor in the female.

METHODSThirty female patients with the hand glomus tumor underwent early resection by microsurgery. The average age was 35 years ranging from 18 to 48 years. The course of disease was from 3 months to 3 years. All patients' tumors occured on single finger.

RESULTSIn the 30 cases, there were 28 patients with localized eminences and hepatic plaques under the nail. The compression of distal phalanx could be seen on radiographs in 18 patients, definite and localised tenderness on nails could be found in all cases, the tenderness disappeared and no recurrence after 15 months of follow-up in all cases.

CONCLUSIONThe hepatic plaque under the nail and fixed tenderness point on the nail are of significance in diagnosis for the hand glomus tumor in the female, the early microsurgical resection is unique effective treatment to this disease.

Adolescent ; Adult ; Early Diagnosis ; Female ; Fingers ; surgery ; Glomus Tumor ; diagnosis ; surgery ; Humans ; Middle Aged ; Nail Diseases ; diagnosis ; surgery

Adolescent ; Diagnosis, Differential ; Exostoses ; diagnostic imaging ; pathology ; Fingers ; diagnostic imaging ; pathology ; Humans ; Male ; Nail Diseases ; diagnostic imaging ; pathology ; Radiography

Laugier-Hunziker syndrome (LHS) is an acquired pigmentary condition affecting lips, oral mucosa and acral area, frequently associated with longitudinal melanonychia. There is neither malignant predisposition nor underlying systemic abnormality associated with LHS. Herein, we present three uncommon cases of LHS with possibly new feature of nail pigmentation, which were diagnosed during the past 2 years. We also review the clinical and histological findings, differential diagnosis, and treatment of the syndrome in published literature.
Adult ; Female ; Gingival Diseases ; diagnosis ; Humans ; Hyperpigmentation ; diagnosis ; Lip Diseases ; diagnosis ; Male ; Melanins ; analysis ; Middle Aged ; Mouth Diseases ; diagnosis ; Mouth Mucosa ; pathology ; Nail Diseases ; diagnosis ; Syndrome ; Tongue Diseases ; diagnosis

Objective: To investigate the clinicopathological characteristics, immunohistochemical profiles, molecular features, and prognosis of subungual melanoma in situ (SMIS). Methods: Thirty cases of SMIS were collected in Fudan University Shanghai Cancer Center, Shanghai, China from 2018 to 2022. The clinicopathological characteristics and follow-up data were retrospectively analyzed. Histopathologic evaluation and immunohistochemical studies were carried out. By using Vysis melanoma fluorescence in situ hybridization (FISH) probe kit, combined with 9p21(CDKN2A) and 8q24(MYC) assays were performed. Results: There were 8 males and 22 females. The patients' ages ranged from 22 to 65 years (median 48 years). All patients presented with longitudinal melanonychia involving a single digit. Thumb was the most commonly affected digit (16/30, 53.3%). 56.7% (17/30) of the cases presented with Hutchinson's sign. Microscopically, melanocytes proliferated along the dermo-epithelial junction. Hyperchromatism and nuclear pleomorphism were two of the most common histological features. The melanocyte count ranged from 30 to 185. Most cases showed small to medium nuclear enlargement (29/30, 96.7%). Pagetoid spread was seen in all cases. Intra-epithelial mitoses were identified in 56.7% (17/30) of the cases. Involvement of nailfold was found in 19 cases, 4 of which were accompanied by cutaneous adnexal extension. The positive rates of SOX10, PNL2, Melan A, HMB45, S-100, and PRAME were 100.0%, 100.0%, 96.0%, 95.0%, 76.9%, and 83.3%, respectively. FISH analysis was positive in 6/9 of the cases. Follow-up data were available in 28 patients, and all of them were alive without disease. Conclusions: SMIS mainly shows small to medium-sized cells. High melanocyte count, hyperchromatism, nuclear pleomorphism, Pagetoid spreading, intra-epithelial mitosis, nailfold involvement, and cutaneous adnexal extension are important diagnostic hallmarks. Immunohistochemistry including SOX10 and PRAME, combined with FISH analysis, is valuable for the diagnosis of SMIS.
Male ; Female ; Humans ; Young Adult ; Adult ; Middle Aged ; Aged ; Skin Neoplasms/pathology* ; Prognosis ; Retrospective Studies ; In Situ Hybridization, Fluorescence ; China ; Melanoma/diagnosis* ; Nail Diseases/pathology* ; Antigens, Neoplasm

Alopecia totalis (AT) and alopecia universalis (AU), severe forms of alopecia areata (AA), show distinguishable clinical characteristics from those of patch AA. In this study, we investigated the clinical characteristics of AT/AU according to the onset age. Based on the onset age around adolescence (< or > or = 13 yr), 108 patients were classified in an early-onset group and the other 179 patients in a late-onset group. We found that more patients in the early-onset group had a family history of AA, nail dystrophy, and history of atopic dermatitis than those in the late-onset group. These clinical differences were more prominent in patients with AU than in those with AT. In addition, significantly more patients with concomitant medical disorders, especially allergic diseases were found in the early-onset group (45.8%) than in the late-onset group (31.2%). All treatment modalities failed to show any association with the present hair condition of patients. In the early-onset group, patients with AU or a family history of AA showed worse prognosis, whereas this trend was not observed in the late-onset group. Systemic evaluations might be needed in early-onset patients due to the higher incidence of comorbid diseases. It is suggested that patients with AU or family history of AA make worse progress in the early-onset group than in the late-onset group.
Adolescent ; Adult ; Age of Onset ; Alopecia/diagnosis/epidemiology ; Alopecia Areata/*diagnosis/epidemiology ; Child ; Child, Preschool ; Dermatitis, Atopic/diagnosis ; Family Health ; Female ; Humans ; Infant ; Male ; Middle Aged ; Nail Diseases/diagnosis ; Prognosis ; Young Adult

INTRODUCTIONA subungual exostosis (SE) is a bony overgrowth that is permanently attached to the tip of the distal phalanx. Its pathology differs from osteocartilaginous exostoses in that it mainly involves the overgrowth of normal bone, which may present beneath the toenail or on the sides of the toe. This retrospective study aimed to report the results of surgical treatment when the diagnosis of SE was delayed; the condition was initially considered to be another pathology affecting a different nail or the terminal toe.

METHODSA total of 17 patients (12 female, five male) were included in the study. All surgical resections were performed by the same surgeon using the same surgical technique, with the patient under digital anaesthesia. The patients were evaluated pre- and postoperatively (on Weeks 1 and 6, the first year, and the last follow-up visit) using the American Orthopaedic Foot and Ankle Society questionnaire and the Visual Analogue Scale score.

RESULTSThe patients underwent surgery for SE removal between December 2009 and October 2012. Their mean age was 21.3 ± 4.4 (range 14-29) years and the mean follow-up period was 27.1 ± 7.8 (range 18-45) months. Clinical or radiological recurrence was not observed in any of the patients during the follow-up period. Four patients had superficial infections, which were treated using appropriate antibiotic therapies.

CONCLUSIONAs SE is an uncommon benign lesion, its diagnosis may be delayed. Radiography may be useful in obtaining a differential diagnosis.

Adolescent ; Adult ; Bone Neoplasms ; diagnostic imaging ; surgery ; Cartilage ; diagnostic imaging ; surgery ; Diagnosis, Differential ; Exostoses ; diagnostic imaging ; surgery ; Female ; Humans ; Male ; Middle Aged ; Nail Diseases ; diagnostic imaging ; surgery ; Nails ; surgery ; Orthopedics ; methods ; Pain Measurement ; Postoperative Period ; Recurrence ; Retrospective Studies ; Surveys and Questionnaires ; Young Adult