A distal curved incision approach of lunula for treatment of subungual glomus tumor in nail root / 中国修复重建外科杂志

Obejective: To investigate the feasibility and effectiveness of the distal curved incision approach of lunula in treating subungual glomus tumor in nail root. Methods: Between March 2017 and October 2019, 16 patients (16 fingers) with subungual glomus tumor in nail root were treated. There were 2 males and 14 females with an average age of 35.3 years (range, 21-67 years). The disease duration ranged from 5 months to 17 years, with a median duration of 15 months. There were 6 cases of thumb, 3 cases of index finger, 2 cases of middle finger, 4 cases of ring finger, and 1 case of little finger. All of them showed typical "triad syndromes", and the cold sensitivity test and Love test were positive before operation. Each patient removed the nail, the tumor was exposed under the nail bed via the distal curved incision approach of lunula. After the tumor was removed completely, the nail bed was reducted in situ without suturing. The self-made nail template was pressurized and fixed on the surface of the nail bed with suture. The conditions of nail bed healing, pain, and growth of nail were observed after operation. Results: All wounds of the nail bed with laceration healed by first intention. Postoperative pathological results confirmed the diagnosis of subungual glomus tumor in all the patients. All cases were followed up 3-26 months with an average of 15 months. The pain symptom disappeared and no obvious pain occurred during dressing change in all cases; and the cold sensitivity test and Love test were negative. The nails recovered smoothly with satisfactory appearance, and no obvious complications such as longitudinal ridge deformities or recurrences was observed. Conclusion: The treatment of subungual glomus tumor in nail root via the distal curved incision approach is an effective method, which can easily operated, resect the tumor completely, protect the nail bed effectively, and also has a significant effect on preventing postoperative nail deformity.

A Clinical Study of Morphologic Alterations of Lunula of Fingernail in Dermatologic Patients / 대한피부과학회지

BACKGROUND: The lunula is the visible portion of the distal nail matrix that extends beyond the proximal nail fold. It has a primary structural role in defining the free edge of the distal nail plate. The size of the lunula is variable not only among persons, but also for each digit in the same person. Alterations in the morphologic features or color of the lunula can be an indication of either a cutaneous or a systemic disorder. OBJECTIVE: The purpose of this study was to examine the size, visible pattern and morphologic alterations of lunula of fingernails according to age and sex in dermatologic patients. METHODS: During a 6-month-period from Jan to Jun, 2001, we examined the size, pattern and morphologic alterations of lunula of fingernails according to age and sex in 420 dermatologic patients visiting Hanyang University Hospital. Anolunula and lunular dyschromia were also evaluated in association with cutaneous and systemic disorders. RESULTS AND CONCLUSIONS: 1. Fingernail lunula was observed in highest frequency on thumbnail in both sexes. Lunulae of all fingers showed increased tendency of frequency with age until 50-59-year-old group in male and until 40-49-year-old group in female. 2. In both sexes, thumbnail had the longest length of lunula, followed by index, middle, ring and little fingernail. The length of lunulae of all fingers showed a tendency to increase with age until 50-59-year-old group. With the exception of both thumb and littlel fingers, male had the longer lunulae than female(p<0.05). 3. In both sexes, thumbnail had the widest width of lunulae, followed by middle, index, ring and little fingernail. And the width of lunulae of all fingers showed a tendency to increase with age. With the exception of left little finger, male had the wider lunulae than female(p<0.05). 4. In male, R(L)1 type was the most common observed pattern of lunula for 0-9-year-old group. Thereafter R(L)12345 and R(L)1234 types comprised more than half cases. In female, R(L)1 type was the most common pattern until 10-19-year-old group. Thereafter R(L)12345 and R(L)1234 types comprised more than half cases as male. 5. Anolunula was observed in 14(3.3%) of 420 study patients and associated with several cutaneous and/or systemic disorders including brachyonychia, alopecia areata, renal failure and chronic alcoholism. 6. Lunular dyschromia in confluent/spotted form or in longitudinal band were observed in 13(13.1%) of 420 study patients and associated with several cutaneous and/or systemic disorders including diabetes mellitus, renal failure, and iron deficiency anemia.

A Case of Red Lunulae in Patient with Nephrotic Syndrome / 대한피부과학회지

Red lunula, dusky red erythema of nailbed in the area of lunula, has ben reported in patients with alopecia areata and rheumatuid arthritis. We report a case of red lunula in a 63-year-old man. The patient showed dusky red, blanchable erythema of the lunula area in nailbecl of total fingernail, and toer.iails in association with hypertension due to nephrotic syndromc.