Résumé
Nail unit is an important structure for both aesthetic appearance and functional capability of the fingers and toes,and any defect or lesion at this anatomical site would lead to nail unit deformity.Surgical repair is the main treatment for such deformity.According to etiological and anatomical classification,appropriate surgical procedures can be chosen to repair the nail unit deformity,including autologous fat grafting,split-thickness nail bed grafting,full-thickness nail matrix grafting,nail bed elongation,palmar V-Y advanced flap reconstruction and so on.This review systematically summarizes classification of the nail unit deformity and associated surgical repair techniques.
Résumé
Nail unit is an important structure for both aesthetic appearance and functional capability of the fingers and toes, and any defect or lesion at this anatomical site would lead to nail unit deformity. Surgical repair is the main treatment for such deformity. According to etiological and anatomical classification, appropriate surgical procedures can be chosen to repair the nail unit deformity, including autologous fat grafting, split-thickness nail bed grafting, full-thickness nail matrix grafting, nail bed elongation, palmar V-Y advanced flap reconstruction and so on. This review systematically summarizes classification of the nail unit deformity and associated surgical repair techniques.
Résumé
Pincer nail deformity is often undertreated although it is a cause of pain and disfigurement.This may be attributed to underdiagnosis and lack of awareness of the available treatmentoptions especially surgical options. Not many centres offer surgical correction of pincer naildeformity in Malaysia. We would like to describe a surgical method of correcting this deformity.
Résumé
Pincer nail deformity is a nail deformity characterized by a transverse overcurvature of the nail plate, which increases along the longitudinal axis. Many conservative and surgical treatment modalities have been reported. Conservative methods can be difficult to use in cases of severe deformity because of their high recurrence rate. Therefore, surgical techniques, including nail matricectomy or correction of the nail bed, have been preferred in these cases. Matricectomy is generally considered as the surgical treatment of pincer nail deformity because of low recurrence rate in the field of dermatology. However, poor cosmetic results (e.g. narrowing of nail plate) are frequently observed. We present here a case of pincer nail deformity in the left great toe in a 57-year-old man who was treated successfully with widening of the nail bed without matricectomy. This method is an effective surgical technique preserving the nail matrix for the correction of pincer nail deformity.
Sujets)
Humains , Adulte d'âge moyen , Axis , Malformations , Cosmétiques , Dermatologie , Ongles , Récidive , OrteilsRésumé
Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Malformations , Ongles , Pouce , TransplantsRésumé
Subungual squamous cell carcinoma often presents with atypical clinical manifestations, which can lead to delays in diagnosis. The presence of a tumor can be masked by the presence of infections or other misleading pathological conditions. The authors report on techniques for adequate biopsy and excision of such tumors. A case of subungual squamous cell carcinoma with invasion into the underlying bone is presented. Clinical histopathological evidence is reviewed along with human papillomavirus typing. Accurate diagnosis requires a high index of suspicion and appropriate tissue sampling.
Sujets)
Humains , Biopsie , Carcinome épidermoïde , MasquesRésumé
We report an 82-year-old woman with a solitary neurofibroma occurring on the middle finger and nail deformity. Neurofibroma may present as multiple or solitary lesions. Although there is no predilection site of solitary lesion, the occurrence on hands is rare. We report a case of solitary neurofibroma on hand with typical histologic findings but not with pain, numbness and dysfunction.
Sujets)
Sujet âgé de 80 ans ou plus , Femelle , Humains , Malformations , Doigts , Main , Hypoesthésie , NeurofibromeRésumé
The hook-nail deformity after finger tip amputation is very common problem. This usually occurs after loss of part of the distal pulp, phalanx, and nail bed. This deformity for some patients is a trivial lesion and may be ignored, but it may be of great cosmetic significance or disabling with regard to certain occupations to the others. To correct the deformity, it is necessary to release volarly displaced nailbed, return it to its normal position, and provide adequate support to maintain correction by a carefully planned "antenna" procedure. Deformed nail is removed, tethered pulp is freed from distal phalanx, and then full thickness of the nail bed is elevated and splinted with multiple small Kirschner wires in a straight position like antennae. The coverage of defect created is done by cross finger flap. The knowledge of anatomy and physiology of nail and sorrunding structures is important to obtain good results and reduce secondary deformities. Two cases of antenna procedures for the hook nail deformily is reported with good results.