ABSTRACT
BACKGROUND: Topical onychomycosis therapies are usually inadequate, and patient compliance to systemic therapies is poor. Recently, interest in laser therapy for the treatment of onychomycosis has increased. We sought to investigate the efficacy of long-pulsed Nd:YAG laser therapy for onychomycosis. METHODS: Thirty patients with mycologically confirmed onychomycosis received long-pulsed 1064-nm Nd:YAG laser therapy, moving the beam in a spiral pattern over the whole nail plate two times, with a 1-minute pause between passes. Laser therapy was performed with a spot diameter of 4 mm at a speed of 25 mm/sec once weekly for 4 weeks using fluencies ranging from 40 to 60 J/cm2, depending on the thickness of the nail plate. Patients were evaluated in terms of clinical improvement and mycologic cure. RESULTS: Thirty patients started and 15 completed the study. Mycologic cure was achieved in nine patients (60%), of whom eight (89%) were infected with Trichophyton sp. Complete clinical improvement was achieved in seven patients (47%), all of whom were infected with Trichophyton sp. Mycologic cure was not achieved in one of two patients infected with Epidermophyton or in either patient in whom the agent was Candida or Aspergillus; complete clinical improvement did not occur in any of these patients. No serious adverse events were observed. CONCLUSIONS: Based on these results, long-pulsed Nd:YAG laser can be used as an effective treatment for onychomycosis, but further studies are needed to draw firmer conclusions.
Subject(s)
Foot Dermatoses/therapy , Laser Therapy , Lasers, Solid-State/therapeutic use , Onychomycosis/therapy , Adolescent , Adult , Female , Foot Dermatoses/etiology , Foot Dermatoses/pathology , Humans , Male , Middle Aged , Onychomycosis/etiology , Onychomycosis/pathology , Treatment Outcome , Young AdultSubject(s)
Dermatofibrosarcoma/diagnosis , Dermoscopy , Skin Neoplasms/diagnosis , Adult , Atrophy , Biopsy, Needle , Combined Modality Therapy , Dermatofibrosarcoma/pathology , Dermatofibrosarcoma/surgery , Female , Humans , Neoplasm Invasiveness , Radiotherapy, Adjuvant , Shoulder , Skin/pathology , Skin Neoplasms/pathology , Skin Neoplasms/surgeryABSTRACT
Meningiomas are tumors of the central nervous system that rarely present as extracranial soft tissue masses. Meningioma of the skin is referred to as cutaneous meningioma. Cutaneous meningioma of the scalp is extremely rare and may cause diagnostic challenges. A 70-year-old female patient presented with a painless mass on her scalp. A punch biopsy was performed; histological examination of the specimen revealed an infiltration of spindle-shaped and epithelioid atypical cells arranged in whorls. Immunohistochemistry was positive for vimentin and epithelial membrane antigen. On magnetic resonance imaging, a large intracranial mass eroding through the skull was observed. A diagnosis of intracranial anaplastic meningioma was established and excision was performed in the Department of Neurosurgery. It is important to consider intracranial tumors in the differential diagnosis of nodules on scalp.