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Thin Split-Thickness Toe Nail-Bed Grafts for Nail Bed Defects in Subungal Exostosis: Two Cases Report (얇은 부분층 조갑상 이식을 통한 조갑하 외골종의 치료: 2예 보고)

  • Oh, In Suk;Kim, Chang Hee;Choi, Jong-Sun;Lee, Sang Hyeong
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.2
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    • pp.83-88
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    • 2012
  • We reviewed the clinical features of 2 patients who underwent surgery for subungal exostosis, focusing on postoperative deformity of the nail. The lesion destroyed the nail bed and was excised with a direct approach. then thin split-thickness sterile matrix graft was done after excision of the tumor because the defect of the nail bed was large. Good postoperative appearance of the nail was obtained by thin split-thickness sterile matrix graft. The use of thin split-thickness sterile matrix graft for the replacement of a nail bed defect can regain a smooth, adherent, and normal-looking nail and avoid donor-site morbidity. Thin split-thickness toe-nail bed graft is a good choice for the prevention of postoperative deformity.

Subungual Malignant Melanoma of Greater Toe - Case Report - (무지의 조갑하 흑색종 - 증례 보고 -)

  • Kim, Byung-Cheol;Jung, Chul-Yong;Choi, Sung-Jong
    • The Journal of the Korean bone and joint tumor society
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    • v.11 no.2
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    • pp.199-203
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    • 2005
  • Malignant melanoma commonly occurs in skin and the incidences are uncommon. Especially, the incidences of subungual melanoma is less than 2% of total numbers of melanoma, and most of the cases tended to be misdiagnosed at first time. Thus, the prognoses are not good. We are going to report our experiences of subungual melanoma and diagnostic criteria in great toe initially misdiagnosed as ingrowing nail with a review of the literature.

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A Case of Subungal Abscess and Onycholysis Induced by Docetaxel (Docetaxel 투여 후 발생한 조갑하 농양 및 조갑 박리증 1예)

  • Jung, Han Young;Lee, Chang Youl;Kim, Hyung Jung;Ahn, Chul Min;Chang, Yoon Soo
    • Tuberculosis and Respiratory Diseases
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    • v.62 no.2
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    • pp.125-128
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    • 2007
  • Docetaxel is a taxoid antineoplastic drug, which is widely used to treat locally advanced or metastatic non-small cell lung cancer (NSCLC). Among the adverse dermatological reactions, nail disorders such as bending, onycholysis, hypoor hyperpigmentation are rare. We report a case of a 62-year-old male with advanced NSCLC (cT4N3M1, stage IV), who developed purulent discharge and onycholysis in the nail of all his fingers and the left great toe after five courses of anti-neoplastic chemotherapy, which included docetaxel (cumulative dose: $370mg/m^2$, 590 mg). Seven days after the final session of chemotherapy, the patient had become aware of discoloration and swelling of the nail beds with out pain. Three days later, greenish-yellow purulent discharge oozed out from the involved nails. Microbiologic studies revealed Pseudomonas aeruginosa. Intravenous and topical antibiotics (mupirocin) were applied. After 2 weeks, regrown nails were observed and the onycholysis had improved.

Three-dimensional structure analysis of mouse nails using synchrotron radiation (방사광 X-선을 이용한 마우스 조갑의 3차원적 구조 분석)

  • Jung, Yong-Ju;Hong, Gee-Yun;Moon, Cho-I;Yoo, Hyun-Jong;Lee, On-Seok
    • Proceedings of the Korea Information Processing Society Conference
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    • 2018.10a
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    • pp.790-791
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    • 2018
  • 방사광 X-ray 이미징 기술은 샘플의 고감도 및 고해상도 3차원 해부구조를 규명하는데 매우 유용하다는 장점이 있다. 따라서 이러한 방사광을 이용해 사람의 조갑병변 연구를 위한 동물모델로서 마우스 조갑의 내부 미세구조를 관찰하였고 상대적으로 구분이 명확하고 의학적으로 의미론적인 구조물을 3D로 가시화하여 조갑 구조 해석에 새로이 활용될 가능성을 확인하고자 하였다.

Surgical Treatment for Subungual Exostosis in the foot (족부에 발생한 조갑하 외골증에 대한 수술적 치료)

  • Lee, Kee-Haeng;Kim, Hyoung-Min;Moon, Chan-Woong;Lee, Bum-Seong;Kim, Youn-Soo
    • The Journal of the Korean bone and joint tumor society
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    • v.10 no.2
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    • pp.107-112
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    • 2004
  • Purpose: We described our experience with subungual exostosis in the foot for which we used different surgical technique according as location and size of lesion and revealed excellent results. Materials and Methods: We experienced 12 cases of subungual exostosis that were treated surgically and followed them more than one year between October 1995 and July 2003. There were nine females and three males. The average age of patients at surgery was 13.4 years. Duration of symptoms was 20.3 months on average. The lesion involved the hallux in nine cases; eight dorsomedial and one dorsolateral aspect of distal phalangeal bone. It involved the second, the third, and the fifth toe in one each; all central aspect of dorsum of distal phalanx. We used surgical technique that involves approaching the exostosis under the nail to preserve nail coverage for lesion in the hallux. The nails were extracted totally but preserved nail bed as much as possible in other toes. Results were based on appearance of the regenerated nail and presence of recurrence. Excellent results were those in which the nail appeared nearly normal and there was no clinical or radiographic evidence of recurrence. Good results were associated with a minor nail deformity such as ridging, and no evidence of recurrence. Fair results had obvious nail deformity or a minimal asymptomatic recurrence that was discernable only on radiograph. Poor results were associated with a clinically evident symptomatic recurrence. Results: When the lesion involved hallux, there were six excellent and two good results, and one poor result. All cases that involved other toes revealed good results. Conclusion: We suggest that different surgical technique might be applied according as location and size of the lesion to achieve satisfactory results for subungual exostosis in the foot.

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Clinical Significance of MR Imaging for the Diagnosis and Treatment of Subungual Glomus Tumor in the Fingers (수지 조갑하 사구종의 진단 및 치료에서 자기 공명 영상의 임상적 의미)

  • Kim, Byoung-Suck;Kim, Woo-Sig;Han, Kyoung-Jin;Cho, Jae-Hyun;Lee, Kyi-Beom;Ha, Heon-Kyo;Kang, Shin-Young
    • The Journal of the Korean bone and joint tumor society
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    • v.7 no.1
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    • pp.28-35
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    • 2001
  • Purpose : Authors investigated the efficiency of preoperative MRI in suspicious glomus tumor and the clinical outcomes after marginal excision. Materials and Methods : In 10 cases of glomus tumors in the fingers, authors retrospectively analyzed the clinical data, including previous trauma, treatment history, preoperative symptoms, physical examination, plain radiography, MRI (9 cases), pathological findings and postoperative complications. Results : The patients had pain in 10 cases, tenderness in 9 cases, cold sensitivity in 3 cases and edema in one case. MRI showed low signal (3 cases) or iso-signal (5) intensity on T1 weighted image, high signal intensity (8) on T2 weighted image, and all the lesions were enhanced in gadolinium enhancement images. The exact locations of glomus tumors were median in 6 cases, lateral in 5, lateral fold in 2 and pulp in 3 in transverse section and nail bed in 5 cases and nail matrix in 5 in sagittal section. Marginal excision was performed by lateral approach in one case and transungual in 9 cases. Histologically, all 10 cases were composed of solid sheets of round cells interrupted by thin-walled blood vessels. Most of clinical symptoms were disappeared in all cases after operation. Nail deformity was found in one case, which was originated from nail matrix, however, there was no recurrence. Summary : Clinical symptom was the most impotant factor in diagnosis of glomus tumor in the fingers. However, preoperative MRIs were helpful in patients, who had obscure pain or prolonged clinical symptoms with suspicious glomus tumors. Preoperative MRI might be one of the most useful tools for establishing the exact diagnosis and detecting the location of glomus tumors, in spite of the relatively high expenses.

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Cutaneous Manifestations Associated with Liver Diseases (간질환에 동반된 피부증상에 관한 연구)

  • Cho, Young-Sup;Choi, Jong-Soo;Kim, Ki-Hong;Lee, Heon-Ju
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.167-174
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    • 1985
  • It has been well recognized that the various cutaneous manifestations associated with the liver diseases. A clinical study was made of 255 patients (AVH 84, LC 70, HC 41, CAH 26, CPH 23, AH11) with the liver diseases at Yeungnam University Hospital during the periods from May to November, 1985. The authors classified the cutaneous manifestations into 7 groups according to pathogenesis, and compared them with other reports. The results were as follows; 1. In 255 patients with various liver diseases, 161 patients (63%) showed the various cutaneous manifestations. 2. The various cutaneous manifestations were jaundice and/or pruritus (43.1%), vascular changes (39.6%), allergic manifestations (10.6%), nail changes (5.1%), hormone-induced changes (4.3%), pigmentary changes (3.5%) and others (2.4%) in that order. 3. Cutaneous manifestations were associated most frequently with liver cirrhosis (1.6 groups) and the least with chronic active hepatitis (0.7 group). 4. Allergic manifestations were seen mainly in patients with acute viral hepatitis. Three patients showed the serum sickness-like prodrome. 5. The other cutaneous manifestations were seen mainly in patients with chronic liver diseases.

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Gutter Splint for Ingrown Toe Nail in Young Patients (어린 환자에서 내향성 조갑증에 대한 조갑홈통 부목을 이용한 치료)

  • Shin, Yong-Woon;Bae, Su-Young;Ahn, Sang Jun
    • Journal of Korean Foot and Ankle Society
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    • v.22 no.3
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    • pp.111-115
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    • 2018
  • Purpose: Ingrown toenails are a common disease in the adolescent period and the treatments could be more conservative for this early stage of the disease. This study is a case series on the results of a gutter splint for an adolescent ingrown toe nail as a simple, comfortable treatment method. Materials and Methods: From 2011 to 2018, 22 patients (mean age, 12.2 years; range, 8~15 years) with ingrown toenails were treated with a gutter splint. There were 16 boys and 6 girls with 7 patients on both great toes, and additional 4 both corners of a nail, giving a total of 33 splints. Flat, plastic straws and glue or suture were used to protect the nail corners under local anesthesia. The medical records were reviewed retrospectively and phone calls were made to obtain the long-term results. Results: Fifteen splints were fixed with a suture and the other 18 splints were fixed with glue. There were 9 cases of recurrence out of 33 gutter splints, 8 out of 15 sutured splints and 1 out of 18 glued splints (p=0.010). There was no gender (p=0.383) or age (p=0.305) difference in the number of recurrences. Conclusion: For growing people, ingrown nails can be cured easily by conservative treatment for a transiently shortened or broken toenail. The glued gutter splint had a reasonable success rate as a first line treatment.

Acquired Digital Fibrokeratoma over Nail (조갑 주변의 후천성 수지 섬유각화종)

  • Kwon, Young Woo;Choi, In Cheul;Park, Jong Woong
    • Journal of the Korean Orthopaedic Association
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    • v.56 no.2
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    • pp.168-172
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    • 2021
  • Acquired digital fibrokeratoma is very a rare, benign, fibrous, and hyperkeratotic skin tumor that develops most frequently on the finger or toe. The tumor usually occurs in adults as a solitary, dome-shaped lesion. Sometimes, it appears as a rudimentary supernumerary digit and may be misdiagnosed as an accessory nail (double nail) or verruca vulgaris. The pathophysiology of an acquired digital fibrokeratoma is unknown. On the other hand, trauma has often been proposed as a predisposing factor for an acquired type of digital fibrokeratoma. This paper reports a case of trauma-related acquired digital fibrokeratoma presenting as a supernumerary digit and nail in a 36-year-old male. This case is presented with a 0.5 cm×0.4 cm×1.3 cm sized, firm, hyperkeratotic, protruding mass over the left second finger nail.