Neoplasms of the Nailbed
Abnormal growths of the nailbed may often present with paronychia, ingrown nail, onycholysis, nail-plate dystrophy, longitudinal erythronychia, bleeding, and discolorations. [1] There are various different types of growths, that may occur in or overlying the nail matrix and in the nailbed. Symptoms can often include pain, itching and throbbing. Growths are regarded as tumors, then subdivided into benign vs malignant.
Contents
Benign Growths
Fibroma - Benign tumor of connective tissue that originate commonly from the nail matrix [2] [3] . There are several different types of nail fibromas including: acquired periungual fibrokeratoma, dermatofibroma and periungual fibroma (Koenen Tumor).
Verruca - Commonly caused by a viral infection, commonly Human papilloma virus (HPV). Depending on the location, growths can cause onycholysis, nail plate dystrophy or ridging. Often resistant to treatment when located underneath the nail.
Pyogenic Granuloma - Benign growth of blood vessels. Often presents as red to purple. [4]
Myxoid Pseudocyst - Translucent nodule on the digit, located commonly between the distal interphalangeal joint and the nailbed. Often appear to leak fluid and may additionally create pressure on the nailbed. [5]
Malignant Growths
Squamous Cell Carcinoma - Most common malignant tumor of the nail. Often occurs in the fingernail, within the nailbed or the lateral grooves of the nail. SCC often presents with a keratotic lesions that continues to persist even following treatment for common warts [6] . Keratoacanthoma is a rare subtype of SCC that presents as a rapidly growing lesion.
Melanoma - Often diagnosed late in its course, often appears as a dark stripe within or underneath the nail. [7]
Treatment
Depending on the type of growth, different treatments can be used. Often cryotherapy, liquid nitrogen spray, is used first on lesions. Often, lesions may persist following treatment and require additional follow-up. In rare cases, surgery may be required for definitive treatment.
References
- ↑ James, William D. (William Daniel), et al. Andrews’ Diseases of the Skin : Clinical Dermatology. 10th ed. / William D. James, Timothy G. Berger, Dirk M. Elston., Saunders Elsevier, 2006.
- ↑ BARAN, R.; PERRIN, CH.; BAUDET, J.; REQUENA, L. (1994-01-01). "Clinical and histological patterns of dermatofibromas of the nail apparatus". Clinical and Experimental Dermatology. 19 (1): 31–35. doi:10.1111/j.1365-2230.1994.tb01111.x. ISSN 0307-6938.
- ↑ P, Rich (2003). Nail tumors. In: An Atlas of Diseases of the Nail. Parthenon Publishing. p. 83.
- ↑ Tosti, A (2005). Tumors of the nail appartatus. Nails: Diagnosis, Therapy and Surgery: Elsevier Saunders. p. 195.
- ↑ Richert, B (2011). Surgery of the distal interphalangeal joint. Nail Surgery: Informa Healthcare. p. 165.
- ↑ Starace, Michela; Alessandrini, Aurora; Dika, Emi; Piraccini, Bianca Maria. "Squamous cell carcinoma of the nail unit". Dermatology Practical & Conceptual. 8 (3): 238–244. doi:10.5826/dpc.0803a17. ISSN 2160-9381. PMC 6092066 . PMID 30116671.
- ↑ Haneke, E.; Baran, R. "Longitudinal melanonychia". Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery. 27 (6): 580–584. ISSN 1076-0512. PMID 11442597.