Search Results (39)

Introduction: Acral lentiginous melanoma (ALM), a rare subtype, accounts for 2–3% of melanoma cases, primarily affecting the palms, soles, and nail beds and disproportionately affects people of color. This review focuses on clinical insights into ALM and its management, with a focus on race and ethnicity. Methods: A comprehensive literature search was conducted in public databases using the search term “acral melanoma,” and studies focusing on epidemiology, clinical presentation, and treatment outcomes of ALM in various racial and ethnic groups were reviewed. Results: Significant disparities in ALM outcomes exist across racial and ethnic groups, with African, Hispanic, and Asian individuals presenting with thicker, more advanced tumors at diagnosis. These populations encounter unique challenges, including limited access to dermatologic care, under-recognition of melanoma presentation in darker skin types, and socioeconomic barriers leading to delayed diagnosis and treatment. Surgical management may require specialized approaches, such as partial amputation for subungual melanomas. Additionally, there is uncertainty regarding the tumor immune microenvironment (TME) in ALM, with some studies suggesting that it might be less favorable, resulting in a lower response to immunotherapy. Conclusions: ALM affects diverse populations, and the impact of ethnic and racial origin on ALM biology is largely unknown. Addressing disparities in ALM outcomes among racial and ethnic groups is critical for improving patient care. Increased awareness of melanoma risk in individuals with darker skin can significantly impact early detection and treatment. Future research should focus on the genetic and biological factors contributing to morbidity and mortality in ALM patients. Full article

The purpose of the present study was to evaluate mast cell density in squamous cell carcinoma tissues of dogs and cats to assess species differences. Skin squamous cell carcinoma tissues from dogs (n = 15: n = 10 from body sites and n = 5 nail bed specimens) and cats (n = 15, n = 10 from ears and n = 5 nasal planum specimens) were examined. Intratumoral mast cell density (IMCD), peritumoral mast cell density (PMCD) and total mast cells density (TMCD) as a sum of IMCD and PMCD were calculated from Giemsa-stained slides at high magnification in 1 mm² using an Olympus microscope (Olympus BX41, Tokyo, Japan) equipped with a digital Olympus DP72 image camera and CellSensDimension software V1.16). Both intratumoral and peritumoral tissues of the squa.mous cell carcinoma were divided into two categories: (1) loose, well-vascularized, rich in lymphocytes and plasmocytes, macrophages and neutrophils; and (2) fibrous, with few or no lymphocytes, plasmocytes, macrophages and neutrophils (the presence of neutrophils can be associated with actinic keratosis, mechanical irritation of the tumor in some anatomical areas during scratching with teeth, but, in general, neutrophils are associated with more invasive squamous cell carcinoma). In cats, a markedly higher total number of mast cells was found, and the number was also higher in intratumoral and peritumoral tissues. A similar tendency was found in both dogs and cats—a markedly higher number of mastocytes was found in both peritumoral and intratumoral loose, well-vascularized connective tissue. Conversely, lower numbers of mast cells were found in both intratumoral and peritumoral compact fibrous tissue in both animal species. Full article

Acral melanoma is a distinct subtype of cutaneous malignant melanoma that uniquely occurs on ultraviolet (UV)-shielded, glabrous skin of the palms, soles, and nail beds. While acral melanoma only accounts for 2–3% of all melanomas, it represents the most common subtype among darker-skinned, non-Caucasian individuals. Unlike other cutaneous melanomas, acral melanoma does not arise from UV radiation exposure and is accordingly associated with a relatively low tumor mutational burden. Recent advances in genomic, transcriptomic, and epigenomic sequencing have revealed genetic alterations unique to acral melanoma, including novel driver genes, high copy number variations, and complex chromosomal rearrangements. This review synthesizes the current knowledge on the clinical features, epidemiology, and treatment approaches for acral melanoma, with a focus on the genetic pathogenesis that gives rise to its unique tumor landscape. These findings highlight a need to deepen our genetic and molecular understanding to better target this challenging subtype of melanoma. Full article

The interplay between nutrition and skin health provides a crucial lens for understanding, diagnosing, and managing eating disorders (EDs) such as anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED). This review explores the dermatological manifestations resulting from the nutritional deficiencies commonly associated with EDs, including conditions like hair loss, xerosis, and brittle nails. These changes in the skin and its appendages often reflect deeper systemic dysfunctions, such as deficiencies in essential micronutrients (zinc, iron, and vitamins A and C), hormonal imbalances, and electrolyte disturbances. Recognizing these dermatological signs as diagnostic tools is vital for the early identification and intervention of EDs. By integrating dermatological observations with psychiatric and nutritional care, a holistic, multidisciplinary approach can be developed to address both the physical and psychological complexities of EDs. This review highlights the critical role of these skin-related markers in promoting timely diagnosis and effective treatment. To examine the relationship between specific nutrients and dermatological manifestations in EDs, a systematic review of three electronic databases—PubMed, Google Scholar, and ResearchGate—was conducted. The findings underline the importance of early recognition of these skin symptoms for effective management. Collaborative care involving dermatologists, psychiatrists, and nutritionists is essential for diagnosing and treating EDs. Such integrated efforts ensure a comprehensive approach to these multifaceted conditions, ultimately improving patient outcomes and enhancing overall care. Full article

Yellow nail syndrome (YNS) is a rare clinical syndrome characterized by nail bed changes, pulmonary involvement, and lymphatic drainage disorders. Pulmonary involvement usually manifests as bronchiectasis, bronchiolitis, and pleural effusion. There are few studies on yellow nail syndrome combined with opportunistic infection. Here, we report a case of clinically diagnosed YNS combined with Nocardia cyriacigeorgica infection and the course of treatment used, which can provide some useful information for clinicians to better understand this rare illness. Full article

Nail capillaroscopic examination is an inexpensive and easily applicable method to identify capillary morphological changes in patients with conditions such as systemic sclerosis and Raynaud’s. The detection of changes in capillaries makes an important contribution to diagnosing these diseases. Capillary morphology is important in the symptoms of these diseases, and capillary diameter, visibility, distribution, length, microbleeds, blood flow, and density are important indicators in capillaroscopic evaluation. Manual examination to determine these parameters is subjective, causes inconsistent results, and is labor-intensive and time-consuming. To overcome these problems, a YOLOv8s-based system was proposed in this paper to detect the number, thickness, and density of capillaries in the nail bed. The system’s components include database systems that store the analysis results, artificial intelligence-based software that runs on the SBC (Single-Board Computer), and recorded microscope images. mAP and F1_score parameters were used to evaluate the system’s performance, and values of 0.882 and 0.83 were obtained. The proposed system is promising in improving the diagnosis process of diseases such as systemic sclerosis and Raynaud’s by providing objective measurements and the early diagnosis and monitoring of diseases. Full article

A dual-band (K-/Ka-band) antenna array is presented. An ultra-wideband antenna element in the shape of a double-ridged waveguide is used as a radiation slot, and a novel dual-periodic ridge gap waveguide (RGW) with an interdigital-pin bed of nails (serving as a filter) is used to realize dual-band operation. By periodically arranging the pins of two different heights in two dimensions, the proposed RGW with interdigital-pin bed of nails is able to realize and flexibly adjust two passbands. The widely used GW-based back cavity boosts the realized gain and simplifies the feed network design. A 4 × 4 prototype array was designed, fabricated, and measured. The results show that the array has two operating bands at 24.5–26.4 GHz and 30.3–31.5 GHz, and the realized gain can reach 19.2 dBi and 20.4 dBi, respectively. Meanwhile, there is a very significant gain attenuation at stopband. Full article

(1) Purpose: The management of melanonychia is highly controversial. With growing melanonychia, in case of doubt, the entire lesion should be examined. It may appear similar to nail melanoma or may turn into melanoma. Here, we present surgical cases of nail bed total removal and free flap reconstruction. (2) Methods: Between 1 January 2020 and 31 December 2022, eleven patients were operated on for growing melanonychia, involving the hand and foot. After complete resection of the nail root and plate, immediate reconstruction was performed using a fasciocutaneous free flap. The authors describe the procedures in detail with a few illustrations and clinical photographs depicting the techniques. (3) Results: All patients underwent complete nail unit removal around the anatomic boundaries of the nail. Histology showed a nevus and no malignancy in all cases. We used three onychocutaneous flaps, three hypothenar flaps and five venous flaps. All flaps survived, with one case of partial necrosis which spontaneously healed with secondary intention. In the follow-up periods, there was no recurrence or nail regrowth. (4) Conclusions: These free flap techniques are very useful for total nail bed defect reconstruction after melanonychia lesion total ablation. Full article

This article suggests a new waveguide design that utilizes a “walled” architecture. Instead of relying on conventional gap waveguide structures to create electronic bandgaps and prevent field leakage, the proposed design introduces a “walled” guiding mechanism. This technique preserves transmission while maintaining the multilayer approach and eliminates the need for nails or chemical bonds to attach the layers. Simulations were carried out in the W-band (75–110 GHz) and D-band (110–170 GHz) using several metals, and measurements were performed in the W-band using aluminum. The simulation results show that the reflection coefficient was less than −40 dB over the entire D-band. At the same time, the average insertion loss was around 0.0054 dB/mm and around 0.0065 dB/mm for silver and gold, respectively. Similarly, the reflection coefficient was less than −45 dB over the 75–110 GHz range, with an average insertion loss of 0.0018 dB/mm for silver and 0.003 dB/mm for gold, respectively. The aluminum model’s reflection coefficient was less than −35 dB, and the average insertion loss was 0.0035 dB/mm. The experimental results achieved a reflection coefficient of less than –30 dB and the average transmission coefficient was −0.2 dB, with an insertion loss of 0.002 dB/mm. The simple stacking ability of the weightless walled metal plates and easy fabrication makes the proposed transmission line a promising technology in mmWave and Terahertz applications. Full article

Although rare, subungual carcinoma is the most common malignant nail tumor. The symptomatology is not characteristic, being very similar to that of other nail and periungual diseases. For this reason, early diagnosis is usually established by performing a biopsy. With appropriate treatment, subungual carcinoma usually has a favorable prognosis. Metastatic cases are rarely encountered, but they usually have a poor therapeutic result. This article presents the case of a patient with subungual carcinoma (diagnosed by histopathological exam), initially treated by amputation of the distal and middle phalanges of the fourth finger. Two years after the operation, a recurrence in the epitrochlear nodes was diagnosed, for which epitrochlear lymphadenectomy and postoperative chemotherapy were performed. At 7 months, metastases were detected in the axillary nodes, which were treated with radiotherapy and chemotherapy. The appearance and development of the tumor at the elbow and the lower third of the arm led the patient to accept scapulohumeral disarticulation. The patient finally adapted to the physical infirmity, having a good general condition and an optimistic attitude. Full article

Psoriatic onychopathy is one of the clinical presentations of psoriasis and a well-known risk factor for the development of psoriatic arthritis. High-frequency ultrasounds (HFUS > 20 MHz) have recently been used to evaluate the nail apparatus of healthy and psoriatic subjects. The aim of our study was to detect by means of ultra-high-frequency ultrasound (UHFUS 70–100 MHz) alterations of the nail bed and matrix in patients with psoriatic onychopathy and to monitor these parameters during the treatment with monoclonal antibody (mAb). We enrolled 10 patients with psoriatic onychopathy and naive to previous biologic therapies. Patients were evaluated at baseline, after 1 month and after 3 months from the beginning of mAb therapy by a complete clinical assessment and US evaluation. A UHFUS examination with a 70 MHz probe was performed on the thumbnail (I), the index fingernail (II) and the nail with greater clinical impairment (W). The following measurements were analyzed: nail plate thickness (A), nail bed thickness (B), nail insertion length (C), nail matrix length (D) and nail matrix thickness (E). Among the various parameters analyzed, some measures showed a statistically significant decrease with p-value < 0.05 (t0 WA = 0.52 mm vs. t2 WA = 0.42 mm; t0 WB = 2.8 mm vs. t2 WB = 2.4 mm; t0 WE = 0.76 mm vs. t2 WE = 0.64 mm; t0 IIA = 0.49 mm vs. t2 IIA = 0.39 mm). In conclusion, UHFUS could represent a viable imaging technique for the real-time evaluation and monitoring of psoriatic onychopathy, thus supporting the clinical parameters and revealing any subclinical signs of early drug response. Full article

Background and Objectives: Chronic ionizing radiation has biological effects on exposed healthcare workers, particularly on the skin. Capillaroscopy of the nail bed represents an easy, low cost, and non-invasive test to obtain information on the effects of chronic radiation exposure in healthcare workers. The aim of this study was to evaluate which capillaroscopic parameters are most associated with biological damage by chronic radiation exposure. Materials and Methods: We conducted a case-control study, in which cases were represented by healthcare workers exposed to ionizing radiations and controls by healthy subjects. We recorded anamnestic and personal data, including age and gender, before capillaroscopic examination of proximal nail folds of the fingers of both hands. Ten morphological qualitative/quantitative parameters were taken into consideration, assigning each of them a score on a scale from 0 to 3 (0 = no changes, 1 = <33% abnormal capillaries, 2 = 33–66% of abnormal capillaries, 3 = >66% of abnormal capillaries, for single magnification field at 200×). The parameters evaluated were: changes in the length, distribution and density of capillary loops, reduced visibility, decreased flow, visibility of the sub-papillary plexus, and presence of morphological atypia, such as ectasia, tortuosity, hemorrhage, and signs of neoangiogenesis. Results: We enrolled 20 cases and 20 controls. The two groups did not differ significantly for gender and age. Cases differed from controls in a statistically significant way for the following parameters: decreased capillary length (number of shortened capillaries) (p < 0.05), increased visibility of the subpapillary venous plexus (p < 0.05), tortuosity (p < 0.01), neoangiogenesis (p < 0.01), and ectasias (p < 0.001). Conclusions: We found that some capillaroscopic parameters, such as variability in length of capillaries, visibility of subpapillary venous plexus, presence of ectasias, tortuosity, and neoangiogenesis signs, are particularly associated with exposure to ionizing radiation in healthcare professionals. Alterations of these parameters may represent capillaroscopic clues of biological damage by chronic radiation exposure in healthcare professionals. Based on these observations, capillaroscopy may provide clinical data useful to the prevention and follow-up of radiation-exposed healthcare professionals. Full article

Onychomycoses are a group of fungal nail infections commonly classified either according to the pathogenic fungus, to the duration of the disease or to the mode of fungal invasion. Most cases are diagnosed clinically, although there is a general consensus that the pathogen should be identified prior to initiating a treatment. However, this is often difficult as the classical mycologic methods of direct microscopy and culture frequently remain negative. We came across a particular subset of onychomycoses, which posed extreme diagnostic and therapeutic challenges. Over a period of 15 years, 44 patients were seen in specialized nail clinics with a single nail dystrophy that was examined and treated in vain by many practitioners and dermatologists prior to their consultation. Of the forty-four cases, thirty-nine patients had a fingernail affected and five had a toenail affected. The nail was almost completely onycholytic, the nail bed visibly keratotic, the proximal nail fold smooth and shiny and slightly swollen. All patients except five brought the results of negative mycologic cultures. Thirty-four patients had received antifungal therapy, mostly topical, as a single nail would not qualify for systemic treatment according to most national and international guidelines. The diagnosis was finally confirmed by histopathology of the nail plate showing an invasive onychomycosis in all cases. After nail avulsion and combined topical and systemic antifungal therapy, thirty-six patients were cured, three were lost from follow-up, and five showed improved nails but not a complete clinical and mycologic cure. A single-digit nail disease raises the suspicion of a tumor or a trauma; although, in rare cases, diseases normally affecting several nails may only affect a single nail. Such a case should prompt the clinician to ask for a previous trauma to this digit and to intensify the search for a specific pathogen. This study also underlines the importance of histopathology for the diagnosis of onychomycoses. Full article

(1) Background: Onychopapilloma is a benign tumor of the nail bed and distal matrix. which usually manifests as monodactylous longitudinal eryhtronychia associated with subungual hyperkeratosis. The impossibility to rule out a malignant neoplasm is an indication for surgical excision and histological examination. Our aim is to report and describe the ultrasonographic features of onychopapilloma. (2) Methods: we conducted a retrospective analysis of patients with a histological diagnosis of onychopapilloma who underwent ultrasonographic examination in our Dermatology Unit from January 2019 to December 2021. (3) Results: Six patients were enrolled. Erythronychia, melanonychia, and splinter hemorrhages were the main dermoscopical findings. Ultrasonography detected nail bed dishomogeneity in three patients (50%) and a distal hyperechoic mass (5 patients, 83.3%). Color Doppler imaging did not show vascular flow in any of the cases. (4) Conclusions: the detection of a subungual distal non-vascularized hyperechoic mass by US, together with classical onychopapilloma clinical features, supports the diagnosis, especially in those patients who were unable to perform excisional biopsy. Full article

Transmitting waveform design and signal processing method optimization are effective ways to improve a sonar system’s detection performance. In this study, the spectrum and ambiguity function characteristics of pulse trains of frequency modulation (PTFM) signals were deduced and analyzed to address the problem of serious reverberation interference in the detection of low-speed targets in shallow water environments. The action mechanisms of PTFM signal parameters on the comb spectrum and bed of nails ambiguity function were identified. PTFM signal parameters were designed according to reverberation suppression requirements. The threshold was calculated using the estimate-before-detect method, and the comb spectrum waveform cognitive filtering detection algorithm is proposed. The simulation and lake experimental results show that the PTFM signals’ reverberation suppression ability for low-speed targets was better than it was for stationary or high-speed targets. The proposed method has good universality, which can improve the output signal-to-reverberation ratio (SRR) by more than 6 dB. Full article