Publications by authors named "Nilton Gioia Di Chiacchio"

Nail unit verruca is the most common nail tumor encountered in clinical practice and may be highly distressing to patients due to reduced functionality, cosmesis, and stigmatization. Subungual and periungual verrucae present a challenge for treatment compared to cutaneous warts of other sites and recurrence rates are high. The risk of spread to other skin and mucosal areas inherent to all warts may be increased given location on the fingertips.

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The diagnosis of pigmented nail lesions is a concern for both general practitioners and dermatologists, due to the possibility of indicating nail melanoma. The origin of the dark pigmentation can be either melanocytic or non-melanocytic (fungi, bacteria, or blood), and clinical evaluation alone may not be sufficient for differentiation, requiring additional exams. Onychoscopy provides valuable information prior to biopsy.

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Background: Nail glomus tumor is a well-known tumor, with well-defined clinical characteristics and surgical treatment; however, some of these lesions occur in different locations and sizes with difficult surgical resolution.

Summary: Clinical and imaging tests help in the diagnosis and tumor localization.

Key Message: Adequate surgical knowledge for these cases ensures lower rates of recurrence and nail dystrophy.

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Introduction: Bowen's disease is a squamous cell carcinoma in situ, the most common malignancy of the nail unit. Presenting more frequently in the fingernails, common risk factors include ionizing radiation, oral exposure to arsenic or pesticides, dyskeratosis congenita, and quite commonly diverse subtypes of HPV. We report the first case of multiple periungual pigmented Bowen's disease in a pediatric patient.

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Introduction: Squamous cell papilloma is a benign tumor whose pathogenesis is generally related to the human papillomavirus. Despite affecting several organs, we did not find cases reported in the nails.

Case Presentation: A 67-year-old female presented with a painful lesion in the nail of the right hallux that started in 2021, with an erythematous appearance evolving to black and expansive growth.

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Background: Definitive nail dystrophies, congenital, traumatic, or acquired, affecting mainly elderly patients, may not be sufficiently managed with a periodic conservative treatment. A definitive surgical treatment may be considered an alternative method, especially in symptomatic patients.

Objective: To evaluate the effectiveness of total matricectomy with 88% phenol solution to treat some nail dystrophies, not otherwise satisfactorily managed.

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Background: Trichophyton rubrum and Trichophyton mentagrophytes variant interdigitalis are the most frequent etiologic agents of onychomycosis. Diagnosis of certainty requires mycological examination, which often results unfeasible.

Objectives: The aim of our study is to describe pathogen specific dermoscopic features, allowing a differential diagnosis without the need for cultural examination, in order to prescribe the most appropriate treatment anyway.

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Article Synopsis
  • Benign non-melanocytic nail tumors are often misdiagnosed and have low pathogenicity, leading to confusion with inflammatory or infectious diseases.
  • The presence of a tumor is typically indicated by a mass and changes in the nail structure, particularly when a single digit shows unexplained symptoms.
  • The study aims to review the clinical and dermatoscopic features of common benign nail tumors, correlate these with histopathology, and provide recommendations for effective surgical management.
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Introduction: Onychomycosis is the most common nail disorder in adults, with high recurrence and relapse rates. Its diagnosis may be difficult by non-experts because the clinical signs may overlap with other dermatoses. The treatment may be challenging, as it should be patient-tailored.

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Article Synopsis
  • * A pilot study collected nail dust from gloves and masks of medical personnel after treating 9 patients with diagnosed onychomycosis to investigate the viability of any fungi present.
  • * The results showed that while some deformed fungal structures were found, no viable fungi were grown in cultures, indicating that there was no risk of contamination from the nail abrasion procedure.
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Introduction: Transverse overcurvature of the nail (TON) represents one of the main reasons for dermatological consultations due to nail conditions. Association between TON and subungual hyperkeratosis is common and simulates onychomycosis, constituting a difficult differential diagnosis by clinical features. Many cases are treated in daily practice with antifungal therapy even without mycological confirmation.

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Onychomatricoma is a rare and specific benign tumor of the nail complex, with uncertain etiology. The avulsion of the nail plate reveals cavitations and orifices in its proximal extremity. These are associated with villous tumor formations generating digitiform projections at the nail matrix - typical intraoperative findings.

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Acquired fibrokeratoma is a rare benign skin tumor that usually manifests as a slow-growing solitary nodular lesion of the digits. We report a case of plantar acquired fibrokeratoma evidencing its atypical size and topography, in addition to the treatment with simple surgical excision followed by healing by second intention. Nondigital fibrokeratomas may occur in 18% of cases and rarely affect the palmoplantar region.

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Congenital curved nail of the fourth toe represents an unusual deformity in which the nail of the fourth toe curves in a plantar direction. It is unknown why only this toe is affected; however, the initial descriptions suggest that this is a mesodermal defect. We describe a case of congenital curved nail of the fourth toe associated with bifid uvula.

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