The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Kuniaki Ohara - One of the best experts on this subject based on the ideXlab platform.
-
Medical pearl: Subungual Hematoma: a simple and quick method for diagnosis.
Journal of the American Academy of Dermatology, 2006Co-Authors: Yu-huei Huang, Kuniaki OharaAbstract:A lthough ungual melanomas most commonly start as brown to black nail pigmentations, such appearances may be simulated by a number of other conditions such as bacterial, mycotic, or blood pigments. Among those, blood is by far the most common cause of dark nail pigmentation. Subungual Hematomas usually do not pose diagnostic problems because histories of acute traumas are usually evident. However, hemorrhages mimicking longitudinal streaks may also result from repeated minor traumas that easily escape notice, the most frequent being those caused by frictions with shoes. These are usually found incidentally by the patients, who seek medical advice with concerns about possible malignant melanomas. These patients are poorly prepared for invasive procedures like biopsies or nail avulsions, so a simple diagnostic method is imperative. To this end, the epiluminesence microscope offers an easy means for diagnosing Subungual Hematomas by revealing their irregular red-blue blotches or globules. Alternatively, if a dermatoscope is not available, patients are advised to observe whether the pigments migrate distally with growing nails, as would be expected for Subungual Hematomas. However, because of the general level of anxiety experienced by patients, the observational approach may not be appreciated. Here we propose a simple method of fast detection for blood pigments in nails.
Harris Gellman - One of the best experts on this subject based on the ideXlab platform.
-
Fingertip-Nail Bed Injuries in Children: Current Concepts and Controversies of Treatment
Journal of Craniofacial Surgery, 2009Co-Authors: Harris GellmanAbstract:Crush injuries of the fingertip are the most common hand injuries seen in children. Many involve fracture of the distal phalanx, whereas others result in either crush alone or complete or partial fingertip amputation. The need for nail removal and nail bed repair after crush injury to the fingertip has long been a matter of debate. In our study comparing the outcome of nail removal and formal nail bed reconstruction versus simple evacuation of the Subungual Hematoma via trephination after fingernail crush injuries, simple nail trephination was equal to, or superior to, removal of the nail and nail bed repair with significantly lower cost (Roser SE, Gellman H. Comparison of nail bed repair versus nail trephination for Subungual Hematomas in children. Language: en
-
comparison of nail bed repair versus nail trephination for Subungual Hematomas in children
Journal of Hand Surgery (European Volume), 1999Co-Authors: Steven E Roser, Harris GellmanAbstract:Abstract Fifty-three fingers in 52 children were divided into 2 groups, operative and nonoperative, after fingernail crush injury. Criteria for inclusion into the study were an intact nail and nail margin with Subungual Hematoma and no previous nail abnormality. The length of the follow-up period averaged longer than 2 years for each group. Twenty-six fingers in 26 children were treated by nail removal, exploration, and repair of nail bed lacerations (operative group). Twenty-seven fingers in 26 children were treated by evacuation of Hematoma by nail trephination without nail removal in 11 fingers and by observation in the other 16 fingers (nonoperative group). In the operative group, transient abnormalities (nail depression or hypertrophy), which resolved by 4 months, occurred in 3 patients. In the group treated by simple decompression, there were no complications except for 1 transient nail depression at 3 months. The average cost to the operative group was $1,263 compared with $283 to the trephination group. Although formal nail bed reconstruction has been advocated for Hematomas larger than 25%, we found no notable difference in outcome between the 2 groups regardless of Hematoma size, presence of fracture, injury mechanism, or age. Charges, however, were 4 times greater for the operative group. Based on the results of this study, we do not feel that nail removal and nail bed exploration is indicated or justified for children with Subungual Hematoma and an intact nail and nail margin. (J Hand Surg 1999;24A:1166–1170. Copyright © 1999 by the American Society for Surgery of the Hand.)
Jean-hilaire Saurat - One of the best experts on this subject based on the ideXlab platform.
-
Diagnosis and management of nail pigmentations
Journal of the American Academy of Dermatology, 2007Co-Authors: Ralph P. Braun, R Baran, Frederique Anne Le Gal, Stéphane Dalle, Sandra Ronger, Roberta Pandolfi, Olivier Gaide, Lars E. French, Paul Laugier, Jean-hilaire SauratAbstract:Longitudinal pigmentation of the nail is very common. The differential diagnosis varies from Subungual Hematoma, to a fungal infection, to a melanocytic lesion (lentigo, nevus melanoma, etc.) to others. Often, dermatologists do not feel at ease with these pathologies and management is often not clear. In many cases, a biopsy is not helpful because an inadequate technique was chosen. The use of noninvasive techniques such as dermoscopy has been described to be useful for the preoperative evaluation and the management decision. Using these technique, one will be able to reduce the number of unnecessary surgeries and to choose the most adequate biopsy technique. In this article, we will review the management, including diagnosis as well as differential diagnosis of nail pigmentations and propose a new algorithm for the non invasive diagnosis of nail pigmentation.
Guliz Ikizoglu - One of the best experts on this subject based on the ideXlab platform.
-
extra fine insulin syringe needle an excellent instrument for the evacuation of Subungual Hematoma
Dermatologic Surgery, 2003Co-Authors: Tamer Irfan Kaya, Ümit Türsen, Kıymet Baz, Guliz IkizogluAbstract:Background. The most commonly used treatment method for Subungual Hematoma is nail trephining, which has some disadvantages. Objective. To introduce a very simple and well-tolerated treatment technique for this common problem. Methods. We used an extra-fine, 29-gauge insulin syringe for evacuation. We inserted the needle very close to the nail plate to minimize pain. We drained the blood from the hyponychium under the nail plate using this extra-fine needle. Results. The technique described herein is very fast and simple, and the patients tolerate it well. It is particularly successful for the treatment of smaller Subungual Hematomas of the second, third, and fourth toenails, in which the trephining is harder. Conclusion. For these reasons, we suggest this technique as a practical alternative to the traditional nail trephining methods.
-
Extra‐Fine Insulin Syringe Needle: An Excellent Instrument for the Evacuation of Subungual Hematoma
Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.], 2003Co-Authors: Tamer Irfan Kaya, Ümit Türsen, Kıymet Baz, Guliz IkizogluAbstract:Background. The most commonly used treatment method for Subungual Hematoma is nail trephining, which has some disadvantages. Objective. To introduce a very simple and well-tolerated treatment technique for this common problem. Methods. We used an extra-fine, 29-gauge insulin syringe for evacuation. We inserted the needle very close to the nail plate to minimize pain. We drained the blood from the hyponychium under the nail plate using this extra-fine needle. Results. The technique described herein is very fast and simple, and the patients tolerate it well. It is particularly successful for the treatment of smaller Subungual Hematomas of the second, third, and fourth toenails, in which the trephining is harder. Conclusion. For these reasons, we suggest this technique as a practical alternative to the traditional nail trephining methods.
Yu-huei Huang - One of the best experts on this subject based on the ideXlab platform.
-
Medical pearl: Subungual Hematoma: a simple and quick method for diagnosis.
Journal of the American Academy of Dermatology, 2006Co-Authors: Yu-huei Huang, Kuniaki OharaAbstract:A lthough ungual melanomas most commonly start as brown to black nail pigmentations, such appearances may be simulated by a number of other conditions such as bacterial, mycotic, or blood pigments. Among those, blood is by far the most common cause of dark nail pigmentation. Subungual Hematomas usually do not pose diagnostic problems because histories of acute traumas are usually evident. However, hemorrhages mimicking longitudinal streaks may also result from repeated minor traumas that easily escape notice, the most frequent being those caused by frictions with shoes. These are usually found incidentally by the patients, who seek medical advice with concerns about possible malignant melanomas. These patients are poorly prepared for invasive procedures like biopsies or nail avulsions, so a simple diagnostic method is imperative. To this end, the epiluminesence microscope offers an easy means for diagnosing Subungual Hematomas by revealing their irregular red-blue blotches or globules. Alternatively, if a dermatoscope is not available, patients are advised to observe whether the pigments migrate distally with growing nails, as would be expected for Subungual Hematomas. However, because of the general level of anxiety experienced by patients, the observational approach may not be appreciated. Here we propose a simple method of fast detection for blood pigments in nails.
