Introduction: Chronic paronychia is an inflammatory disorder of the proximal nail fold (PNF) lasting more than six weeks that accounts for 18% of nail dystrophies. Clinically, it is characterized by inflammation of the PNF, absence of the cuticle, and dystrophy of the nail plate. Clinical treatment is usually unsatisfactory. Surgical treatment consists on the removal of the PNF, which can be done using the oblique or perpendicular incision techniques.
Objective: The objective of the present study was to compare the efficacy of oblique and perpendicular surgical techniques in the treatment of chronic paronychia.
Methods: Sixty-two patients with chronic paronychia, in one or more fingers (with a total of 138 surgeries), were randomly divided into two groups, according to the surgical technique used (perpendicular or oblique incision). Postoperative evaluation was done after six months using a three-point scale: absence of improvement, improved, cured.
Results: One hundred and thirty-four cases (97.1%) were considered cured, and 4 (2.9%), two in each group, were considered as having improved.

Introduction: The subungual glomus tumor is characterized by painful nodules triggered by thermal and tactile change. A complete lesion excision is the treatment of choice but relapses are frequent. Objective: To compare the rates of recurrence of conventional surgeries described in the literature with the ones we found after the Mohs micrographic surgery (MMS). Material and ethods: We included 10 patients diagnosed with subungual glomus tumor of which 9 were female and 1 male and who also underwent withdrawal of these lesions by the technique of Mohs micrographic surgery. Results: Of the 10 patients, eight were considered cured after following 14 to 93 months (around 47.8 months). There were two recurrences which occurred after 47 and 51 months, respectively. One case was reoperated by MMS without evidence of disease after 24 months. Conclusion: The results obtained with the use of MMS in subungual glomus tumors were similar to those reported in the literature with conventional techniques, usually with more limited follow-up.

Keywords: MICROGRAPHIC SURGERY, MOHS MICROGRAPHIC SURGERY, GLOMUS TUMOR

Nail unit surgery requires that the surgical field be free of bleeding to allow good visibility of the structures and lesions involved.There are several types of tourniquets aimed at meeting this requirement, each with its advantages and disadvantages.We present a new and simple buckle tourniquet that is adjustable, safe, and cost-effective.

Keywords: TOURNIQUETS, SURGERY, NAILS, FINGERS

Introduction: Transverse over curvature is a commoninaes the tic and pain ful deformity of the nail plate. There are several conservative and surgical techniques for trea ting this condition. We describe a simple and cost effective techni que using auto logous dermal grafts.

Keywords: NAIL DISEASES, NAILS, NAILS, MALFORMED, NAILS, INGROWN, AMBULATORY SURGICAL PROCEDURES

Introduction: Chronic paronychia is an inflammatory disease of the proximal nail fold that usually lasts for more than six weeks. Surgical of removal the proximal nail fold is recommended in cases that are resistant to clinical treatment. Objective: To analyze the long-term response to the surgical treatment of chronic paronychia. Methods: Prospective cohort study of 62 patients who had undergone surgical treatment to correct chronic paronychia from November 2004 to April 2008. The patients were asked to return for reassessment and clinical observation of the presence or absence of signs of chronic paronychia and were classified into two groups: cured and uncured. Results: Of the 62 patients, 12 attended the clinical reassessment, for a total of 31 procedures for analysis. The average length of patient follow-up was 5 years and 2 months. The results were maintained in 27 (87%) of the procedures performed. Conclusions: Surgical removal of the proximal nail fold is a good option for the treatment of chronic paronychia due to its simplicity, effectiveness, and long-lasting results.

Keywords: PARONYCHIA, NAIL DISEASES, AMBULATORY SURGICAL PROCEDURES

Onychomatricoma is a benign neoplasia that occurs pecifically in the nail apparatus. It was described in 1992, and is the only tumor in which the change of the nail plate is actively caused by the lesion. It lies in the nail matrix,and has fingerlike projections that are embedded in the nail plate, resulting in thickening, longitudinal grooves, yellow discoloration and splinter hemorrhages. Although described as a rare tumor, it is believed to be underdiagnosed. The present study is aimed at reviewing onychomatricoma’s clinical features as well as the complementary examinations that are used to recognize and diagnose this tumor.

Keywords: NAIL DISEASES, NAILS / PATHOLOGY, NEOPLASMS

Introduction: Workshops are offered during Dermatological Meetings in order to teach surgical procedures, both live and in detail. Nevertheless, access to post-operative developments, as well as to the results obtained, are restricted to the physicians from the medical services responsible for organizing these events. Objective: To assess, and make known, the progress and results of previously operated cases. Methods: Eight patients with different pre-operative diagnoses were operated on the nail surgery workshop that occurred during the Brazilian dermatological meeting RADESP 2011, with a nine-month follow up. The results were evaluated using photographs, taken every three months, by the surgeons responsible for the surgeries. Results: Of the eight operated cases, two were considered as yielding satisfactory results (one with mild dystrophy of the nail plate and the other with time considered insufficient for better assessment), and five were deemed as cured. One case did not return for the follow-up visits. Conclusion: Following up and presenting the post-operative development of these patients as well as publishing the responsible surgeons' evaluations, complements the knowledge acquired by the workshops' attendees, and that of other participants at the meetings.

Keywords: GENERAL SURGERY, NAILS, TREATMENT OUTCOME

Introduction: Onychomycosis is a fungal nail infection, corresponding to about 50% of onychopathies. The most frequently used tests for diagnosis are direct microscopy and fungal culture. The collection of samples is the most critical stage in the diagnosis of onychomycosis. Due to lack of knowledge or technical difficulty, samples are collected from the most distal part of the nail, where the fungal viability is low. Objective: To evaluate the use of nail abrasion as an auxiliary method to collect material for the diagnosis of onychomycosis, comparing it with results obtained using the traditional collection method. Methods: Thirty patients with clinical suspicion of onychomycosis in the feet had samples of their finger nails collected for examination using two different methods. The collection was initially made with the traditional method (distal part of the nail). Subsequently, nail abrasion was performed in the most proximal portion of the lesion, with the collection of scales from the abraded area. Both samples underwent mycological examination and culture. Results: The samples collected following nail abrasion showed a higher percentage of positive results than those collected from the distal portion, with positivity rates of 76.7% and 36.7%, respectively (p = 0.0018). Conclusions: Nail abrasion is an effective auxiliary method in the diagnosis of onychomycosis, having been proved superior to the traditional collection technique.

Keywords: NAILS; ONYCHOMYCOSIS; ONYCHOMYCOSIS/DIAGNOSIS; DIAGNOSIS.

The present article discusses the importance of differential diagnosis with lesions located in the umbilicus. A case of verrucous nevus is described in this location, emphasizing the role of dermoscopy in the diagnosis.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

Lichen planus pigmentosus is a rare variant of lichen planus and represents a therapeutic challenge. Dermabrasion was performed with a good clinical response in the treatment of this condition, on the face of a female patient who also bears frontal fibrosing alopecia.

Keywords: DERMABRASION; LICHENOID ERUPTIONS; ALOPECIA.

Introduction: A topical cosmetic formulation is currently commercially available for the treatment of Brittle Nail Syndrome, a formulation made up of Equisetum arvense, Methyl sulfonyl methane and Hydroxypropyl chitosan. However, the habit of applying nail polish hinders the adherence to treatments that preclude their use. Objective: To propose a scheme that alternates the use of the formulation five times a week, with nail polish. Methods: A clinical, single-blind, crossover controlled intraindividual trial was carried out with 38 female patients. The patients' hands were randomized into two groups (A and B). Results: From weeks 1 to 8, and from Sunday to Thursday, Group A applied the formulation A while Group B did not undergo treatment. In weeks 9 to 16, Group A suspended the application of the formulation, while Group B began treatment. From Thursday to Sunday Groups A and B had their nails painted. A common nail polish was standardized for both groups. A quantitative score was used to evaluate outcomes and observe the percentage of patients who had improvements greater than 50% and 75%. Conclusions: The formulation was more effective in controlling the signs of the syndrome when the nail polish was used in the intervals of the applications. The present study allowed the authors to propose a treatment regimen using the formulation 5 times a week, alternating with the practice of painting the nails.

Keywords: NAIL DISEASES; NAILS; PRODUCTS FOR NAILS AND CUTICLES

Transverse hypercurvature is a deformity of the nail plate, unaesthetic and painful, causing discomfort to the patient. Treatment can be conservative or surgical. Related to the conservative treatments, placing the flexible plastic blade on the nail plate using cyanoacrylate glue, promotes rapid improvement of pain and its widening from three to six months. The use of cyanoacrylate accelerator facilitates the procedure, making it faster.

Keywords: NAILS, MALFORMED; NAILS, INGROWN; NAIL DISEASES; AMBULATORY SURGICAL PROCEDURES

Viral warts are one of the most prevalent dermatoses. The clinical picture varies from a single lesion with spontaneous cure to multiple recalcitrant lesions. Bleomycin sulfate is a cytotoxic action drug approved for the chemotherapeutic treatment of some malignancies. There are a number of studies that have been carried out during the last 45 years demonstrating its usefulness in dermatology, especially in intralesional therapy for viral warts, meaning it is an excellent option for lesions in difficult-to-handle topographies and for cases that do not respond to other approaches.

Keywords: Bleomycin; Drug therapy; Viral wart

Onychomatricoma is a tumor of the nail matrix with well-known clinical features; however, sometimes underdiagnosed. It is often mistaken for onychomycosis due to thickening of the nail plate. dermoscopy of the plate and its free margin allows the visualization of important features for the diagnosis, many times not seen with the naked eye.

Keywords: Dermoscopy; Nail Diseases; Nails/Pathology; Neoplasms

Onychomycosis is the nail disease responsible for 50% of onychopathies. The most common clinical form is distal and lateral onychomycosis. The dermoscopic finding of subungual hyperkeratosis in “ruin appearance” in the nail free margin is a relevant diagnostic clue and, when present, suggests the diagnosis of onychomycosis.

Keywords: Dermoscopy; Nail diseases; Onychomycosis

The “harpoon nail” is a variant of the ingrown toenail. In this condition, the nail spicule pierces the distally growing periungual tissue and may emerge through the hyponychium. Its diagnosis can be confirmed by high-frequency ultrasound, facilitating the therapeutic programming.

Keywords: Dermoscopy; Nail diseases; Onychomycosis