Diego Leonardo Bet

Dermoscopy and Onychomycosis: guided nail abrasion for mycological samples

Mycological examination is still the cornerstone for the diagnosis of onychomycosis for many dermatologists, but sampling technique interferes on its sensitivity and specificity. Nail abrasion may be used to reach the most proximal part of the lesion and can be easily accomplished with an electric abrasor. We suggest nail plate dermoscopy to identify the best location for localized abrasion to obtain adequate samples for mycological examination.

Synchronous subungual glomus tumors in the same finger

The glomus tumor is an uncommon benign neoplasm of glomus cells. In the majority of the cases it is presented as a solitary painful papule in the subungual region. We report a rare case of a patient with two individual synchronous glomus tumors under the nail bed of the same finger.

Dermoscopy of the Nail Plate, Nail Matrix, and Nail Bed

Dermoscopy of the nail unit allows better characterization of pigmented lesions compared with the naked eye. Dermoscopy easily differentiates subungual hemorrhages from melanin inclusions, and may reveal clues regarding the diagnosis of fungal melanonychia. Background and lines are evaluated on dermoscopy of the nail plate, according to the color and regularity of the pattern. Gray usually indicates melanocytic activation, whereas brown indicates melanocytic hyperplasia. Sometimes it may be hard to differentiate gray from light brown. An irregular brown/black pattern may indicate a melanoma of the nail unit. Intraoperative polarized dermoscopy of the nail matrix and nail bed allows direct visualization and better characterization of pigmented lesions originating longitudinal melanonychia. Four main patterns are described and validated for dermoscopy of the nail matrix and bed: 1. Gray regular pattern: indicates melanocytic activation 2. Regular brown lines: indicate benign melanocytic hyperplasia 3. Regular lines with regular globules and blotches: indicate lentigo and melanocytic nevis 4. Irregular pattern: favors a melanoma of the nail matrix These dermoscopic patterns demonstrate good histopathological correlation and enhance diagnosis accuracy, even for non–nail experts. Intraoperative dermoscopy permits better characterization of surgical margins for biopsy and excision, aiding the surgical management of longitudinal melanonychias.

Correlação clínica e dermatoscópica da colagenose perfurante reativa

The acquired perforating dermatosis is constituted by a group of diseases whose main characteristic is the transepithelial elimination of altered dermal material. It has the clinical appearance of crateriform papules or nodules, with central keratotic plug, which may suggest some kind of transepithelial purging; nevertheless the final diagnosis is histologic. The dermoscopic examination is a useful tool that helps to exclude similar dermatoses, such as nodular prurigo and hypertrophic lichen planus. The present article discusses the clinical and dermoscopic correlation of this dermatosis.