Juan Honeyman

Benign Tumors and Pseudotumors of the Nail A Novel Application of Sonography

Objective. The purpose of this study was to determine the scope of high‐resolution sonography in the detection of benign tumors and pseudotumors of the nail unit. Methods. We performed a retrospective study of the sonographic findings in 103 consecutive patients with benign tumors and pseudotumors of the nail that were medically derived and confirmed histologically. Statistical analysis (Student t test) was performed comparing clinical and sonographic diagnoses. Results. Common benign tumors and pseudotumors of the nail can be detected on sonography, and they present different sonographic morphologic characteristics. According to origin, the lesions were considered ungual in 73% (n = 75) and periungual in 27% (n = 28) of the cases. Sonography showed their nature (solid or cystic), location, and extension as well as regional blood flow. In 35% of the cases, the use of sonography modified the clinical diagnosis, although the detailed anatomic information provided by sonography was useful in the planning of surgery in all cases. The addition of sonography was significant (P < .001) for the diagnosis of subungual exostosis and granulomas in comparison to clinical diagnosis. Conclusions. Sonography is a noninvasive imaging method that can reliably detect common benign tumors and pseudotumors of the nail and provide precise data about their characteristics. This imaging modality can support diagnosis and surgery and can allow a better definition and improvement of the cosmetic outcome of the treatment.

The role of ultrasound in rheumatic skin and nail lesions: a multi-specialist approach

The skin and nails are commonly involved in rheumatic conditions, both by the primary disease and/or long-term immunosuppressive treatments. These superficial affections may also imply a worsening of the quality of life in patients and cosmetic sequels. The latest advances in ultrasound technology show that skin and nail abnormalities are now recognizable and therefore susceptible to follow-up non-invasively. Thus, an ultrasound examination of these superficial tissues may be an adjunct tool for evaluating the progression and/or severity of rheumatic diseases in their primary or secondary manifestations.

Practical management of acne for clinicians: An international consensus from the Global Alliance to Improve Outcomes in Acne

&NA; Scientific advances are continually improving the knowledge of acne and contributing to the refinement of treatment options; it is important for clinicians to regularly update their practice patterns to reflect current standards. The Global Alliance to Improve Outcomes in Acne is an international group of dermatologists with an interest in acne research and education that has been meeting regularly since 2001. As a group, we have continuously evaluated the literature on acne. This supplement focuses on providing relevant clinical guidance to health care practitioners managing patients with acne, with an emphasis on areas where the evidence base may be sparse or need interpretation for daily practice.

Asertividad en el diagnóstico clínico de los tumores cutáneos

Background: There is an increase in the incidence rates of skin cancer in Chile. Aim: To study the clinical diagnostic accuracy (CDA) for skin cancer. Material y methods: CDA was defined as the percentage of agreement between clinical and pathological diagnosis. Approximately 600,000 pathological reports from five hospitals in Santiago were reviewed. A total of 2,593 skin tumours; 230 Malignant Melanoma (MM); 412 Squamous Cell Carcinoma (SCC) and 1,951 Basal Cell Carcinoma (BCC) were studied. These tumours were clinically diagnosed and surgically treated by dermatologists. The CDA was studied for each tumour, by the anatomical localization of the tumour, Breslow Index in MM, by age and sex of the patient. Results: The highest CDA was observed for BCC (76.2%); followed by MM (64.3%) and SCC (34.7%). By anatomical localization, for MM the highest CDA was observed in the soles (p <0.05); for BCC, the hightest CDA was in the face (p <0.05). No significant differences were observed in SCC. By age, for MM, the CDA was higher in patients aged less than 50 years. No differences in CDA by age were observed in the other two tumours. By sex, no differences were found. A higher CDA was found in MM with Breslow indexes III and IV than for MM with Breslow indexes I and II. Conclusions: CDA is affected by the clinical variables analyzed in this study. A more accurate clinical diagnosis of skin cancer could be obtained taking into account these variables (Rev Med Chile 2003; 131: 1421-7).