Subungual melanomas are rare neoplasms that tend to debut as longitudinal melanonychia. They are primarily found in patients over 60 years of age and are usually diagnosed late, representing a diagnostic challenge. We present a case report of a 59-year-old female Hispanic patient who initially presented with melanonychia and was eventually diagnosed with subungual melanoma in situ. She was surgically treated and, after three months, remained healthy. Relevant risk factors, clinical and onychoscopic findings, diagnostic criteria, and treatment options are also discussed. Since many benign entities present similarly, high clinical suspicion is critical for diagnosing this entity.
Clear cell renal cell carcinoma (ccRCC) comprises most renal cell carcinoma (RCC) cases, with its incidence increasing in recent years. Metastases are most commonly found in the lungs, bones, liver, and brain. However, few patients present with cutaneous metastases, which are usually associated with poor outcomes. We present the case of a 52-year-old man with ccRCC and skin metastasis. Our aim was to highlight the variability in the presentation of cutaneous metastasis of ccRCC. Clinicians should be aware of the various manifestations and possible locations of RCC skin metastases to better identify these lesions and further guide treatment.
Introducción: el onicomatricoma es un tumor fibroepitelial originado en la matriz ungular, es infrecuente y suele presentarse alrededor de la quinta y sexta década de la vida. Métodos: se presenta el caso de un paciente masculino de 57 años, sin antecedentes patológicos, quien consultó por una lesión no dolorosa en la uña del tercer dedo de la mano derecha. Al examen físico presentaba cromoniquia amarilla longitudinal, estrías blanquecinas y hemorragias en astilla. Se realizó onicectomía y matricectomía proximal y se envió el especimen resecado a estudio histopatológico. Resultados: el examen histopatológico reportó una lesión fibroepitelial, con invaginaciones del epitelio y ausencia de la capa granulosa. En el estroma se observaban células ondulantes y fusocelulares acompañadas de mastocitos. Se realizaron tinciones de inmunohistoquímica, confirmando el diagnóstico de onicomatricoma, variante micropapilifera. Conclusiones: debido a los múltiples diagnósticos diferenciales de esta condición, es importante para el dermatólogo familiarizarse con la clínica, hallazgos dermatoscópicos y manejo de esta entidad.
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