Caso para diagnóstico

Abstract

Patients presenting with plantar puncture wounds with presence of foreign bodies are treated in emergency departments, dermatology and orthopedic clinics. The clinical features of these lesions are rarely cited in journals and textbooks of dermatology. We report a case of foreign body in the plantar surface of the foot, in which clinical history and dermatological examination were decisive for the diagnosis.

Imaging technique for the diagnosis of onychomatricoma

“…Analysis with colour Doppler US showed a non-specific hypovascular pattern. 25,[28][29][30] In our experience, axial images of the tumoral digitations can be obtained at the free edge margin of the nail plate ( Fig. 3).…”

“…Six onychomatricomas were evaluated by high-resolution variable-frequency US. 13,25,[28][29][30][31] In two cases, ultrasound imaging failed to provide diagnostic evidence of the disease. 13,31 In the other four cases, longitudinal oblique US image of the nail evidenced hypoechogenic solid areas affecting the nail matrix (under the proximal nail fold) with hyperechogenic linear dots corresponding to the finger-like tumoral projections deforming the plate.…”

“…We found five studies that evaluated MRI in onychomatricoma, and they showed a low signal uptake for the portion that affects the nail matrix and a high signal uptake for the tumoral projections. 10,13,16,30,31 Tumoral digitations into the nail plates appeared with a Y-shape and with high-intensity signal, probably due to their higher concentration of water than the surrounding nail. Axial images revealed the holes in the nail plate and the tumoral digitations.…”