Maligne Tumoren des Nagelorgans

Abstract

Because of the large number of different tissues making up the distal phalanx of fingers and toes, a large variety of malignant tumors can be found in and around the nail apparatus. Bowen disease is probably the most frequent nail malignancy. It is usually seen as a verrucous plaque of the nail fold and nail bed in persons above the age of 40 years. It slowly grows over a period of years or even decades before degenerating to an invasive squamous cell carcinoma. The latter may also occur primarily often as a weeping onycholysis. The next most frequent nail malignancy is ungual melanoma. Those arising from the matrix are usually pigmented and often start with a longitudinal melanonychia whereas those originating from the nail bed remain amelanotic, are often nodular and mistaken for an ingrown nail in an elderly person. The treatment of choice for in situ and early invasive subungual melanomas is generous extirpation of the nail apparatus whereas distal amputation is only indicated for advanced melanomas. In addition to these frequent nail malignancies, nail-specific carcinomas, malignant vascular and osseous tumors, other sarcomas, nail involvement in malignant systemic disorders and metastases may occur. In most cases, they cannot be diagnosed accurately on clinical grounds. Therefore, a high degree of suspicion is necessary in all isolated or single-digit proliferations that do not respond to conservative treatment.

The Diagnosis and Treatment of Nail Disorders

“…Onychomycosis is an infection of the nail apparatus by dermatophytes, yeasts, or molds. worse than that of cutaneous melanoma, with a diseasespecific 10-year survival rate of only 43% (25,26). It is treated with micrographically guided surgery (21,22).…”

Superficial Dermatophytosis across the World’s Populations: Potential Benefits from Nanocarrier-Based Therapies and Rising Challenges

“…104,105 It gave the benefits of high keratin adherence as well as prolonged therapeutic levels in the systemic circulation (SC) for up to 10 days after therapy had been discontinued. 106,107 Although there have been sporadic reports of high in vitro MICs, to the best of our knowledge, no clinical instance of resistance to KTZ has been recorded up to this point. 99,108 On the other hand, due to the hepatotoxic nature of the medicine's side effects, it has been banned in certain nations, and strict limitations and extreme care have been recommended in others, despite the fact that there are some people who say that this should not be the case.…”

“…The clinical efficacy of KTZ was found to be superior to that of griseofulvin (GRI), which was the sole systemic antifungal agent used for treating dermatophytosis at the time. KTZ was able to address various challenges associated with GRI, such as extended treatment durations, frequent treatment failures, an unfavorable skin pharmacokinetic (PK) profile, and limited oral bioavailability. , It gave the benefits of high keratin adherence as well as prolonged therapeutic levels in the systemic circulation (SC) for up to 10 days after therapy had been discontinued. , Although there have been sporadic reports of high in vitro MICs, to the best of our knowledge, no clinical instance of resistance to KTZ has been recorded up to this point. , On the other hand, due to the hepatotoxic nature of the medicine’s side effects, it has been banned in certain nations, and strict limitations and extreme care have been recommended in others, despite the fact that there are some people who say that this should not be the case. In addition, the drug has been linked to a number of deaths .…”

Es brennt uns wieder auf den Nägeln

“…Und auch in der Zeitschrift Der Hautarzt sind wieder 4 Jahre seit dem letzten Themenheft zum Nagel vergangen [2]. In konzentrierten, immer noch aktuellen Übersichten ging es seinerzeit um anatomische und physiologische Grundlagen [3], die Diagnostik durch die Dermatoskopie des Nagelorgans [4], häufige Nageldermatosen in der Praxis [5], die Nagelchirurgie zur Therapie von Neoplasien [6], den pigmentierten Nagel [7] und nagelchirurgische Herausforderungen bei Kindern [8]. Wer tiefer in die Materie eintaucht, erfährt schnell die Vielschichtigkeit des Themas, allein schon zu nagelchirurgischen Themen.…”