The role of dermoscopy in the diagnosis of subungual glomus tumors

Abstract

Background and Objectives The dermoscopic features of glomus tumors have only been described in a few case reports. The aim of this research was to define the clinical and dermoscopic features of subungual glomus tumors. Methods Thirty‐two patients with subungual glomus tumors were evaluated retrospectively. Results On the photographs, longitudinal erythronychia, longitudinal leukonychia, punctate leukonychia, splinter hemorrhage, isolated capillaries, distal notching, distal subungual hyperkeratosis, onycholysis, and onychoschizia were found. There was no statistical difference between the rates of detection of these findings by evaluation from clinical photographs alone and from both clinical and dermoscopic photographs. While ramified vessels with bluish spots could be detected in only five of 26 cases with bluish spots in their clinical photographs, these ramified vessels were seen in 14 cases in bluish spots in dermoscopic photographs (P = 0.004). Compared to clinical examination, dermoscopy was able to detect blue spots in three more cases. Lesion duration was higher in the cases with ramified vessels (P = 0.018). Conclusions Dermoscopy seems to contribute to the clinical examination in displaying only ramified vessels located in bluish spots and in determining the localization of the subungual tumors. The presence of ramified vessel in the bluish spots is strongly related to lesion duration.

Dermoscopy of glomus tumour: a cross‐sectional study of 86 cases

“…In our series, we found vessels in approximately 28% of cases (35.1% of those with a visible structureless subungual spot). The presence of vascular structures in the dermoscopic examination of SUGTs has been previously reported, ranging from 13.3% to around 50% in the largest series published to date 5,12 . As previously published by Nogueira Maheara et al ., these vessels can be better visualized if intraoperative dermoscopy is performed 18,19 .…”

“…5,6,12,13 As recently published by G€ oktay et al, who observed this structure in 29/32 SUGTs (90.6%), dermoscopy can reveal this feature when it is invisible to the naked eye. 12 The histopathological explanation for this finding is the presence of a subungual unencapsulated tumour, composed by glomus cells forming nests, sheets, and trabeculae, interspersed by a variable amount of vascular channels. 1 In our series, we found vessels in approximately 28% of cases (35.1% of those with a visible structureless subungual spot).…”

“…In this line, Göktay et al . reported distal notching in 43.8% of cases (58.3% nail matrix SUGTs), being absent in 100% of nail bed tumours 12 . These observations allowed us to create specific patterns depending on the location of the tumour.…”

“…This association has been recently reported by G€ oktay et al in 21.9% of SUGTs, but, as in our case, it did not reach statistical significance. 12 It should be kept in mind, however, that splinter haemorrhages are non-specific and can be present in many neoplastic, inflammatory, or systemic conditions that affect the nail apparatus. 11 In our study, we have observed that nail plate changes, such as distal notching (40.4%) and longitudinal clefting (29.8%), were only present in matrix SUGTs, probably reflecting the end stage of an impaired matrix function Dermoscopy of glomus tumour: a cross-sectional study of 86 cases due to compression.…”

“…[11][12][13] However, current data regarding dermoscopy of GTs are limited and are mostly based on isolated reports and two relatively small case series. 5,7,12,[14][15][16] The aim of this study was to analyse the dermoscopic features and patterns of a large series of SUGTs and EUGTs.…”