Surgical excision is the treatment of choice for subungual glomus tumor. However, the anatomical location has inherent difficulties. We report the outcomes of surgical treatments for subungual glomus tumor. Sixteen patients, who were seen over an eight-year period (1995-2003) and confirmed as gloums tumor by histopathologic examination were reviewed. The most common subjective symptom was pain induced by contact in 81%. The tumor presented as a discolorated spot or subungual nodule and 38% of tumors were acccompanied with nail dystrophy. All tumors showed discolorated spots or subungual nodules. As shown in the Table 2, the dystrophic nail change was found in 38% of tumors. Differently oriented incisions were made according to the location of tumor, matrix, or bed. The original nail plate was restored in eight patients. Thirteen patients (81%) had cosmetically excellent nail plates, and three patients (19%) had partial distal splits of nail plates. There was no recurrence. Our series suggests that a transungual approach with nail avulsion and an incision selected according to the tumor location can produce an excellent outcome with minimal postoperative complications. Dressing with a trimmed nail plate may also be beneficial in managing the wound and preventing postoperative nail deformity.

Subungual glomus tumor: clinical manifestations and outcome of surgical treatment.

BACKGROUND The glomus tumor, described as a painful subcutaneous nodule, commonly occurs in subungual regions and is accompanied by tenderness and temperature sensitivity. In treatment of subungual glomus tumor, surgical excision is known to be the only curative method. Under surgical approach, it is challenging to minimize postoperative nail deformity and to reduce tumor recurrence. OBJECTIVE To evaluate the efficacy and safety of surgical treatment of subungual glomus tumor using simple blunt dissection. MATERIALS AND METHODS Twenty-three patients diagnosed with subungual glomus tumor underwent surgical procedure using a dorsal transungual approach. A single linear incision was made above the tumor, and the exposed mass was meticulously dissected with the opposite end of a single-end probe, and the tumor "popped up." Recurrence of symptom, tumor recurrence, and local complication were evaluated through long-term follow-up. RESULTS After a mean follow-up period of 30 months, only one case recurred, and partial-thickness skin necrosis occurred around the tourniquet site. There was no postoperative nail deformity. CONCLUSIONS In treatment of subungual glomus tumor, meticulous simple blunt dissection using a transungual approach led the tumor to "pop up" from the tumor bed. This unique and simple method of treating subungual glomus tumor showed low recurrence and minimal complications.

Surgical treatment of subungual glomus tumor: a unique and simple method.

Nail dystrophy and periungual dermatitis due to cyanoacrylate glue sensitivity.

background. Schwannoma is a benign tumor of neural tissue and usually develops in deeper soft tissue. Cutaneous involvement is uncommon, and a subungual location is extremely rare. In fact, it has not been previously reported.



objective. To present a case of subungual schwannoma.



method. A 49-year-old man had a subungual tumor on his right thumb of 8 years duration. The lesion caused a mild stinging sensation in winter and grew slowly. The tumor was excised using a transungual approach. After closure, the wound was dressed with a trimmed original nail plate.



results. The nail plate grew normally, and there was no recurrence 1 year postoperatively.



conclusion. We describe a case of schwannoma that developed in the subungual area of a thumb. Although schwannoma rarely develops in this area, it should be considered in the differential diagnosis of subungual tumor.

Subungual schwannoma: a rare location.

Repair of the nail bed and plate after distal phalanx trauma remains controversial. The aim of this study was to determine whether simple approximation of the nail bed flaps maintained by tension band suture of the nail plate is sufficient to prevent nail dystrophies. Our series gathered 27 fingers in 25 patients with a mean age of 36 years. In 15 cases (Group I), the nail plate was fixed in a single layer by a point in a frame, and in 12 cases (Group II), the bed and the plate were fixed layer-by-layer using the wound adhesive, 2-octylcyanoacrylate. At the last follow-up, the Zook score was excellent and very good in 100% of Group I patients, and in 83.3% of Group II patients. Within 8 days, the average pain was 1/10 in Group I, and 2.5/10 in Group II. There was one infection in Group I and four hematomas in Group II. The Quick DASH score was 1.13/100 in Group I and 0 in Group II. Our results show that in the case of a traumatic nail bed injury, suturing the nail bed and applying 2-octylcyanoacrylate adhesive is less effective than simple approximation of the nail bed flaps by tension band suture of the nail plate.

Fixation of the nail plate by tension band suture versus 2-octyl-cyanoacrylate gluing for traumatic nail bed injuries reduced without suture: A retrospective study of 27 cases

The replacement of a surgically avulsed nail as a splint and dressing with “Superglue” isreported. It provides a painless cover for the sterile matrix and facilitates the dressing of finger tip injuries.

The best dressing for a nail bed is the nail itself

A case is reported in which metacarpophalangeal joint capsulotomy is augmented by the use of a flap of fibrous tissue from around previously implanted silicone sheet as a form of capsular reconstruction.

H. P. Henderson

Papers

The best dressing for a nail bed is the nail itself

A possible new operative method for the treatment of metacarpophalangeal joint stiffness