1
|
Sławińska M, Żółkiewicz J, Ribereau-Gayon E, Maińska U, Sobjanek M, Thomas L. Intra-operative dermoscopy (onychoscopy) of the nail unit-A systematic review. J Eur Acad Dermatol Venereol 2024; 38:1988-1996. [PMID: 38717320 DOI: 10.1111/jdv.20078] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Accepted: 03/28/2024] [Indexed: 09/26/2024]
Abstract
Dermoscopy of the nail unit (onychoscopy) is a method which allows for non-invasive observation of the nail structures, increasing the accuracy of clinical diagnosis. Currently, it is used in evaluation of both inflammatory and neoplastic conditions of the nail unit. However, in contrast to the skin, the anatomy of the nail unit prevents direct observation of nail bed or nail matrix structure during classic onychoscopy. Intra-operative onychoscopy is a variant of the technique which uses direct visualization of the nail unit structures after nail plate avulsion. The aim of this systematic review was to summarize the current state of knowledge on intra-operative onychoscopy. The MEDLINE, EMBASE and Cochrane databases were systematically searched in January 2024. All types of study designs assessing intra-operative dermoscopy of the nail unit were included in this study. The risk of bias in included studies was assessed using the Joanna Briggs Institute critical appraisal tools. The qualitative synthesis of 19 studies totalling a number of 218 cases in 217 patients included the following entities: melanoma, nevus, hypermelanosis (melanocytic activation), melanocytic hyperplasia, melanophages accumulation, squamous cell carcinoma, glomus tumour, lichen planus, onychomatricoma, onychomycosis and subungual exostosis. The main limitation of the study was a relatively low number of identified studies, most with low levels of evidence. Intra-operative onychoscopy does not replace histologic examination, though it may be useful in determining the modality of surgical diagnostic procedures.
Collapse
Affiliation(s)
- M Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - J Żółkiewicz
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - E Ribereau-Gayon
- Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon, France
- Lyon 1 University, Lyon, France
| | - U Maińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - M Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - L Thomas
- Department of Dermatology, Centre Hospitalier Lyon Sud, Lyon, France
- Lyon 1 University, Lyon, France
- Lyons Cancer Research Center UMR INSERM U1052 - CNRS5286 - UCBL1, Lyon, France
| |
Collapse
|
2
|
Sechi A, Wortsman X, Tosti A, Iorizzo M. Advances in image-based diagnosis of nail disorders. J Eur Acad Dermatol Venereol 2024. [PMID: 39230323 DOI: 10.1111/jdv.20309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/02/2024] [Indexed: 09/05/2024]
Abstract
This paper provides a comprehensive overview of image-based techniques, particularly focusing on their applications and advancements in the context of nail disorders. Nowadays, high-resolution digital cameras and dermoscopes enable dermatologists to capture detailed images of nail abnormalities, facilitating early diagnosis and meticulous tracking of disease progression. Onychoscopy is now a routine technique with well-known criteria for the diagnosis, but recent developments allow us to visualize certain diseases better. Imaging modalities like high-frequency ultrasound, magnetic resonance imaging, optical coherence tomography and confocal microscopy are being increasingly adopted for their superior diagnostic capabilities. These techniques are described in their technology, scanning protocols, normal findings, advantages and limitations. Moreover, the integration of technology in patient education has fostered a more informed patient population, capable of actively participating in their disease monitoring and treatment regimens. Proper training, validation, regulation and ethical considerations are, however, essential when integrating technology into healthcare practices. Imaging technologies that present the potential to add critical anatomical information to clinical diagnoses within reasonable costs and are available worldwide are the ones that will probably be used the most.
Collapse
Affiliation(s)
- Andrea Sechi
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Ximena Wortsman
- Department of Dermatology and Cutaneous Surgery, Miller School of Medicine, University of Miami, Miami, Florida, USA
- Department of Dermatology, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Department of Dermatology, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile
- Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues, Santiago, Chile
| | - Antonella Tosti
- Fredric Brandt Endowed Professor of Dermatology - Mille School of Medicine, University of Miami, Miami, Florida, USA
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
| |
Collapse
|
3
|
Lee JS, Mun JH. Preoperative and intraoperative dermoscopy of nail unit squamous cell carcinoma and its relationship with the depth of invasion: A retrospective study. J Am Acad Dermatol 2024; 91:522-524. [PMID: 38692436 DOI: 10.1016/j.jaad.2024.01.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 12/26/2023] [Accepted: 01/05/2024] [Indexed: 05/03/2024]
Affiliation(s)
- Ji Su Lee
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea; Laboratory of Cutaneous Aging and Hair Research, Clinical Research Institute, Seoul National University Hospital, Seoul, Korea; Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Korea
| | - Je-Ho Mun
- Department of Dermatology, Seoul National University Hospital, Seoul, Korea; Institute of Human-Environmental Interface Biology, Medical Research Center, Seoul National University, Seoul, Korea; Department of Dermatology, Seoul National University College of Medicine, Seoul, Korea.
| |
Collapse
|
4
|
Bray ER, Tosti A, Morrison BW. Update on Squamous Cell Carcinoma of the Nail Unit: An Human Papillomavirus-Associated Condition. Skin Appendage Disord 2024; 10:199-206. [PMID: 38835716 PMCID: PMC11147528 DOI: 10.1159/000537760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 02/08/2024] [Indexed: 06/06/2024] Open
Abstract
Background Squamous cell carcinoma (SCC) and SCC in situ (Bowen's disease) are the most common malignancies of the nail unit. They are frequently seen in men over 50 and most commonly affect the fingers. The role of high-risk human papillomavirus (HPV) infection has been identified as a key contributor to the development of nail unit SCC. Summary In this review, we aimed to summarize the current state of our understanding of how HPV contributes to nail unit SCC, the role of genitodigital transmission of HPV, and the clinical features of HPV-associated nail unit SCC. We also review current advances in the treatment of nail unit SCC, with a focus on the potential role of HPV vaccination in the treatment and prevention of nail unit SCC. Key Messages Nail unit SCC should be recognized as an HPV-associated disease. HPV vaccination may represent a non-surgical modality for the management of these challenging malignancies in the appropriate clinical setting.
Collapse
Affiliation(s)
- Eric R Bray
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Antonella Tosti
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Brian W Morrison
- Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| |
Collapse
|
5
|
Tu XJ, Lyu C, Zhang F, Liu Y, Sun Y. Delayed diagnosis of metastatic squamous cell carcinoma presenting as mild subungual bleeding. Indian J Dermatol Venereol Leprol 2024; 0:1-3. [PMID: 38841962 DOI: 10.25259/ijdvl_967_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/09/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Xiao Jiao Tu
- Department of Dermatology, Hospital for Skin Diseases, Shandong First Medical University, Shandong, Jinan, China
| | - Chen Lyu
- Department of Dermatology, Hospital for Skin Diseases, Shandong First Medical University, Shandong, Jinan, China
| | - Fan Zhang
- Department of Dermatology, Hospital for Skin Diseases, Shandong First Medical University, Shandong, Jinan, China
| | - Yongxia Liu
- Department of Dermatology, Hospital for Skin Diseases, Shandong First Medical University, Shandong, Jinan, China
| | - Yonghu Sun
- Department of Dermatology, Hospital for Skin Diseases, Shandong First Medical University, Shandong, Jinan, China
| |
Collapse
|
6
|
Erdem O, Göktay F, Atış G, Erdemir VA. How We Do It: Intraoperative Cross-Polarized Photography as an Alternative to Intraoperative Dermoscopy During Nail Surgery. Dermatol Surg 2024; 50:213-214. [PMID: 37962978 DOI: 10.1097/dss.0000000000004025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Affiliation(s)
- Ozan Erdem
- Department of Dermatology, Istanbul Medeniyet University, Istanbul, Turkey
| | | | - Güldehan Atış
- Memorial Health Group, Ataşehir Memorial Hospital, Istanbul, Turkey
| | - Vefa Aslı Erdemir
- Department of Dermatology, Istanbul Medeniyet University, Istanbul, Turkey
| |
Collapse
|
7
|
Polesie S, Zaar O. Frequency of Publication of Dermoscopic Images in Inter-observer Studies: A Systematic Review. Acta Derm Venereol 2021; 101:adv00621. [PMID: 34853864 PMCID: PMC9472090 DOI: 10.2340/actadv.v101.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Research interest in dermoscopy is increasing, but the complete dermoscopic image sets used in inter-observer studies of skin tumours are not often shared in research publications. The aim of this systematic review was to analyse what proportion of images depicting skin tumours are published in studies investigating inter-observer variations in the assessment of dermoscopic features and/or patterns. Embase, MEDLINE and Scopus databases were screened for eligible studies published from inception to 2 July 2020. For included studies the proportion of lesion images presented in the papers and/or supplements was extracted. A total of 61 studies (53 original studies and 8 shorter reports (i.e. research letters or concise reports)). published in the period 1997 to 2020 were included. These studies combined included 14,124 skin tumours, of which 373 (3%) images were published. This systematic review highlights that the vast majority of images included in dermoscopy research are not published. Data sharing should be a requirement for future studies, and must be enabled and standardized by the dermatology research community and editorial offices.
Collapse
Affiliation(s)
- Sam Polesie
- Department of Dermatology and Venereology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna stråket 16, SE-413 45 Gothenburg, Sweden.
| | | |
Collapse
|