tailieunhanh - Disorders Techniques in Investigation and Diagnosis - part 5

Thông thường, khâu không cần thiết. Khối u phát triển từ dưới nếp gấp móng tay gần được gỡ bỏ sau khi phản ánh các móng tay gần gấp lại bằng cách làm cho các vết mổ bên mỗi cọc một khoản tiền ở trên trục rãnh móng tay bên. Fibromas Subungual được gỡ bỏ sau khi sự nhổ lên của phần tương ứng của các tấm móng tay. | Periungual tissue disorders 133 Figure Periungual fibroma. Courtesy of Akiro Kamumochi Japan. Figure Koenen s tumour associated with nail plate destruction. Figure A text atlas of nail disorders 134 Multiple Koenen s tumours. Koenen s tumours are cured by simple excision. Usually no suture is necessary. Tumours growing out from under the proximal nail fold are removed after reflecting the proximal nail fold back by making lateral incisions down each margin in the axis of the lateral nail grooves. Subungual fibromas are removed after avulsion of the corresponding part of the nail plate. Acquired periungual fibrokeratoma Acquired periungual fibrokeratomas are probably identical to acquired digital fibrokeratomas and Steel s garlic clove fibroma. They are acquired benign spontaneously developing asymptomatic nodules with a hyperkeratotic tip and a narrow base Figures . They most commonly occur in the periungual area or on other parts of the fingers. A case was described in which the lesion was located beneath the nail visible under the free margin of the great toe nail. Most periungual fibrokeratomas emerge from the most proximal part of the nail sulcus growing on the nail and causing a sharp longitudinal depression. Trauma is thought to be a major factor initiating acquired periungual fibrokeratoma. Microscopically acquired periungual fibrokeratomas resemble hyperkeratotic dermal hernias . The core consists of mature eosinophilic collagen fibres oriented along the main vertical axis of the tumour. The fibroblastic cells are increased in number. Most fibromas are highly vascular. The epidermis is thick and acanthotic. There is a marked orthokeratotic horny layer which may be parakeratotic and contains serum or blood at the tip of the tumour. Elastic fibres are normal. Acid mucopolysaccharide levels are not increased. Figure Acquired fibrokeratoma. Periungual tissue disorders 135 Figure Garlic clove fibrokeratoma. Surgical treatment .