{"title":"指甲色素性恶性甲鳞瘤:“串征”的描述。","authors":"Rachel C Hill, Cynthia M Magro, Shari R Lipner","doi":"10.1159/000543433","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Onychopapilloma is a benign nail tumor of the nail bed and distal matrix that typically presents as isolated longitudinal erythronychia on clinical examination. In 2021, Haneke et al. [J Cutan Pathol. 2021;48(1):174-9] described the 1st case of a malignant variant of onychopapilloma.</p><p><strong>Case presentation: </strong>We present the case of a 34-year-old female patient, Fitzpatrick type V, who presented to our specialty outpatient nail clinic with a 10-year history of a pigmented growth on the lateral nail fold of the left 3rd fingernail that resembled a string. On histopathology, the patient's biopsy showed significant onycholemmal squamous dysplasia with intracytoplasmic melanin pigment deposition in a background of onychopapilloma; concurrent abnormal suprabasilar nuclear staining amidst keratinocytes for Ki67 was observed.</p><p><strong>Conclusion: </strong>The proportion of onychopapilloma cases that develop malignant potential is currently unknown, as onychopapillomas were believed to be entirely benign until 2021. Malignant onychopapilloma often presents with longitudinal melanonychia in patients with skin of color and with longitudinal erythronychia in patients with lighter phototypes. Our case highlights the importance of performing a biopsy in patients who present with atypical features of onychopapilloma, including changes in pigmentation and growth, the latter potentially presenting with the \"string sign.\"</p>","PeriodicalId":9619,"journal":{"name":"Case Reports in Dermatology","volume":"17 1","pages":"54-60"},"PeriodicalIF":0.8000,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867635/pdf/","citationCount":"0","resultStr":"{\"title\":\"Pigmented Malignant Onychopapilloma of the Fingernail: Description of the \\\"String Sign\\\".\",\"authors\":\"Rachel C Hill, Cynthia M Magro, Shari R Lipner\",\"doi\":\"10.1159/000543433\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Onychopapilloma is a benign nail tumor of the nail bed and distal matrix that typically presents as isolated longitudinal erythronychia on clinical examination. In 2021, Haneke et al. [J Cutan Pathol. 2021;48(1):174-9] described the 1st case of a malignant variant of onychopapilloma.</p><p><strong>Case presentation: </strong>We present the case of a 34-year-old female patient, Fitzpatrick type V, who presented to our specialty outpatient nail clinic with a 10-year history of a pigmented growth on the lateral nail fold of the left 3rd fingernail that resembled a string. On histopathology, the patient's biopsy showed significant onycholemmal squamous dysplasia with intracytoplasmic melanin pigment deposition in a background of onychopapilloma; concurrent abnormal suprabasilar nuclear staining amidst keratinocytes for Ki67 was observed.</p><p><strong>Conclusion: </strong>The proportion of onychopapilloma cases that develop malignant potential is currently unknown, as onychopapillomas were believed to be entirely benign until 2021. Malignant onychopapilloma often presents with longitudinal melanonychia in patients with skin of color and with longitudinal erythronychia in patients with lighter phototypes. Our case highlights the importance of performing a biopsy in patients who present with atypical features of onychopapilloma, including changes in pigmentation and growth, the latter potentially presenting with the \\\"string sign.\\\"</p>\",\"PeriodicalId\":9619,\"journal\":{\"name\":\"Case Reports in Dermatology\",\"volume\":\"17 1\",\"pages\":\"54-60\"},\"PeriodicalIF\":0.8000,\"publicationDate\":\"2025-01-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11867635/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Case Reports in Dermatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1159/000543433\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"DERMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Case Reports in Dermatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1159/000543433","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"DERMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
甲乳头瘤是甲床和远端基质的良性指甲肿瘤,临床检查典型表现为孤立的纵向赤甲。In 2021, Haneke et . [J] Cutan Pathol. 2021;[48(1):174-9]报道了第一例甲鳞瘤的恶性变异。病例介绍:我们报告一名34岁的女性患者,Fitzpatrick V型,她在我们的专业门诊指甲诊所就诊,10年的历史,左侧第3个指甲的外侧指甲褶皱上有色素生长,类似于一根弦。在组织病理学上,患者的活检显示明显的甲状上皮鳞状异常增生,伴有细胞浆内黑色素沉积,背景为甲状上皮瘤;在Ki67的角质形成细胞中观察到同时异常的基底上核染色。结论:发展为恶性潜能的甲乳头瘤病例比例目前尚不清楚,因为直到2021年,甲乳头瘤被认为是完全良性的。恶性甲状鳞状瘤常表现为纵向黑甲,在肤色较浅的患者表现为纵向红甲。我们的病例强调了对表现出非典型特征的甲乳头瘤患者进行活检的重要性,包括色素沉着和生长的变化,后者可能表现为“线状征象”。
Pigmented Malignant Onychopapilloma of the Fingernail: Description of the "String Sign".
Introduction: Onychopapilloma is a benign nail tumor of the nail bed and distal matrix that typically presents as isolated longitudinal erythronychia on clinical examination. In 2021, Haneke et al. [J Cutan Pathol. 2021;48(1):174-9] described the 1st case of a malignant variant of onychopapilloma.
Case presentation: We present the case of a 34-year-old female patient, Fitzpatrick type V, who presented to our specialty outpatient nail clinic with a 10-year history of a pigmented growth on the lateral nail fold of the left 3rd fingernail that resembled a string. On histopathology, the patient's biopsy showed significant onycholemmal squamous dysplasia with intracytoplasmic melanin pigment deposition in a background of onychopapilloma; concurrent abnormal suprabasilar nuclear staining amidst keratinocytes for Ki67 was observed.
Conclusion: The proportion of onychopapilloma cases that develop malignant potential is currently unknown, as onychopapillomas were believed to be entirely benign until 2021. Malignant onychopapilloma often presents with longitudinal melanonychia in patients with skin of color and with longitudinal erythronychia in patients with lighter phototypes. Our case highlights the importance of performing a biopsy in patients who present with atypical features of onychopapilloma, including changes in pigmentation and growth, the latter potentially presenting with the "string sign."