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Nail changes in myxoid cysts. (A) Longitudinal groove of nail plate (20 cases). (B) Concave canaliform shape of nail plate (9 cases). (C) Washboard-like transverse grooves of nail plate (5 cases). (D) Longitudinal groove with beaded ridges (1 case).
Source publication
Digital myxoid cyst is relatively common on the digits. Nail changes and osteoarthritis are usually associated with this pathogenesis.
The objective was to clarify this relationship and its significance by analyzing the clinical, radiologic, and pathologic data.
Fifty-one patients with digital myxoid cysts were diagnosed and analyzed during a 5-yea...
Contexts in source publication
Context 1
... changes were recorded in 35 (68.6%) patients. The different clinical expressions of onychodystro- phy were longitudinal groove (20 cases; Figure 2A), concave longitudinal canaliform dystrophy (9 cases; Figure 2B), ''washboard'' transverse lines (5 cases; Figure 2C), and longitudinal grooves with beaded ridges (1 case; Figure 2D). The characteristics are tabulated and correlated with radiologic findings and nail changes ( Table 3). ...
Context 2
... changes were recorded in 35 (68.6%) patients. The different clinical expressions of onychodystro- phy were longitudinal groove (20 cases; Figure 2A), concave longitudinal canaliform dystrophy (9 cases; Figure 2B), ''washboard'' transverse lines (5 cases; Figure 2C), and longitudinal grooves with beaded ridges (1 case; Figure 2D). The characteristics are tabulated and correlated with radiologic findings and nail changes ( Table 3). ...
Context 3
... changes were recorded in 35 (68.6%) patients. The different clinical expressions of onychodystro- phy were longitudinal groove (20 cases; Figure 2A), concave longitudinal canaliform dystrophy (9 cases; Figure 2B), ''washboard'' transverse lines (5 cases; Figure 2C), and longitudinal grooves with beaded ridges (1 case; Figure 2D). The characteristics are tabulated and correlated with radiologic findings and nail changes ( Table 3). ...
Context 4
... changes were recorded in 35 (68.6%) patients. The different clinical expressions of onychodystro- phy were longitudinal groove (20 cases; Figure 2A), concave longitudinal canaliform dystrophy (9 cases; Figure 2B), ''washboard'' transverse lines (5 cases; Figure 2C), and longitudinal grooves with beaded ridges (1 case; Figure 2D). The characteristics are tabulated and correlated with radiologic findings and nail changes ( Table 3). ...
Citations
... Risk factors include HPV, trauma, ionizing radiation, smoking, arsenic exposure, and chronic paronychia [6,71]. Myxoid cyst skin-colored to translucent, smooth, dome-shaped, and fluctuant nodules located distal to the interphalangeal joint [34,72]. Most commonly on the first three fingers [34,72]. ...
... Myxoid cyst skin-colored to translucent, smooth, dome-shaped, and fluctuant nodules located distal to the interphalangeal joint [34,72]. Most commonly on the first three fingers [34,72]. ...
... Myxoid cysts affect the distal fingers and toes, and may be superficial (located near the proximal fold nail) or deep (located near the DIP joint). Clinically, they present as skin-colored to translucent, smooth, dome-shaped, and fluctuant nodules located distal to the interphalangeal joint, most commonly on the first three fingers [34,72] (Figure 12). ...
As the world’s population of adults greater than 60 years old continues to increase, it is important to manage nail disorders that may impact their daily lives. Nail disorders may have significant impact on quality of life due to decreased functionality, extreme pain, or social embarrassment. In this review, we discuss nail disorders affecting older patients, including physiologic, traumatic, drug-induced, infectious, environmental, inflammatory, and neoplastic conditions. Diagnosis of these conditions involves a detailed history, physical examination of all 20 nails, and depending on the condition, a nail clipping or biopsy and/or diagnostic imaging. Nails grow even more slowly in older adults compared to younger individuals, and therefore it is important for accurate diagnosis, and avoidance of inappropriate management and delay of treatment. Increased awareness of nail pathologies may help recognition and management of nail conditions in older adults.
... Degeneration of the DIP joint or the tendon sheath have been suggested as the initiators of this pathological process 17 . A strong association of DMCs with the presence of osteoarthritic changes of the DIP joint has been reported by several authors [18][19][20] . Nevertheless, the relation between osteoarthritis and the occurrence of DMCs is questioned by more recent studies. ...
Digital mucous cysts are common, benign and highly recurrent tumors of the distal interphalangeal joints of the fingers
and often associated with osteoarthritis. Multiple treatment modalities have been described, but still no consensus is
stated. In the absence of degenerative changes, we promote a novel non-surgical approach. The aim of this study was
to examine all patients with digital mucous cysts without underlying osteoarthritis, undergoing this injection technique
and to assess outcome and complications of this procedure. This was a single center study (2018-2019) of 17 patients
who received a long needle trajectory aspiration and injection for treatment of digital mucous cysts. Exclusion criteria
were prior surgical treatment, post-traumatic cyst formation and the presence of radiographic distal interphalangeal
joint osteophytosis. A total of 15 patients were found eligible for inclusion. The patient reports were retrospectively
analyzed with a follow-up of 6 months. The primary study outcome was resolution of the cyst; secondary outcomes
were complications of the procedure. Twelve (80%) resolved completely and three (20%) had limited local recurrence
at 6 months. No complications were reported. None of the patients with limited recurrence desired further treatment.
We believe that this technique offers a non-invasive, low-cost treatment option for digital mucous cysts, particularly
in the subset of patients with ample evidence of degenerative articular changes in the distal interphalangeal joint. The
described technique can be performed in an office-based setting and avoids typical surgical as well as aspiration-associated
complications.
... Digital myxoid cyst is relatively common benign tumors on the proximal nail fold usually associated with osteoarthritis and secondary nail changes. It presents as asymptomatic semi-translucent papulonodule, we report one case in this study [24]. ...
Our nails change as we get older. Aging can affect color, contour, surface, thickness, growth rate, chemical composition and histology of the nail unit. Our aim was to study the frequency and spectrum of nail abnormalities in elderly Libyans attended dermatology outpatient clinic. One thousand patients of variable ages were subjected to onychologic study. Elderly patients constituted 13% of the total patients seen. Frequency of nail conditions among elderly was significantly higher (100%) than the other age groups (27%). All the elderly patients have at least one nail change because of ageing. Other conditions caused by infections (60%), trauma (26%), and tumors (3%) or associated with skin (18%) or systemic diseases (12%). The observed senile nail changes were longitudinal ridges (92%), brittle nails (19%), onychauxis (37%), onychocromia (86%), pincer nail (7%) and onychogryphosis (3%). Nail infection were tinea ungums (47%), chronic paronychia (9%) and periungual wart (3%). Though nail disorders are frequently asymptomatic, however they may cause pain and affect daily activities. Understanding the signs and symptoms of the aging nail and the associated diseases is important for better assessment, diagnosis and management of the onychologic disorder in the large and growing senile population.
... Usualmente aparece en los dedos de las manos, como una pápula o nódulo normocrómico de apariencia translúcida y superficie suave, asintomático. Puede presentar descarga intermitente de un material mucoide o gelatinoso que corresponde a ácido hialurónico o es posible obtenerlo al puncionarlo (5,57) . El compromiso que puede causar en la matriz se manifiesta con surcos ligeros y ondulados en la lámina, lo que se ha denominado el signo de las olas (58) . ...
Introducción: las neoplasias benignas de la unidad ungular tienen apariencia clínica y comportamiento biológico distintivos frente a tumores similares en otra localización. Algunas son únicas del aparato ungular, como los tumores onicocíticos y el onicopapiloma, por ejemplo. En general, tienden a respetar la morfología de la uña, a diferencia de las de origen maligno.Metodología: revisión narrativa con búsqueda en las bases de datos PubMed y Google Académico, y en el buscador de Google.Resultados: caracterización clínica y dermatoscópica de los tumores ungulares benignos más frecuentes en la práctica clínica.Conclusiones: los tumores ungulares benignos tienen características clínicas distintivas y únicas que permiten al dermatólogo diferenciarlos fácilmente entre sí y con tumores de origen maligno.
... Type B DMC looks similar to Type A but may exert a mass-like effect on the underlying matrix, leading to a longitudinal channel-like, gutterlike, or ridge-like plate shape. 4 As a result, variablewidth longitudinal dystrophy provides useful information about DMC dimensions and possible changes in size. Both these types share a positive transillumination test 5 and may discharge a clear, viscous fluid spontaneously or when "popped." Type C is the most tricky variant; it may induce a longitudinal groove if located between the nail bed and the PNF, or when lying in the submatrix plane, it causes a nail plate transverse curvature (with possible lateral ingrowing), red or blue lunula, because of microvascular changes, and splitting or partial destruction of the nail plate. ...
... 22 Moreover, many stimuli could activate fibroblasts to overproduce hyaluronic acid-containing mucin with consequent dermal deposition and cyst formation, including trauma, increased joint pressure, or OA-driven osteophytosis. 4 The prevalence of OA in DMC ranges from 15.8% 17 to 93% 21 in the literature, whereas in our series was 53.3%. The subgroup free of radiological/sonographic signs of OA has shown the best outcome for steroid injection therapy. ...
Background:
Digital mucous cysts (DMCs) are benign myxoid pseudocysts that develop on the distal interphalangeal joint's lateral or dorsal aspects. Management consists either of a surgical approach, conservative therapy, or simple follow-up.
Objective:
To correlate the initial and long-term response with clinical and ultrasound parameters in DMCs treated with intralesional steroids as first-line therapy.
Methods:
A single-center prospective open-label study recruited 15 patients affected by DMCs, who had been treated with a cycle of up to 3 steroid injections at a 6 to 9 week time interval.
Results:
At the first follow-up visit, 53.3% of patients were cleared of DMCs, achieving a complete response, whereas 46.7% experienced a >30% decrease in their DMC volume, and were considered partial responders. After 1 year of follow-up, the cure rate decreased to 40%, and the recrudescence rate was 27.3%. Clinical and sonographic characteristics that positively correlated with a maintained complete response at follow-up were as follows: young age, absence of osteophytes, low volume, complete clearance at T1, and short disease duration (p < .05).
Conclusion:
Intralesional steroid therapy is an easy approach for DMC, with minimal side effects; identifying predictive hallmarks is useful to offer a straightforward surgical treatment to patients who have nonresponder characteristics.
... Suelen ser asintomáticos, aunque hay casos que generan dolor, disminución del rango de movimiento y secreción continua 1---3 . En una cuarta parte de los casos se genera de forma secundaria algún tipo de distrofia ungueal, como la depresión longitudinal 1,4 . ...
... Su etiopatogenia no está clara. Se especula sobre la implicación de la degeneración mucoide del tejido conectivo, la relación con los osteofitos y la enfermedad degenerativa articular, que facilitaría la comunicación del quiste con el espacio articular adyacente, y el papel de los traumatismos repetitivos 1,4 . El diagnóstico diferencial debe realizarse principalmente con el tumor glómico subungueal, el granuloma piogénico, el fibroqueratoma digital adquirido, el tumor de células gigantes de vainas tendinosas, la verruga vulgar, el mixoma, el angiomixoma superficial, el ganglión y los nódulos de Heberden y de Bouchard asociados a osteoartritis 1,5 . ...
... [2,3] These cysts can lead to development of osteoarthritis, though rarely. [4] Treatment options vary depending upon the characteristics of the lesion, the patient related factors and ultimately the surgeon's choice. We present our experience of excision using proximal nail fold flap technique. ...
... 13 Some studies reported that 64-74.5% of myxoid cysts were associated with interphalangeal osteoarthritis. 14,15 There are numerous therapeutic options including puncture, drainage, sclerotherapy, intralesional steroid injection and cryotherapy. However, these treatments can have a high recurrence rate. ...
Nail neoplasms include all tumors occurring in the nail or periungual apparatus tissue. While some nail tumors can be similar to tumors located on the skin, others are unique. Both benign and malignant lesions can affect the nail apparatus. In particular, early malignant tumors like melanoma and squamous cell carcinoma can present similarly to onychomycosis or benign melanonychia and frequently missed by clinicians. Therefore, physicians should be aware of nail structures and the characteristics of nail tumors. Our review covers the normal nail structure and the most common nail tumors from benign to malignant.
... During surgery, pedicles were ligated in most patients except for those with DMCs near the nail fold (Case no. 1, 2, 8, 14, 24) and on the small joint of toe (Case no. 11,12,19). Recurrences were observed in 4 cases during at least 1 year follow-up period, and recurrence rate was 16.7%. Of 4 cases, 2 were fingers (2/19, 10.5%) and 2 were toes (2/5, 40.0%). ...
... DMCs are commonly associated with degenerative changes of DIP joints including osteoarthritis. It has been pointed out that DMCs originate from the area of the arthritic spurs and almost all of the patients had evidence of osteophytes noted on X-ray 3,11 , and removing the spurs may improve treatment outcome 12,13 . However, in our study, osteophytes were found in only 3 patients (15.8%) despite the − − -G a n g l i o n fact that all of our patients were over 50 years of age. ...
... It has been suggested that there are two histologic types in DMCs, the myxomatous type and the ganglion type. The former is located near the nail fold and the latter is located near the joint 10,11,16 . The current study shows that the location of DMCs and the histologic types did not always match. ...
Background
It has been suggested digital mucous cysts (DMCs) are associated with osteoarthritis and osteophytes in the elderly, and usually have a communicating pedicle with the joint. Surgical excision is a standard therapy with a high cure rate.
Objective
The purpose of this prospective study is to evaluate the features of DMCs via clinical, radiological and pathological examination and the efficacy of surgical excision of DMCs.
Methods
Between 2010 and 2014, 24 Korean patients were treated with the resection of the cyst and the pedicle. Preoperative X-ray and ultrasonography were performed to detect the presence of the osteophyte and the connection to the joint space. Postoperative patients' satisfaction score was assessed by the visual analogue scale (0~10).
Results
The osteophytes were found in 15.8%. In ultrasonographic findings, there were prominent flow signals between the cyst and the joint space in 13.6%. There were no serious postoperative complications, and recurrences were observed in 16.7%. Mean postoperative satisfaction score was 8.3.
Conclusion
It seems that preoperative X-ray for osteophytes and ultrasonographic study for connection are not always helpful for the treatment of DMCs, and that the surgical excision with a pedicle ligation and electrocoagulation is an effective treatment modality.
... [2,3,5,6] . Surgical excision of the lesion, for investigation and exclusion of malignancies, was the most appropriate therapeutic option in this case [2] . ...
Melanocytic nevi result from the proliferation of melanocytes at the dermal-epidermal junction and/or in the dermis and very rarely affect the nail matrix and bed. Intradermal nevi are tumors often diagnosed in routine clinical dermatological practice, with typical clinical and histopathologic aspects, and found in a wide variety of skin sites. We report a case of intradermal melanocytic nevus of the proximal nail fold with uncommon intraoperative gross findings and without involvement of the nail bed or matrix, showing intradermal component only, which draws our attention to the possible different presentation of melanocytic lesions. No description of intradermal nevi at this site has been reported in the literature so far.
