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- Presentation
Update: Recognition & Management of Pediatric Nail Disorders
Description
The session focuses on the recognition and management of pediatric nail disorders, highlighting significant recent literature. The discussion includes a rare case of Subungul Spitz Nevus observed in a 15-year-old, showcasing characteristic longitudinal pigmentation changes. It emphasizes the rarity of such conditions and the need for careful monitoring as melanonychia can evolve in children. Several studies are reviewed, including a case of expanding melanonychia in a young girl, demonstrating the importance of not applying adult diagnostic criteria to pediatric cases. The talk also covers retronichia, a painful condition often misdiagnosed, underscoring the necessity of recognizing its distinct features from paronychia. Another fascinating case discussed is an intraosseous hemangio-lymphangioma in a 10-year-old presenting with nail dystrophy post minor trauma, highlighting its slow, painless growth and the importance of considering rare diagnoses in similar presentations. Overall, the session advocates for tailored approaches in treating pediatric nail conditions, emphasizing the need for awareness and proper diagnosis to guide effective management.
View moreConclusions
- Subungual Spitz nevus is an extremely rare condition in pediatric patients and should be considered in cases of significant nail pigmentation.
- Melanonychia in children can evolve over time, and adult diagnostic criteria should not be applied to pediatric cases.
- Nail unit melanoma is exceptionally rare in children, indicating the need for cautious monitoring of lesions without immediate concern for malignancy.
- Retronychia is distinct from paronychia, characterized by detachment of the nail plate from the proximal matrix and is often caused by trauma.
- There are effective management strategies for retronychia, including topical treatments for mild cases and surgical options for severe cases.
- Intraosseous hemangiolymphangioma can cause progressive nail deformities and should be considered in cases of unexplained nail dystrophy in children.
- Subungual injuries can sometimes be misdiagnosed; therefore, rare entities like intraosseous hemangiolymphangioma should be considered in differential diagnoses.
- C. Atypical Presentation of Spitz Nevus: A Case Report. Skin Appendage Disord. 2023 Dec;9(6):461-464.
- Dominguez-Cherit J, Toussaint-Caire S, Kamino H, Iorizzo M, Tosti A. Subungual Spitz nevus in a Hispanic infant. Dermatol Surg. 2008 Nov;34(11):1571-3.
- Huang C, Bullpitt P, Nabarro M, Murrell DF. Practice Dilemma: Expanding Melanonychia in the Paediatric Setting. Skin Appendage Disord. 2023 Jan;9(1):58-60.
- Tsiogka A, Laimer M, Rigopoulos D, Ahlgrimm-Siess V. Equivocal Longitudinal Melanonychia in a 3-Year-Old Caucasian Girl: Rapid Evolution and Fading during Digital Dermoscopy Follow-Up. Skin Appendage Disord. 2022 Mar;8(2):150-153.
- Lee JH, Lim Y, Park JH, Lee JH, Jang KT, Kwon EJ, Lee DY. Clinicopathologic features of 28 cases of nail matrix nevi (NMNs) in Asians: Comparison between children and adults. J Am Acad Dermatol. 2018 Mar;78(3):479-489.
- Díaz MS, Boggio P, Calvano R, Scacchi MF, Giachetti A. Retronychia in children: A case series. Pediatr Dermatol. 2023 Dec 21. Epub ahead of print.
- Vastarella M, Annunziata MC, Panariello L, Ferrillo M, Fabbrocini G. A novel treatment for retronychia: case series. J Dermatolog Treat. 2020; 31(3): 254-255.
- Navarro Vergara AD, Navarro Fretes A, Medina Villate MM. Infrequent Pediatric Subungual Injury Diagnosed by Intraoperative Anatomopathological Material: A Case Report. Cureus. 2024 Jan 1;16(1):e51482.