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- Few tumors are unique to the nail, but neoplasms in this area may have a different clinical appearance, course, biologic behavior and even histologic features, from similar tumors located elsewhere in the body.
- The clinical pictures are governed by the site of the pathologic changes.
- There is a limited response of the nail apparatus to various insults which can be misleading.
- The screening effect of the nail plate obscures the morphology of nail bed tumors.
- Nail fold infection is often present and may mistakenly be diagnosed as primary rather than secondary.
- Nails are subject to repeated trauma and alterations of physical appearance are all too often attributed by the patient to an injury that ultimately proves to be insignificant.
- Consequently, diagnosis tends to be delayed because of altered or indistinct morphology.
- The presenting sign associated with a nail tumor may involve (on one or more digits:
- The contour of the nail
- The volume of the distal phalanx
- The coloration of the nail plate and/or the periungual tissue.
- Onycholysis
- Pain
- Finally, the key to the early diagnosis of a nail tumor is a high index of suspicion of any non-healing or recurrent condition in the nail area.
© 2001 Dermatology Online Journal
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