Moon Sang Eun, Won Jong Hyun, Kwon Oh Sang, Kim Jeong Aee
Department of Dermatology, Seoul National University College of Medicine, Boramae Hospital, 425 Shindaebang-dong, Dongjak-gu, Seoul 156-707, Korea.
J Dermatol. 2004 Dec;31(12):993-7. doi: 10.1111/j.1346-8138.2004.tb00643.x.
Surgical excision is the treatment of choice for subungual glomus tumor. However, the anatomical location has inherent difficulties. We report the outcomes of surgical treatments for subungual glomus tumor. Sixteen patients, who were seen over an eight-year period (1995-2003) and confirmed as gloums tumor by histopathologic examination were reviewed. The most common subjective symptom was pain induced by contact in 81%. The tumor presented as a discolorated spot or subungual nodule and 38% of tumors were acccompanied with nail dystrophy. All tumors showed discolorated spots or subungual nodules. As shown in the Table 2, the dystrophic nail change was found in 38% of tumors. Differently oriented incisions were made according to the location of tumor, matrix, or bed. The original nail plate was restored in eight patients. Thirteen patients (81%) had cosmetically excellent nail plates, and three patients (19%) had partial distal splits of nail plates. There was no recurrence. Our series suggests that a transungual approach with nail avulsion and an incision selected according to the tumor location can produce an excellent outcome with minimal postoperative complications. Dressing with a trimmed nail plate may also be beneficial in managing the wound and preventing postoperative nail deformity.
手术切除是甲下血管球瘤的首选治疗方法。然而,其解剖位置存在一些固有困难。我们报告了甲下血管球瘤的手术治疗结果。回顾了1995年至2003年八年间诊治的16例经组织病理学检查确诊为血管球瘤的患者。最常见的主观症状是81%的患者因接触而诱发疼痛。肿瘤表现为变色斑点或甲下结节,38%的肿瘤伴有甲营养不良。所有肿瘤均表现为变色斑点或甲下结节。如表2所示,38%的肿瘤出现甲营养不良改变。根据肿瘤、甲母质或甲床的位置做不同方向的切口。8例患者的原甲板得以恢复。13例患者(81%)的甲板外观良好,3例患者(19%)甲板远端部分裂开。无复发情况。我们的系列研究表明,采用拔甲经甲入路并根据肿瘤位置选择切口可取得良好效果,术后并发症最少。用修剪后的甲板包扎伤口可能也有助于处理伤口并防止术后指甲畸形。