Ha Gi Ung, Kim Jin Ho, Ha Dae-Lyong, Lee Hoseok, Lee Seok-Jong
Department of Dermatology, School of Medicine, Kyungpook National University, Daegu, Korea.
Semyung Radiologic Clinic, Gumi, Korea.
J Dermatol. 2024 Aug;51(8):1117-1119. doi: 10.1111/1346-8138.17340. Epub 2024 Jun 14.
Recently, functional or preservative surgery has been preferred for nail unit melanoma; however, complete resection of the nail unit, particularly the matrix, is challenging because of its complex structure. This study aims to measure the distance of important nail structures through ultrasonography. Herein, 14 patients without nail deformity were included. The length from the nail cuticle to the distal interphalangeal joint (distance X), to the attachment part of the extensor muscle (distance A), to the median proximal end of the nail matrix (distance B), and to the lateral proximal end of the nail matrix (distance C) were measured. In the axial plane, the length from the highest point of the nail plate to the bottom of the distal phalanx (distance Y) and to the lateral tip of the nail plate (distance D) were measured. On the first fingernail, third fingernail, first toenail, and third toenail, the mean ratio A:X, ratio B:X, ratio C:X, and ratio D:Y were 78.6%, 44.3%, 57.2%, 40.1%, and 84.6%; 55.9%, 64.9%, 40.2%, and 66.4%; 35.6%, 50.8%, 34.3%, and 81.9%; and 57.2%, 59.6%, and 31.7%, respectively. Nail units are often invisible to the naked eye; thus, this study will help identify the approximate scope of excision.
最近，功能性或保留性手术已成为甲单位黑色素瘤的首选治疗方式；然而，由于甲单位结构复杂，尤其是甲母质，要完全切除具有挑战性。本研究旨在通过超声测量重要甲结构的距离。在此，纳入了14例无甲畸形的患者。测量了从甲小皮到远侧指间关节的长度（距离X）、到伸肌附着部的长度（距离A）、到甲母质近侧中端的长度（距离B）以及到甲母质近侧外侧端的长度（距离C）。在轴向平面上，测量了从甲板最高点到远节指骨底部的长度（距离Y）以及到甲板外侧尖端的长度（距离D）。在食指、中指、拇趾和中趾上，A:X、B:X、C:X和D:Y的平均比值分别为78.6%、44.3%、57.2%、40.1%和84.6%；55.9%、64.9%、40.2%和66.4%；35.6%、50.8%、34.3%和81.9%；以及57.2%、59.6%和31.7%。甲单位通常肉眼不可见；因此，本研究将有助于确定大致的切除范围。
