Squamous cell carcinoma of the nail bed

Squamous Cell Carcinoma of the Nail Unit: Review of the Literature

Squamous cell carcinoma of the nail unit (SCCNU) is often misdiagnosed and improperly treated because it mimics a number of other conditions. This review details current knowledge of anatomy, pathophysiology, clinical presentation, diagnosis, and treatment of SCCNU. A heightened clinical awareness is critical to treating SCCNU and preventing development of advanced disease at which time amputation is needed and metastasis may occur. Physicians should consider SCCNU in each case of a nail abnormality unresponsive to topical treatment. For adequate diagnosis and excision of SCCNU, timely and appropriate specialist referral is necessary.

Photoacoustic and Fluorescence Imaging of Cutaneous Squamous Cell Carcinoma in Living Subjects Using a Probe Targeting Integrin αvβ6

Cutaneous squamous cell carcinoma (cSCC) is the second most common non-melanoma skin cancer worldwide. Today, cSCC is diagnosed by visual inspection followed by invasive skin biopsy. There is a need to develop non-invasive diagnostic tools to achieve early and accurate detection. Photoacoustic imaging (PAI) possesses high ultrasonic resolution and strong optical contrast at new depths (<1-5 cm). Together with exogenous contrast agents, PAI has found promising use in various tumors in living subjects. The expression of integrin α_vβ₆ is significantly up-regulated in cSCC. We fabricated an anti-integrin α_vβ₆ antibody and labeled it with indocyanine green (ICG) to form an ICG-α_vβ₆ antibody. The results showed that the ICG-α_vβ₆ antibody probe could be used to detect cSCC with high specificity (3-fold over the control by PAI) and deep penetration (approximately 1 cm) by PAI. This suggests that the ICG-α_vβ₆ antibody is a promising probe targeting the integrin α_vβ₆ for detection of cSCC tumors by PAI and fluorescence imaging. It may find clinical application in the early diagnosis of cSCC as well as in intraoperative navigation.

Stability of the distal phalanx fracture - A biomechanical study on the importance of the nail and the influence of fixation by crossing Kirschner wires

BACKGROUND

With respect to the stability of displaced distal-phalanx fracture, the relevance of nail loss and the biomechanical effects of fixation using crossed Kirschner wires have not been investigated. The present study aimed to determine whether the nail or the type of fixation contributes to stabilizing distal-phalanx fracture.

METHODS

In 48 specimens (fingers), a model of the comminuted fracture of the distal phalanx (AO type A3) was created by resecting a 1-mm osseous segment from the distal phalanx. Specimens were assigned to one of four groups, depending on whether the fracture was accompanied with nail loss, and whether the fracture fixation employed a single Kirschner wire or a crossing of two Kirschner wires. Each specimen was subjected to either a bending or a torsion test.

FINDINGS

Regardless of the fixation form, the mean peak bending and torsion forces were higher for the specimens with the nail intact. Furthermore, these forces were also higher in specimens which had received fixations based on the Kirschner wires, compared to those specimens which had received fixations based on a single Kirschner wire. The highest mean peak torque 1.39 (0.12) N·m was found for the specimens with no nail loss and fixation using two crossed Kirschner wires, while the lowest mean peak torsion 0.46 (0.02) N·m was found for specimens with nail loss and fixation using a single Kirschner wire.

INTERPRETATION

Our results suggest that the nail can provide additional stability for comminuted fractures of the distal phalanx after fixation. Furthermore, when nail loss occurs, fixation using two crossed Kirschner wires can provide significantly more stability than fixation using single Kirschner wire.