Tırnak Altı Lezyonlarında Cerrahi Yaklaşım

Amaç: Tırnak bölgesinde birçok farklı doku bir arada olduğundan görülen tümöral lezyonlar oldukça çeşitlidir. Pigmente veya nonpigmente olabilen benign tümörler genellikle daha sıklıkla gözükür ancak sadece muayene ile benign-malign tümör ayrımının yapılması zordur. Bunun dışında tümöral olmayan tırnak hastalıklarının da ayırıcı tanıda yer alması gerektiği unutulmamalıdır. Gereç ve Yöntemler: Bu çalışmada 2009-2020 tarihleri arasında tırnakta kitle şikayetiyle iki farklı merkezdeki plastik cerrahi kliniklerine başvuran 12 hasta dahil edilmiştir. Hastaların klinik bulguları, yapılan tedaviler ve sonuçları değerlendirilmiştir. Bulgular: Her iki plastik cerrahi kliniğine ortalama yaşları 45,9 (34-58) olan 12 hasta başvurmuştur. Hastalardan 11’i cerrahi tedavi edilmiş, bir hasta tedavi edilmemiştir. Histopatolojik tanı olarak bir hasta- da ganglion kisti, beş hastada glomus tümörü ve beş hastada lineer nevüs tanısı konulmuştur. Opere edilen 11 hastanın 10’unda hastaların tedavi sonucu çok iyi olarak değerlendirilmiştir. Glomus tümörü olan bir hastada nüks görülmüş ve hasta tekrar opere edilmiştir ve nüks gözlenmemiştir. Sonuç: Tırnak yatağındaki lezyonlar sıklıkla hastalar tarafından göz ardı edilmektedir. Hem benign, hem de malign lezyonlar benzer bulgular verebileceğinden tanı için biyopsi alınması şarttır. Uygun tedavi biyopsi sonucuna göre belirlenmelidir.

Surgical Approach in Subungual Lesions

Aim: Since there are many different tissues in the nail area, the tumoral lesions seen are quite diverse. Benign tumors that can be pigmented or nonpigmented are usually seen more often, but it is difficult to distinguish between benign and malignant tumors by examination alone. Apart from this, it should be kept in mind that non-tumoral nail diseases should also be included in the differential diagnosis. Material and Methods: In this study, 12 patients who presented to two different centers with the complaint of a mass in the nail between 2009-2020 were included. Clinical findings, treatments and results of the patients were evaluated. Results: Twelve patients with a mean age of 45.9 (34-58) applied to both clinics. 11 of the patients were treated surgically, one patient was not treated. Histopathological diagnosis was ganglion cyst in one patient, glomus tumor in five patients and linear nevus in five patients. In 10 of the 11 operated patients, the treatment result of the patients was evaluated as very good. Recurrence was observed in one patient with glomus tumor and the patient was re-operated and no recurrence was observed. Conclusion: Lesions in the nail bed are often overlooked by patients. Since both benign and malignant lesions may give similar findings, biopsy is essential for diagnosis. The appropriate treatment should be determined according to the biopsy result.

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