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Background: The dermatoscopic examination of the nail plate has been recently introduced for the evaluation of pigmented nail lesions. There is, however, no evidence that this technique improves diagnostic accuracy of in situ melanoma. Objective: To establish and validate patterns for intraoperative dermatoscopy of the nail matrix. Methods: Intraoperative nail matrix dermatoscopy was performed in 100 consecutive bands of longitudinal melanonychia that were excised and submitted to histopathologic examination. Results: We identified 4 dermatoscopic patterns: regular gray pattern (hypermelanosis), regular brown pattern (benign melanocytic hyperplasia), regular brown pattern with globules or blotch (melanocytic nevi), and irregular pattern (melanoma). Limitations: Nail matrix dermatoscopy is an invasive procedure that can not routinely be performed in all cases of melanonychia. Conclusion: The patterns described present high sensitivity and specificity for intraoperative differential diagnosis of pigmented nail lesions. [ABSTRACT FROM AUTHOR]

Melanonychia striata represents a diagnostic dilemma for dermatologists. The use of dermoscopy to assess the nail has advantages over clinical examination. However, when compared to skin lesions, it gives fewer details. We describe two cases of melanonychia striata submitted to dermoscopic examination of the nail bed and matrix. This is a new procedure that enables observing dermoscopic characteristics that are not visualized in the nail plate, thus, providing additional information. [Copyright &y& Elsevier]

Background: Involvement of the oral mucosa can occur in lepromatous leprosy; however, lesions in the oral mucosa of paucibacillary patients have not been previously observed. Objective: The objective of this study is to determine whether clinical and subclinical lesions exist in oral mucosa in nontreated paucibacillary leprosy patients, using clinical and histopathological examination. Materials and Methods: A clinical and histopathological study involving 30 untreated paucibacillary leprosy patients was conducted. All patients underwent biopsies of the buccal mucosa, soft palate, and tongue. When acid-fast bacilli in association with inflammatory infiltrate, granulomatous or not, were encountered, it was considered “specific” involvement of the oral mucosa; and “nonspecific” involvement when the bacilli were not encountered. Results: Eight nonspecific chronic inflammatory reactions and 1 granulomatous inflammatory process without acid-fast bacilli were detected. Conclusions: Paucibacillary leprosy patients do not exhibit specific, clinical or subclinical, involvement in the oral mucosa; nonspecific alterations occur even in the absence of signs and symptoms. [Copyright &y& Elsevier]

Elastoderma is an exceedingly rare condition characterized clinically as an acquired localized laxity of skin and, histologically, as an excessive accumulation of pleomorphic elastic structures within the dermis. We report the case of a 16-year-old white man with a 2-year history of progressive laxity, extensibility, and wrinkling of the skin localized to the anterior aspect of the neck. Histologic examination of specimens from the affected area showed dense aggregates of eosinophilic material present within the dermis. Transmission and scanning electron microscopic examination demonstrated apposition of abnormal elastic structures at the periphery of elastic tissue fibers, with grapelike globular structures. To our knowledge, we report the third case of elastoderma. [Copyright &y& Elsevier]