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Correo electrónico: fcxkf0xkfcnBucpkvcvkpvgitcn0qti *F0"Xkfcn+0
Ecografía aplicada al manejo de la patología de la uña
D. Vidal
a,*, B. Echeverria
b, J. García-Gavín
c,dy L. Comba Pérez-Pérez
c,da Servicio de Dermatología, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, España
b Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
c Estructura Organizativa de Xestión Integrada de Vigo, Vigo, Pontevedra, España
f"Clínica Pérez & Gavín Dermatólogos, Vigo, Pontevedra, España
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gp"gzvtgokfcfgu"uwrgtkqtgu"{"4.88"ł"2.9"oo"gp"gzvtgokfcfgu"
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Correspondencia ecogr Þca
Guvcu"guvtwevwtcu"cpcv„okecu"vkgpgp"uw"eqttgurqpfkgpvg"vtc- fweek„p"geqit Þec0"Gp"oqfq"D"ug"qdugtxcp"nqu"ukiwkgpvgu"
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nc"hcncpig"fkuvcn"gp"hqtoc"fg"wpc"n pgc"eqpvkpwc"jkrgtgeqkec0"
Gp"nc"rctvg"rtqzkocn"fg"nc"hcncpig"fkuvcn"ug"qdugtxcp"gu- vtwevwtcu"nkpgcngu"jqoqifipgcu"jkrqgeqkecu."swg"ug"eqttgu- rqpfgp"eqp"nc"kpugtek„p"fkuvcn"fg"nqu"vgpfqpgu"gzvgpuqt"{"
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Ecografía ungueal en otras enfermedades inàamatorias
Alopecia areata
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32"cn"88'"fg"nqu"rcekgpvgu+0"Nc"ocpkhguvcek„p"o u"htgewgpvg"
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fg"gphgtogfcf"ciwfc550"Ncu"ocpkhguvcekqpgu"rwgfgp"rctgegt- ug"c"ncu"fg"nc"ruqtkcuku"wpiwgcn0"Nqu"jcnnc|iqu"geqit Þequ"uqp"
jkrgtgeqigpkekfcf."gpitqucokgpvq"{"qpfwncek„p"fg"nc"n okpc"
wpiwgcn."kpetgogpvq"fg"nc"eqpecxkfcf."{"cfgo u"ug"gxkfgpekc"
fkuokpwek„p"fg"nc"xcuewnctk|cek„p"fgn"ngejq."nq"swg"rwgfg"ugt"
¿vkn"rctc"gn"fkcip„uvkeq"fkhgtgpekcn"eqp"ruqtkcuku560 Conectivopatías
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fgn"àwlq"xcuewnct"fg"nqu"ecrknctgu"rgtkwpiwgcngu"{"uwdwpiwgc- ngu0"Jc"fgoquvtcfq"wvknkfcf"rctc"fkhgtgpekct"gpvtg"hgp„ogpq"
fg"Tc{pcwf"rtkoctkq"{"ugewpfctkq"cn"fgvgevct"cpqocn cu"gp"
nc"oketqektewncek„p"eqp"o u"rtgekuk„p"swg"nc"ecrknctqueqrkc0"
Vcodkfip"ug"jc"wvknk|cfq"rctc"gn"guvwfkq"fg"cpqocn cu"oketq- xcuewnctgu"gp"rcekgpvgu"eqp"gphgtogfcf"kpfkhgtgpekcfc"fgn"
vglkfq"eqpgevkxq"{"guengtquku"ukuvfiokec57/5:0"
Cfgo u"ug"jcp"fguetkvq"jcnnc|iqu"geqit Þequ"gp"guengtqfgt- okc."fgtocvqokqukvku"{"nwrwu"gtkvgocvquq"ukuvfiokeq3:0"Nqu"jc- nnc|iqu"geqit Þequ"gp"nc"guengtquku"ukuvfiokec"uqp"xctkcdngu0"Ug"
jc"fguetkvq"wp"kpetgogpvq"fg"nc"eqpecxkfcf."gpitqucokgpvq"{"
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gxkfgpekc"fkuokpwek„p"fgn"àwlq"xcuewnct."rtqdcdngogpvg"fg- dkfq"cn"gpngpvgekokgpvq"fg"nc"ektewncek„p."nq"swg"jceg"swg"pq"
ugc"vgepqn„ikecogpvg"rqukdng"gxkfgpekctnc"eqp"nqu"fkurqukvkxqu"
cevwcngu0"Gp"nc"ecnekpquku"cuqekcfc"c"fgtocvqokqukvku."eqp"nc"
geqitch c"rwgfgp"crtgekctug"fgr„ukvqu"rgtkwpiwgcngu"fg"ecn- ekq."swg"pqtocnogpvg"ug"nqecnk|cp"gp"nc"rwpvc"fg"nqu"fgfqu"{"
ug"gxkfgpekcp"eqoq"hqequ"jkrgtgeqkequ"eqp"uqodtc"ce¿uvkec"
rquvgtkqt0"Gp"qecukqpgu."guvg"jcnnc|iq"ug"ceqorc‚c"fg"jk- rqgeqigpkekfcf"fg"nc"fgtoku"uwrtc{cegpvg."rtqdcdngogpvg"
rqt"gn"gfgoc"rtqfwekfq0"Ug"rwgfg"gxkfgpekct"vcodkfip"kpetg- ogpvq"fg"nc"xcuewnctk|cek„p"fgn"ngejq0"Nc"chgevcek„p"wpiwgcn"
fgn"nwrwu"gtkvgocvquq"ukuvfiokeq"ug"gxkfgpekc"eqoq"wp"kpetg- ogpvq"fgn"itquqt"fg"nc"n okpc"wpiwgcn"{"fg"nc"ocvtk|"{"ngejq"
wpiwgcn."cu "eqoq"wpc"fkuokpwek„p"fg"nc"xcuewnctk|cek„p"fgn"
ngejq"wpiwgcn0
Otras enfermedades inàamatorias
Ug"jcp"rwdnkecfq"nqu"jcnnc|iqu"geqit Þequ"fg"nc"w‚c"gp"nc"
tgvtqpkswkc"{"qpkeqocfguku5;.62."kevkquku"cwvqu„okec"tgegukxc63."
nkphgfgoc"et„pkeq"fg"ncu"rkgtpcu"*gpitqucokgpvq"fg"nc"oc- vtk|+32."h uvwncu"uwdwpiwgcngu56"{"Þdtquku"sw uvkec640"Gp"guvc"
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rtqzkocn0"
40"Chgevcek„p"fgn"ngejq1ocvtk|"wpiwgcn0
̋" Kpetgogpvq"fg"nc"fkuvcpekc"gpvtg"nc"rctvg"xgpvtcn"fg"nc"
n okpc"wpiwgcn"{"nc"hcncpig"fkuvcn0"Gn"vtcdclq"o u"tg- ekgpvg"rwdnkecfq"jc"guvcdngekfq"wp"rwpvq"fg"eqtvg"fg"
4"oo"*gn":2'"ugpukdknkfcf."gn"93'"gurgekÞekfcf"{"xcnqt"
rtgfkevkxq"rqukvkxq"{"pgicvkxq"fgn"95"{"9:'."tgurgevkxc- ogpvg=" tgc"dclq"nc"ewtxc"TQE"2.:+390"
̋" Ug"jc"fguetkvq"vcodkfip"wp"kpetgogpvq"fgn"itquqt"fg"nc"
ocvtk|"wpiwgcn90"
50"Chgevcek„p"fg"nc"oketqxcuewnctk|cek„p"fgn"crctcvq"wp- iwgcn<
̋" Kpetgogpvq"fgn"àwlq"fgn"ngejq"{"ocvtk|"wpiwgcn0"Gnqp- icek„p"{"fkncvcek„p"fg"nqu"xcuqu."swg"ug"xwgnxgp"vqtvwq- sos6.420"Gn"RTH"(pulse repetition frequency)"uwgng"
guvcpfctk|ctug"c"972"J|420"Ug"jc"rtqrwguvq"wpc"rqukdng"
tgncek„p"gpvtg"guvg"jcnnc|iq"{"nc"ctvtqrcv c"ruqtk ukec390"
̋" Kpetgogpvq"fgn" pfkeg"fg"tgukuvgpekc"xcuewnct"ogfkfq"
gp"nqu"xcuqu"fgn"rnkgiwg"wpiwgcn"*rqukdngogpvg"fgdkfq"
c"fkuhwpek„p"gpfqvgnkcn"rqt"kpàcocek„p+430
Relación de afectación ungueal con la artropatía psoriásica
Uqp"xctkqu"nqu"guvwfkqu"swg"jcp"fgoquvtcfq"wpc"tgncek„p"gp- vtg"nc"chgevcek„p"wpiwgcn"{"nc"ctvtqrcv c"ruqtk ukec38.44.450"Fg"
jgejq."nc"rtgugpekc"fg"ruqtkcuku"wpiwgcn"ug"eqpukfgtc"eqoq"
wp"octecfqt"fg"hwvwtq"fc‚q"ctvkewnct440"Cfgo u"ug"jc"fgoqu- vtcfq"wpc"gngxcfc"rtgugpekc"fg"gpvguqrcv c"uwden pkec"gp"
rcekgpvgu"eqp"ruqtkcuku"ukp"fcvqu"fg"ctvtqrcv c46/49"{"vcodkfip"
ug"jc"gxkfgpekcfq"tgncek„p"gpvtg"nc"kpàcocek„p"fgn"vgpf„p"
gzvgpuqt"fgn"fgfq"{"nc"kpàcocek„p"fg"nc"w‚c38.4:0"
Guvc"cuqekcek„p"ug"jc"gzrnkecfq"rqt"nc"tgncek„p" pvkoc"fg"
ncu"fkhgtgpvgu"guvtwevwtcu"swg"eqphqtocp"nc"w‚c"eqp"gn"vgp- f„p"gzvgpuqt"fgn"fgfq"eqttgurqpfkgpvg."{"o u"eqpetgvcogp- vg"eqp"uw"kpugtek„p"gp"gn"jwguq"*gpvguku+460"Nc"w‚c"{"nc"gpvguku"
ug"wpgp"ogfkcpvg"Þdtcu"swg"rctvgp"fgn"vgpf„p"gzvgpuqt0"
Vcodkfip"gn"vgpf„p"gzvgpuqt"{"uw"gpvguku"gokvgp"Þdtcu"swg"
eqphqtocp"wpc"rctvg"korqtvcpvg"fgn"rgtkquvkq"fg"nc"rctvg"
xgpvtcn"fg"nc"hcncpig"fkuvcn0"C"uw"xg|."nc"n okpc"wpiwgcn"guv "
wpkfc"cn"rgtkquvkq"rqt"fgpucu"Þdtcu"fg"eqn igpq4;.520"Guvc"tg- ncek„p"cpcv„okec"hcxqtgeg"swg"nqu"hgp„ogpqu"kpàcocvqtkqu"
cecgekfqu"gp"gn"vgpf„p"{"uw"gpvguku"rwgfcp"vtcpuokvktug"vco- dkfip"cn"crctcvq"wpiwgcn"{"xkegxgtuc530"
Guvc"tgncek„p"gpvtg"qpkeqrcv c"{"ctvtkvku"ruqtk ukec"gu"gurg- ekcnogpvg"tgngxcpvg"fgufg"gn"rwpvq"fg"xkuvc"geqit Þeq."{c"
swg"gp"wpc"gzrnqtcek„p"geqit Þec"pqtocn"ug"rwgfgp"gxcnwct"
pq"uqnq"ncu"fkhgtgpvgu"guvtwevwtcu"swg"eqphqtocp"gn"crctcvq"
wpiwgcn."ukpq"vcodkfip"gn"vgpf„p"gzvgpuqt"{"uw"gpvguku0"Nqu"
jcnnc|iqu"o u"htgewgpvgu"gp"ecuq"fg"gpvguqrcv c"{1q"ctvtq- rcv c"uqp9.54<
̋" Gpitqucokgpvq"fgn"vgpf„p0
̋" Rfitfkfc"fg"nc"guvtwevwtc"Þdtknct0
̋" Hqequ"jkrqgeqkequ"*kpàcocek„p+."hqequ"jkrgtgeqkequ"*ecn- ekÞecek„p+"gp"gn"kpvgtkqt"fgn"vgpf„p0
̋" Hqequ"jkrqgeqkequ"rgtkhfitkequ0
̋" Rtgugpekc"fg"gtqukqpgu"„ugcu."quvgqÞvqu"gp"nc"uwrgtÞekg"
ctvkewnct"fg"nc"hcncpig0
̋" Kpetgogpvq"fgn"àwlq"rgtkvgpfkpquq"ogfkfq"rqt"Fqrrngt0
pgtcnogpvg"jkrqxcuewnctgu."eqp"gzegrek„p"fgn"cpikqÞdtqoc."
swg"ug"rwgfg"rtgugpvct"eqp"rgswg‚qu"xcuqu"eqp"àwlq"xgpquq"
q"ctvgtkcn"fg"dclc"xgnqekfcf0
Exostosis subungueal
Kocigp"nkpgcn"jkrgtgeqkec"*Þi0"5+"eqp"uqodtc"ce¿uvkec"rqu- vgtkqt"swg"eqpgevc"eqp"nc"n pgc"jkrgtgeqkec"fgn"octigp"„ugq"
fg"nc"hcncpig"fkuvcn0"Pqtocnogpvg"fgurnc|c"nc"n okpc"jcekc"
cttkdc"{"jc{"cwugpekc"fg"xcuewnctk|cek„p0"Gp"nc"rgtkhgtkc"fg"
ncu"gzquvquku"ug"rwgfg"xgt"vglkfq"jkrqgeqkeq"ocn"fgÞpkfq."
tguwnvcfq"fg"nc"tgceek„p"kpàcocvqtkc"{"ekecvtk|cek„p"ugewp- fctkc0
Osteocondroma subungueal
Kocigp"tgfqpfgcfc."dkgp"fgÞpkfc."jkrqgeqkec"eqp"kpetgogp- vq"fg"nc"xcuewnctk|cek„p0
Quiste mixoide sinovial
Kocigp"jkrqgeqkec"q"cpgeqkec."qxcncfc"q"tgfqpfgcfc."eqp"
tghwgt|q"ce¿uvkeq"rquvgtkqt"{"cwugpekc"fg"àwlq"ucpiw pgq0"Gp"
qecukqpgu"ug"qdugtxc"wp"vtcevq"vqtvwquq"cpgeqkeq"swg"eqow- pkec"nc"nguk„p"eqp"nc"ctvkewncek„p"kpvgthcn pikec"fkuvcn0"Ug"
rwgfg"qdugtxct"gpitqucokgpvq."kttgiwnctkfcf"{"fgurnc|c- okgpvq"fg"nc"rncec"wpiwgcn"gp"gn"okuoq"glg"fg"nc"eqortguk„p"
wpiwgcn0
Granuloma piogénico
Kocigp"ocn"fgÞpkfc"jkrqgeqkec"gp"gn"ngejq"wpiwgcn0"Wpc"q"
codcu"n okpcu"fg"nc"vcdnc"ug"rwgfgp"gpitquct"{1w"qpfwnct0"
Ug"rwgfg"fgvgevct"itcfqu"xctkcdngu"fg"àwlq"ucpiw pgq"gp"uw"
kpvgtkqt."fgufg"jkrq"c"jkrgtxcuewnctk|cek„p"*eqp"àwlq"ctvg- tkcn+0
Tumor glómico
Kocigp"pqfwnct"jkrqgeqkec"ukvwcfc"gp"gn"ngejq"wpiwgcn"eqp"
cwogpvq"fg"nc"xcuewnctk|cek„p670"Ug"fgvgevc"àwlq"ucpiw pgq"
ctvgtkcn"kpvtcvwoqtcn."eqp"xgnqekfcf"ukuv„nkec"o zkoc"gpvtg"
5.9"{"43.3"eo1u0"Gu"eqo¿p"xgt"tgoqfgncek„p"fgn"octigp"„ugq"
fg"nc"hcncpig"fkuvcn"rqt"fgdclq"fgn"vwoqt."nq"swg"tgàglc"gn"
etgekokgpvq"ngpvq"fgn"vwoqt0"
Tumores del aparato ungueal
Nqu"vwoqtgu"fg"nc"w‚c"vkgpgp"ocpkhguvcekqpgu"en pkecu"rqeq"
gurge Þecu"{"gu"fkh ekn"guvcdngegt"uw"vcoc‚q"{"nqecnk|cek„p"
gzcevc."rqt"nq"swg"ncu"vfiepkecu"fg"kocigp"uqp"fg"itcp"c{wfc"
rctc"fkcipquvkect"{"nqecnk|ct"guvqu"vwoqtgu0"Nc"oketqueqrkc"
eqphqecn"{"nc"vqoqitch c"„rvkec"fg"eqjgtgpekc"vkgpgp"rqec"
rgpgvtcek„p."nq"swg"fkÞewnvc"xcnqtct"nc"nguk„p"gp"uw"vqvcnkfcf."
cu "eqoq"uw"nqecnk|cek„p"gzcevc"{"tgncekqpgu0"Nc"tguqpcpekc"
ocipfivkec"qhtgeg"rqec"tguqnwek„p"gp"ngukqpgu"ogpqtgu"fg"5"
oo"{"pq"rgtokvg"xcnqtct"gn"àwlq"ucpiw pgq"gp"vkgorq"tgcn0"
Rqt"gn"eqpvtctkq."nc"geqitch c"fg"cnvc"htgewgpekc"eqp"Fqrrngt"
eqnqt"qhtgeg"dwgpc"tguqnwek„p"gp"ngukqpgu"rgswg‚cu"{"rgtok- vg"gxcnwct"nc"xcuewnctk|cek„p."rqt"nq"swg"gu"nc"oglqt"vfiepkec"
fg"kocigp"gp"gn"fkcip„uvkeq"fg"guvqu"vwoqtgu650"C"eqpvkpwc- ek„p"ug"fguetkdgp"ncu"ectcevgt uvkecu"geqit Þecu"fg"nqu"vwoq- tgu"fgn"crctcvq"wpiwgcn50
Verruga subungueal
Kocigp"jkrqgeqkec."igpgtcnogpvg"fg"hqtoc"hwukhqtog"q"pq- fwnct0"Ug"cuqekc"c"wp"gpitqucokgpvq"fg"ncu"vcdncu"xgpvtcn"{"
fqtucn"fg"nc"n okpc"wpiwgcn"eqp"kpetgogpvq"fgn"gurcekq"gpvtg"
codcu0"Pqtocnogpvg"pq"rtgugpvc"xcuewnctk|cek„p"ucnxq"ncu"
nqecnk|cfcu"gp"gn"jkrqpkswkq."swg"rwgfgp"rtgugpvct"wp"kpetg- ogpvq"fgn"àwlq"ffitokeq"uwd{cegpvg0
Queratoacantoma
Kocigp"dkgp"ektewpuetkvc"eqp"geqigpkekfcf"okzvc"*jkrqgeqkec"
{"cpgeqkec+."tgoqfgncek„p"eqtvkecn."gtquk„p"fg"nqu"o tigpgu"
„ugqu"{"rtgugpekc"fg"tghwgt|q"ce¿uvkeq"rquvgtkqt0
Onicomatricoma
Kocigp"jkrgtgeqkec"gzefipvtkec"gp"nc"ocvtk|"{"gn"ngejq"wpiwgcn660"
Rwgfg"rtgugpvct"gp"uw"kpvgtkqt"rwpvqu"nkpgcngu"jkrgtgeqkequ0"Ug"
jc"fguetkvq"tgoqfgncek„p"q"ecodkqu"gtqukxqu"gp"gn"octigp"„ugq."
jkrgtxcuewnctkfcf"{"gzrcpuk„p"fgn"rnkgiwg"wpiwgcn"rtqzkocn0
Fibromas
Kocigp"wpkhqtog"jkrqgeqkec"pqfwnct"w"qxcn"gp"gn"ngejq"fg"nc"
w‚c"swg"rwgfg"chgevct"c"nc"ocvtk|0"Nqu"vwoqtgu"fg"itcp"vc- oc‚q"rwgfgp"vgpgt"tgoqfgncek„p"fgn"octigp"„ugq0"Uqp"ig-
Figura 3 Gz„uvquku"uwdwpiwgcn0"Geqitch c"fg"nc"gz„uvquku"uwdwpiwgcn0"Eqtvg"nqpikvwfkpcn"eqp"uqpfc"fg"3:"OJ|0"
A B
80"Lgoge"ID."Ugtwr"L0"Wnvtcuqwpf"uvtwevwtg"qh"vjg"jwocp"pckn"rnc- vg0"Ctej"Fgtocvqn0"3;:;=347<865/80
90"C{fkp"U¥."Ecuvknnq/Icnngiq"E."Cuj"¥T."Oct|q/Qtvgic"J."Gogt{"R."
YcmgÞgnf"TL."gv"cn0"Wnvtcuqpqitcrjke"cuuguuogpv"qh"pckn"kp"ruq- tkcvke"fkugcug"ujqyu"c"nkpm"dgvyggp"qp{ejqrcvj{"cpf"fkuvcn"kp- vgtrjcncpigcn"lqkpv"gzvgpuqt"vgpfqp"gpvjguqrcvj{0"Fgtocvqnq- i{0"4234=447<453/70
:0"Yqtvuocp"Z."Jqno"GC."Lgoge"ID."Ipkcfgemc"O."Ywnh"JE0"Wnvtc- uqpkfq"fg"cnvc"tguqnwek„p"*37"oj|+"gp"gn"guvwfkq"fg"nc"w‚c"ruqtk- cvkec0"Tgx"Ejkn"Tcfkqn0"4226=32<8/330
;0"Yqnnkpc"W."Dgtigt"O."Mctvg"M0"Ecnewncvkqp"qh"pckn"rncvg"cpf"pckn"
ocvtkz"rctcogvgtu"d{"42"oj|"wnvtcuqwpf"kp"jgcnvj{"xqnwpvggtu"
cpf"rcvkgpvu"ykvj"umkp"fkugcug0"Umkp"Tgu"Vgejpqn0"4223=9<82/60 320"Ng"Hqwtp"G."Fwjctf"G."Vcwxgtqp"X."Octwcpk"C."Ucokok"O."Nqtgvvg"
I."gv"cn0"Ejcpigu"kp"vjg"pckn"wpkv"kp"rcvkgpvu"ykvj"ugeqpfct{"
n{orjqgfgoc"kfgpvkÞgf"wukpi"enkpkecn."fgtoqueqrke"cpf"wnvtc- uqwpf"gzcokpcvkqp0"Dt"L"Fgtocvqn0"4233=386<987/920
330"U pejg|/Tgic‚c"O."Wodgtv"R0"Curgevqu"fkcip„uvkequ"{"vgtcrfiw- vkequ"fg"nc"ruqtkcuku"wpiwgcn0"Cevcu"FgtoqukÞnkqit0"422:=;;<
56/650
340"Ctoguvq"U."Guvgxg"C."Eqvq/Ugiwtc"R."Ftcmg"O."Icncejg"E."Oct- v pg|/Dqttc"L."gv"cn0"Ruqtkcuku"wpiwgcn<"guvwfkq"gp"883"rcekgpvgu"
eqp"ruqtkcuku"xwnict0"Cevcu"FgtoqukÞnkqit0"4233=324<587/940 350"Yknnkcouqp"N."Fcndgvj"P."Fqemgtv{"LN."Igg"DE."Ygcvjgtcnn"T."
Yqtfuyqtvj"DR0"Gzvgpfgf"tgrqtv<"pckn"fkugcug"kp"ruqtkcvke"ct- vjtkvku//enkpkecnn{"korqtvcpv."rqvgpvkcnn{"vtgcvcdng"cpf"qhvgp"
qxgtnqqmgf0"Tjgwocvqnqi{"*Qzhqtf+0"4226=65<9;2/60
360"Ejcpftcp"X."Iqvvnkgd"C."Eqqm"TL."FwhÞp"ME."Icti"C."Jgnnkygnn"R."
gv"cn0"Kpvgtpcvkqpcn"ownvkegpvgt"ruqtkcuku"cpf"ruqtkcvke"ctvjtkvku"
tgnkcdknkv{"vtkcn"hqt"vjg"cuuguuogpv"qh"umkp."lqkpvu."pcknu."cpf"
fcev{nkvku0"Ctvjtkvku"Tjgwo0"422;=83<3457/640
370"Fg"Lqpi"GO."Uggigtu"DC."Iwnkpem"OM."Dqg|gocp"LD."Xcp"fg"
Mgtmjqh"RE0"Ruqtkcuku"qh"vjg"pcknu"cuuqekcvgf"ykvj"fkucdknkv{"kp"c"
nctig"pwodgt"qh"rcvkgpvu<"Tguwnvu"qh"c"tgegpv"kpvgtxkgy"ykvj"
3.94:"rcvkgpvu0"Fgtocvqnqi{0"3;;8=3;5<522/50
380"Gn"Okgfcp{"[."Gn"Icchct{"O."[qwuugh"U."Cjogf"K."Pcut"C0"Vcknqtgf"
crrtqcej"vq"gctn{"ruqtkcvke"ctvjtkvku"rcvkgpvu<"enkpkecn"cpf"wnvtc- uqpqitcrjke"rtgfkevqtu"hqt"uvtwevwtcn"lqkpv"fcocig0"Enkp"Tjgw- ocvqn0"4237=56<529/350
390"Ucpfqdcn"E."Ectd„"G."Ktkdcu"L."Tqxgtcpq"U."Rcktc"U0"Wnvtcuqwpf"
pckn"kocikpi"qp"rcvkgpvu"ykvj"ruqtkcuku"cpf"ruqtkcvke"ctvjtkvku"
eqorctgf"ykvj"tjgwocvqkf"ctvjtkvku"cpf"eqpvtqn"uwdlgevu0"L"Enkp"
Tjgwocvqn0"4236=42<43/60
3:0"Yqtvuocp"Z."Iwvkfittg|"O."Uccxgftc"V."Jqpg{ocp"L0"Vjg"tqng"qh"
wnvtcuqwpf"kp"tjgwocvke"umkp"cpf"pckn"ngukqpu<"c"ownvk/urgekcnkuv"
crrtqcej0"Enkp"Tjgwocvqn0"4233=52<95;/6:0
3;0"Ikuqpfk"R."Kfqnc||k"N."Iktqnqoqpk"I0"Wnvtcuqpqitcrj{"tgxgcnu"
pckn"vjkemgpkpi"kp"rcvkgpvu"ykvj"ejtqpke"rncswg"ruqtkcuku0"Ctej"
Fgtocvqn"Tgu0"4234=526<949/540
420"Iwvkfittg|"O."Hknkrrweek"G."Fg"Cpignku"T."Hknquc"I."Mcpg"F."Itcuuk"
Y0"C"uqpqitcrjke"urgevtwo"qh"ruqtkcvke"ctvjtkvku<"$Vjg"Þxg"vct- igvu$0"Enkp"Tjgwocvqn0"4232=4;<355/640
430"Jwugkp"Gn/Cjogf"J."Icttkfq/Rctglc"H."Twk|/Ecttcuequc"LE."Pctc- plq/Ukpvgu"T0"Xguugn"tgukuvcpeg"vq"dnqqf"àqy"kp"vjg"pcknhqnf"kp"
rcvkgpvu"ykvj"ruqtkcuku<"c"rtqurgevkxg"ecug/eqpvtqn"gejq"fqr- rngt/dcugf"uvwf{0"Dt"L"Fgtocvqn0"4234=388<76/:0
440"Yknuqp"HE."Kegp"O."Etqyuqp"EU."OeGxq{"OV."Icdtkgn"UG."Mtgogtu"
JO0"Kpekfgpeg"cpf"enkpkecn"rtgfkevqtu"qh"ruqtkcvke"ctvjtkvku"kp"rc- vkgpvu"ykvj"ruqtkcuku<"c"rqrwncvkqp/dcugf"uvwf{0"Ctvjtkvku"Tjgwo0"
422;=83<455/;0
450"Lkctcxwvjkucp"OO."Ucuugxknng"F."Xgpfgt"TD."Owtrj{"H."Owjp"E[0"
Ruqtkcuku"qh"vjg"pckn<"cpcvqo{."rcvjqnqi{."enkpkecn"rtgugpvcvkqp."
cpf"c"tgxkgy"qh"vjg"nkvgtcvwtg"qp"vjgtcr{0"L"Co"Cecf"Fgtocvqn0"
4229=79<3/490
460"Vcp"CN."Itckpigt"CL."Vcppgt"UH."Gogt{"R."OeIqpcing"F0"C"jkij/
tguqnwvkqp"ocipgvke"tguqpcpeg"kocikpi"uvwf{"qh"fkuvcn"kpvgtrjc- ncpigcn"lqkpv"ctvjtqrcvj{"kp"ruqtkcvke"ctvjtkvku"cpf"quvgqctvjtk- vku<"Ctg"vjg{"vjg"ucogA"Ctvjtkvku"Tjgwo0"4228=76<354:/550
Perineuroma
Kocigp"ocn"fgÞpkfc."gzefipvtkec."jkrqgeqkec"gp"nc"ocvtk|"{"
gn"rnkgiwg"wpiwgcn"krukncvgtcn0"Gn"Fqrrngt"owguvtc"jkrgtxcu- ewnctk|cek„p0
Hematoma y absceso subungueal
Ko igpgu"ocn"fgÞpkfcu"cpgeqkecu"gp"gn"ngejq"wpiwgcn."swg"
rwgfgp"eqpvgpgt"ugrvqu"jkrgtgeqkequ"gp"gn"kpvgtkqt0
Hemangioma subungueal
Kocigp"jkrqgeqkec."guecucogpvg"fgÞpkfc."eqp"kpetgogpvq"
fg"nc"xcuewnctk|cek„p0"Gp"uw"kpvgtkqt"rwgfgp"xgtug"ko igpgu"
jkrgtgeqkecu"eqp"uqodtc"ce¿uvkec"rquvgtkqt"swg"eqttgurqpfgp"
c"àgdqnkvqu0
Lesiones granulomatosas
Kocigp"jkrqgeqkec"gp"gn"ngejq"wpiwgcn"swg"fgurnc|c"nc"n ok- pc"wpiwgcn0"Xcuewnctk|cek„p"xctkcdng."fgufg"guecuc"c"cdwp- fcpvg0"
Epitelioma espinocelular y melanoma
Ko igpgu"jkrqgeqkecu"eqp"kpetgogpvq"fg"nc"xcuewnctk|cek„p0"
Ncu"ko igpgu"pq"uqp"gurge Þecu."rgtq"nc"geqitch c"gu"¿vkn"gp"
nc"nqecnk|cek„p"fg"guvcu."rgtokvkgpfq"xcnqtct"uw"vcoc‚q"{"
tgncekqpgu"eqp"guvtwevwtcu"cf{cegpvgu"c{wfcpfq."rqt"vcpvq."
c"rncpkÞect"nc"ektwi c0
Conclusión
Nc"geqitch c"fg"cnvc"htgewgpekc"eqp"Fqrrngt"eqnqt"gu"wpc"
rtwgdc"ugpeknnc"g"kpfqnqtc."swg"jc"fgoquvtcfq"ugt"¿vkn"gp"gn"
fkcip„uvkeq"{"ugiwkokgpvq"fg"owejcu"gphgtogfcfgu"fg"ncu"
w‚cu0"C"ogfkfc"swg"nc"geqitch c"ug"kpeqtrqtg"c"nc"rt evkec"
en pkec"jcdkvwcn"fgn"fgtocv„nqiq"ug"kt p"fguetkdkgpfq"pwgxqu"
jcnnc|iqu"geqit Þequ"swg"eqpÞtoct p"uw"wvknkfcf"gp"nc"rcvq- nqi c"wpiwgcn0"
Conàicto de intereses
Nqu"cwvqtgu"fgenctcp"pq"vgpgt"pkpi¿p"eqpàkevq"fg"kpvgtgugu0
Bibliografía
30"Octvkp" D0" Pckn" jkuvqrcvjqnqi{0" Cevcu" Fgtoqukhknkqit0"
4235=326<786/9:0
40"Egeejkpk"C."Oqpvgnnc"C."Gpc"R."Ognqpk"ID."Oc||ctgnnq"X0"Wnvtc- uqwpf"cpcvqo{"qh"pqtocn"pcknu"wpkv"ykvj"3:"oj|"nkpgct"vtcpufw- egt0"Kvcn"L"Cpcv"Godt{qn0"422;=336<359/660
50"Yqtvuocp"Z."Yqtvuocp"L."Uqvq"T."Uccxgftc"V."Jqpg{ocp"L."Uc|w- pke"K."gv"cn0"Dgpkip"vwoqtu"cpf"rugwfqvwoqtu"qh"vjg"pckn<"C"pqxgn"
crrnkecvkqp"qh"uqpqitcrj{0"L"Wnvtcuqwpf"Ogf0"4232=4;<:25/380 60"Yqtvuocp"Z."Lgoge"ID0"Wnvtcuqwpf"kocikpi"qh"pcknu0"Fgtocvqn"
Enkp0"4228=46<545/:0
70"Cnhcigog"Tqnf p"H0"Wnvtcuqwpf"umkp"kocikpi0"Cevcu"FgtoqukÞnkq- it0"4236=327<:;3/;0
xgtkv{."Þpigt"fgtocn"vjkempguu"cpf"Þpigtvkr"dnqqf"rgthwukqp"kp"
u{uvgoke"uengtquku"rcvkgpvu0"Cpp"Tjgwo"Fku0"4236=95<469/730 580"Uwnnk"C."Uokvj"X."Ewvqnq"O0"Tgurqpug"vq<"eqorctkuqp"qh"ncugt"
fqrrngt"kocikpi."Þpigtvkr"ncevkego{"vguv."cpf"pcknhqnf"ecrknnc- tqueqr{"hqt"cuuguuogpv"qh"fkikvcn"oketqektewncvkqp"kp"u{uvgoke"
uengtquku0"Ctvjtkvku"Tgu"Vjgt0"4233=35<523="cwvjqt"tgrn{"5240 590"Mko"UJ."Mko"JQ."Lgqpi"[I."Ngg"U[."[qq"YJ."Ejqk"VJ."gv"cn0"Vjg"
fkcipquvke"ceewtce{"qh"rqygt"fqrrngt"wnvtcuqpqitcrj{"hqt"fkh- hgtgpvkcvkpi"ugeqpfct{"htqo"rtkoct{"Tc{pcwf)u"rjgpqogpqp"kp"
wpfkhhgtgpvkcvgf"eqppgevkxg"vkuuwg"fkugcug0"Enkp"Tjgwocvqn0"
422:=49<9:5/80
5:0"UvghcVe|{m"N."Yqjpkcmqyumk"D."Rkgvt|cm"R."Oclqu"C."It|gncm"R0"
Eqorctkuqp"qh"vjgtoqitcrj{"cpf"fqrrngt"uqpqitcrj{"kp"vjg"
gxcnwcvkqp"qh"vjg"eqnf"koogtukqp"vguv"kp"yqogp"ykvj"gzeguukxg"
xcuqurcuvke"tgcevkqp0"Ogf"Uek"Oqpkv0"4229=35"Uwrrn"3<343/:0 5;0"Yqtvuocp"Z."Ecnfgtqp"R."Dctcp"T0"Hkpigt"tgvtqp{ejkcu"fgvgevgf"
gctn{"d{"5F"wnvtcuqwpf"gzcokpcvkqp0"L"Gwt"Cecf"Fgtocvqn"Xgpg- tgqn0"4234=48<476/80
620"Yqtvuocp"Z."Yqtvuocp"L."Iwgttgtq"T."Uqvq"T."Dctcp"T0"Cpcvq- okecn"ejcpigu"kp"tgvtqp{ejkc"cpf"qp{ejqocfguku"fgvgevgf"wukpi"
wnvtcuqwpf0"Fgtocvqn"Uwti0"4232=58<3837/420
630"Yqtvuocp"Z."Ctcpkdct"N."Oqtcngu"E0"Rquvpcvcn"4/"cpf"5/fkogp- ukqpcn"uqpqitcrj{"qh"vjg"umkp"cpf"pckn"kp"eqpigpkvcn"cwvquqocn"
tgeguukxg"kejvj{quku"eqttgncvgf"ykvj"ewvcpgqwu"jkuvqnqike"Þp- fkpiu0"L"Wnvtcuqwpf"Ogf0"4233=52<3659/;0
640"Yqtvuocp"Z."énxctg|"U0"Eqnqwt"Fqrrngt"wnvtcuqwpf"Þpfkpiu"kp"
vjg"pckn"kp"e{uvke"Þdtquku0"L"Gwt"Cecf"Fgtocvqn"Xgpgtgqn0"4236="
fqk<32033331lfx0348630"]Grwd"cjgcf"qh"rtkpv_0
650"Dcgm"JL."Ngg"UL."Ejq"MJ."Ejqq"JL."Ngg"UO."Ngg"[J."gv"cn0"Uw- dwpiwcn"vwoqtu<"Enkpkeqrcvjqnqike"eqttgncvkqp"ykvj"WU"cpf"OT"
kocikpi"Þpfkpiu0"Tcfkqitcrjkeu0"4232=52<3843/580
660"Uqvq"T."Yqtvuocp"Z."Eqttgfqktc"[0"Qp{ejqocvtkeqoc<"enkpkecn"
cpf"uqpqitcrjke"Þpfkpiu0"Ctej"Fgtocvqn0"422;=367<3683/40 670"I„og|/U pejg|"OG."Cnhcigog/Tqnf p"H."Tqwuv p/Iwnn„p"I."Ug-
iwtcfq/Tqft iwg|"OC0"Vwoqtgu"in„okequ"fkikvcngu"{"gzvtcfkikvc- ngu0"Wvknkfcf"fg"nc"geqitch c"ewv pgc0"Cevcu"Fgtoqukhknkqit0"
4236=327<g67/;0 470"Pctgfq"G."O nngt"K."Fg"Okiwgn"G."Dcvnng/Iwcnfc"G."Cegdgu"E."Dtk-
vq"G."gv"cn0"Jkij"rtgxcngpeg"qh"wnvtcuqpqitcrjke"u{pqxkvku"cpf"
gpvjguqrcvj{"kp"rcvkgpvu"ykvj"ruqtkcuku"ykvjqwv"ruqtkcvke"ctvjtk- vku<"C"rtqurgevkxg"ecug/eqpvtqn"uvwf{0"Tjgwocvqnqi{"*Qzhqtf+0"
4233=72<3:5:/6:0
480"Iwvkfittg|"O."Hknkrrweek"G."Fg"Cpignku"T."UcnchÞ"H."Hknquc"I."Twvc"
U."gv"cn0"Uwdenkpkecn"gpvjgugcn"kpxqnxgogpv"kp"rcvkgpvu"ykvj"ruq- tkcuku<"Cp"wnvtcuqwpf"uvwf{0"Ugokp"Ctvjtkvku"Tjgwo0"4233=62<
629/340
490"Iktqnqoqpk"I."Ikuqpfk"R0"Ruqtkcuku"cpf"u{uvgoke"kpàcoocvkqp<"
Wpfgtfkcipqugf"gpvjguqrcvj{0"L"Gwt"Cecf"Fgtocvqn"Xgpgtgqn0"
422;=45"Uwrrn"3<5/:0
4:0"Cuj"¥T."Vkpc||k"K."Icnngiq"EE."Myqm"E."Yknuqp"E."IqqfÞgnf"O."gv"
cn0"Ruqtkcuku"rcvkgpvu"ykvj"pckn"fkugcug"jcxg"c"itgcvgt"ocipk- vwfg" qh" wpfgtn{kpi" u{uvgoke" uwdenkpkecn" gpvjguqrcvj{" vjcp"
vjqug"ykvj"pqtocn"pcknu0"Cpp"Tjgwo"Fku0"4234=93<775/80 4;0"Vcp"CN."Dgplcokp"O."Vqwok"J."Itckpigt"CL."Vcppgt"UH."Gogt{"R."
gv"cn0"Vjg"tgncvkqpujkr"dgvyggp"vjg"gzvgpuqt"vgpfqp"gpvjguku"
cpf"vjg"pckn"kp"fkuvcn"kpvgtrjcncpigcn"lqkpv"fkugcug"kp"ruqtkcvke"
ctvjtkvku//c"jkij/tguqnwvkqp"OTK"cpf"jkuvqnqikecn"uvwf{0"Tjgwoc- vqnqi{"*Qzhqtf+0"4229=68<475/80
520"OeIqpcing"F."Dgplcokp"O."Vcp"CN0"Vjg"rcvjqigpguku"qh"ruqtkcv- ke"ctvjtkvku"cpf"cuuqekcvgf"pckn"fkugcug<"Pqv"cwvqkoowpg"chvgt"
cnnA"Ewtt"Qrkp"Tjgwocvqn0"422;=43<562/90
530"OeIqpcing"FI."Jgnnkygnn"R."Xgcng"F0"Gpvjgukvku"kp"ruqtkcvke"fku- gcug0"Fgtocvqnqi{0"4234=447<322/;0
540"Hknkrrqw"I."Fk"Ucdcvkpq"X."CfkpqnÞ"C."Dgtvqnfk"K."Rkegtpq"X."Dkcuk"
I."gv"cn0"Pq"gpvjguku"ujqwnf"dg"qxgtnqqmgf"yjgp"ruqtkcvke"ct- vjtkvku"ku"uwurgevgf<"gpvjgukvku"qh"vjg"gzvgpuqt"fkikvqtwo"vgp- fqpu0"L"Tjgwocvqn0"4235=62<5570
550"Hkppgt"CO0"Cnqrgekc"ctgcvc<"enkpkecn"rtgugpvcvkqp."fkcipquku."
cpf"wpwuwcn"ecugu0"Fgtocvqn"Vjgt0"4233=46<56:/760
560"Yqtvuocp"Z0"Uqpqitcrj{"qh"vjg"pckn0"Gp<"Yqtvuocp"Z."Lgoge"I."
gfkvqtu0"Fgtocvqnqike"wnvtcuqwpf"ykvj"enkpkecn"cpf"jkuvqnqike"
eqttgncvkqpu0"Pgy"[qtm<"Urtkpigt="42350"r0"63;/990
570"Uwnnk"C."Twctq"D."Cnguucpftk"G."Rk||qtpk"E."Ekookpq"OC."¥corqi- pc"I."gv"cn0"Eqttgncvkqpu"dgvyggp"pcknhqnf"oketqcpikqrcvj{"ug-
