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Liu J, Zhou Y, Liu MX, Liu ZR, Wang XQ, Li F, Wang DG. Comparative efficacy of modified Noel's technique and matrix phenolization on onychocryptosis: a retrospective study. Int J Dermatol 2024. [PMID: 38939959 DOI: 10.1111/ijd.17349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 05/03/2024] [Accepted: 06/17/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Onychocryptosis is a common pathological condition requiring clinical intervention. Selecting an appropriate and effective treatment based on individual patient circumstances is crucial. METHODS We compared the efficacy and safety of the modified Noel's technique and matrix phenolization in 107 participants with onychocryptosis. Participants were divided into two groups: 75 nails (73 patients) were treated with the modified Noel's technique (modified Noel's group), while 42 nails (34 patients) were treated with matrix phenolization (Phenol group). Outcomes on clinical cure rates and postoperative complications from both groups were collected. Additionally, the efficacy of the modified Noel's technique was assessed in 31 nails with stage IV onychocryptosis. RESULTS After 18 months, among the remaining 102 patients (110 nails), the modified Noel's group exhibited fewer complications (5.88% vs. 45.2%, P < 0.001) with similar cure rates (P = 0.62). Furthermore, there was a shorter healing time in the modified Noel's group (13.5 ± 1.4 vs. 27.6 ± 2.3 days, P < 0.001). Postoperative pain was notable in the modified Noel's group on the first postoperative day (P < 0.001), with a significant decrease in the pain score 2 weeks after surgery (P = 0.407). Postoperative nail plate narrowing was observed in the Phenol group (33%). Moreover, the modified Noel's technique achieved a 100% cure rate in stage IV patients. CONCLUSIONS The modified Noel's technique, offering precise excision of the proliferative nail fold and strategic suturing, is suitable for stage IV patients and for those who find significant aesthetic impact unacceptable following narrowed plate postmatrix phenolization.
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Affiliation(s)
- Juan Liu
- Department of Dermatology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
| | - Yuan Zhou
- Chinese Academy of Medical Sciences and Peking Union Medical College, Institute of Dermatology, Nanjing, China
| | - Meng-Xi Liu
- Department of Dermatology, Suzhou Municipal Hospital East Area, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Zhen-Ru Liu
- Department of Dermatology, Jen Ching Memorial Hospital, Suzhou, China
| | - Xiao-Qing Wang
- Department of Dermatology, Jiangsu Province Geriatric Hospital, Nanjing, China
| | - Fang Li
- Chinese Academy of Medical Sciences and Peking Union Medical College, Institute of Dermatology, Nanjing, China
| | - Da-Guang Wang
- Department of Dermatology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China
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Li Y, Ma H, Xue L, Chen H, Pang R, Shang Y, Luo J, Xie X, Zhang J, Ding Y, Chen M, Wang J, Wu Q. Imbalanced Dermic Microbiome Aggravates Inflammation in Toenail Paronychia. Front Cell Infect Microbiol 2021; 11:781927. [PMID: 34926325 PMCID: PMC8677670 DOI: 10.3389/fcimb.2021.781927] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/18/2021] [Indexed: 11/17/2022] Open
Abstract
The commensal microbiome influences skin immunity, but its function in toenail health remains unclear. Paronychia is one of the most common inflammatory toenail diseases, but antibiotic treatment is seldom effective in clinical cases. In this study, we performed 16S rRNA sequencing to investigate the characteristics of microbes associated with paronychia in order to identify the key microorganisms involved in inflammation. Seventy dermic samples were collected from patients with paronychia and the differences in dermic microbiota were analyzed in patients with different inflammation severities. Distinct clustering of dermal microbiota was observed in the dermis with different inflammation severities. A higher relative abundance of anaerobic microorganisms such as Parvimona, Prevotella, and Peptoniphilus was observed in severe paronychia, whereas Lactobacillus disappeared with disease progression. Co-occurring network analysis suggested that the disturbance of the dermic microbiome and attenuation of antagonism by Lactobacillus against anaerobic pathogens may aggravate inflammation in paronychia. Functional analysis showed that dermic microbiome disturbance may worsen microbial metabolism and tissue repair in the skin. In conclusion, we revealed that an increased abundance of anaerobic microorganisms and loss of Lactobacillus in the dermis may promote paronychia progression and microbiological imbalance may aggravate inflammation in patients with paronychia.
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Affiliation(s)
- Ying Li
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Han Ma
- Department of Dermatology, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, China
| | - Liang Xue
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Huizhen Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China.,School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China
| | - Rui Pang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Yanyan Shang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China.,School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China
| | - Juan Luo
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Xinqiang Xie
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Jumei Zhang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Yu Ding
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Moutong Chen
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Juan Wang
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
| | - Qingping Wu
- Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Guangdong Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China
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Atış G, Göktay F, Altan Ferhatoğlu Z, Kaynak E, Sevim Keçici A, Yaşar Ş, Aytekin S. A Proposal for a New Severity Index for the Evaluation of Chronic Paronychia. Skin Appendage Disord 2018; 5:32-37. [PMID: 30643778 PMCID: PMC6323378 DOI: 10.1159/000489024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 04/05/2018] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Chronic paronychia (CP) is an inflammatory disease of the nail folds. Staging of CP is important for clinicians. We developed an objective scale that evaluates each finding of CP separately in addition to evaluating the treatment process and follow-up. METHODS A new "chronic paronychia severity index scale" was developed to enable dermatologists to examine all features of CP. A previous categorical severity scale and this new scale were used for the evaluation of CP by 6 different dermatologists. The dermatologists evaluated the nails with both scales again 20 days later using randomly ordered photographs. RESULTS Using the previous scale, the intra-observer intraclass correlation coefficient (ICC) values between the first and second evaluations were 0.767, 0.860, 0.734, 0.609, 0.900, and 0.840 for the 6 dermatologists. Using the new proposed scale, the intra-observer ICC values between the first and second evaluations were 0.930, 0.931, 0.942, 0.934, 0.938, and 0.920 for the 6 dermatologists. All intra-observer ICC values were higher for the results of the proposed scale than for those of the previous scale. The inter-observer ICC values were also higher for the proposed scale than for the previous scale for the 6 dermatologists. CONCLUSION The new scale is a standardized, more suitable, objective, and valuable method to use in clinical practice and studies on CP.
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Affiliation(s)
- Güldehan Atış
- Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Fatih Göktay
- Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Zeynep Altan Ferhatoğlu
- Department of Dermatology, Sultan Abdülhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Emre Kaynak
- Department of Dermatology, Tunceli State Hospital, Tunceli, Turkey
| | - Ayşegül Sevim Keçici
- Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Şirin Yaşar
- Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Sema Aytekin
- Department of Dermatology, Haydarpaşa Numune Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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