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Francavilla V, Secolo G, D'Armetta M, Toscano R, Campo A, Catanzaro V, Manno M, Secolo I, Messina G. Onychocryptosis: a retrospective study of clinical aspects, inflammation treatment and pain management using Ozoile as a hydrogel and cream formulation. Eur J Transl Myol 2024; 34:12487. [PMID: 38934121 PMCID: PMC11264223 DOI: 10.4081/ejtm.2024.12487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/09/2024] [Indexed: 06/28/2024] Open
Abstract
Ingrown toenails account for roughly 20% of all foot problems in primary care. It is most common in young men, with nail care habits and footwear being major contributors. Onychocryptosis is typically caused by self-treatment attempts to cure the condition in its early stages. Its clinical features are frequently confused with other osseous and soft tissue abnormalities. The goal of this study was to provide perspectives on the management of pain and inflammation in Onychocryptosis using an Ozoile-based hydrogel formulation in a semi-occlusive bandage for 14 days, while incorporating natural pharmacological solutions into established protocols. The primary outcomes measured were pain reduction on NRS and stadiation according to the Al Kline Classification. The reduction was statistically significant, with a mean decrease in VAS score from 10 to 4 (p < 0.05), and Al Kline classification decreased by an average of 1.6 stages. 42% of patients recovered within the first 15 days of treatment, and 93% by the end of the scheduled treatment.
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Affiliation(s)
| | - Giuseppe Secolo
- Faculty of Medicine and Pharmacy, University Dunarea de Jos, Galati.
| | | | - Rosario Toscano
- Studio di Podologia Dott. Toscano Rosario Emanuele, Viagrande, Catania.
| | - Angelo Campo
- Studio di podologia Dott. Campo Angelo, Pozzallo, Ragusa.
| | | | | | | | - Giuseppe Messina
- Department of Human Sciences and Promotion of the Quality of Life San Raffaele University, Rome.
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2
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Haneke E. Onychomycosis in Foot and Toe Malformations. J Fungi (Basel) 2024; 10:399. [PMID: 38921385 PMCID: PMC11204549 DOI: 10.3390/jof10060399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 05/10/2024] [Accepted: 05/27/2024] [Indexed: 06/27/2024] Open
Abstract
Introduction: It has long been accepted that trauma is one of the most important and frequent predisposing factors for onychomycoses. However, the role of direct trauma in the pathogenesis of fungal nail infections has only recently been elucidated in a series of 32 cases of post-traumatic single-digit onychomycosis. The importance of repeated trauma due to foot and toe abnormalities was rarely investigated. Aimof the study: This is a multicenter single-author observational study over a period of 6 years performed at specialized nail clinics in three countries. All patient photographs taken by the author during this period were screened for toenail alterations, and all toe onychomycosis cases were checked for whether they contained enough information to evaluate potential foot and toe abnormalities. Particular attention was paid to the presence of hallux valgus, hallux valgus interphalangeus, hallux erectus, inward rotation of the big toe, and outward rotation of the little toe, as well as splay foot. Only cases with unequivocal proof of fungal nail infection by either histopathology, mycologic culture, or polymerase chain reaction (PCR) were accepted. Results: Of 1653 cases, 185 were onychomycoses, proven by mycologic culture, PCR, or histopathology. Of these, 179 involved at least one big toenail, and 6 affected one or more lesser toenails. Three patients consulted us for another toenail disease, and onychomycosis was diagnosed as a second disease. Eight patients had a pronounced tinea pedum. Relatively few patients had a normal big toe position (n = 9). Most of the cases had a mild to marked hallux valgus (HV) (105) and a hallux valgus interphalangeus (HVI) (143), while hallux erectus was observed in 43 patients, and the combination of HV and HVI was observed 83 times. Discussion: The very high percentage of foot and toe deformations was surprising. It may be hypothesized that this is not only a pathogenetically important factor but may also play an important role in the localization of the fungal infection, as no marked hallux deviation was noted in onychomycoses that affected the lesser toes only. As the management of onychomycoses is a complex procedure involving the exact diagnosis with a determination of the pathogenic fungus, the nail growth rate, the type of onychomycosis, its duration, and predisposing factors, anomalies of the toe position may be important. Among the most commonly mentioned predisposing factors are peripheral circulatory insufficiency, venous stasis, peripheral neuropathy, immune deficiency, and iatrogenic immunosuppression, whereas foot problems are not given enough attention. Unfortunately, many of these predisposing and aggravating factors are difficult to treat or correct. Generally, when explaining the treatment of onychomycoses to patients, the importance of these orthopedic alterations is not or only insufficiently discussed. In view of the problems encountered with the treatment of toenail mycoses, this attitude should be changed in order to make the patient understand why there is such a low cure rate despite excellent minimal inhibitory drug concentrations in the laboratory.
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Affiliation(s)
- Eckart Haneke
- Schlippehof 5, 79110 Freiburg, Germany;
- Department of Dermatology, Inselspital, University of Berne, 3010 Bern, Switzerland
- Private Dermatology Practice Dermaticum, 79098 Freiburg, Germany
- Centro de Dermatología Epidermis, Instituto CUF, Senhora da Hora, 8050 Matosinhos, Grande Porto, Portugal
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3
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Sun Y, Lan CCE, Tsai TY, Lin SY. Using dental floss pick and alternative packing material for ingrown toenails: A video demonstration. J Am Acad Dermatol 2024; 90:e115-e116. [PMID: 37062460 DOI: 10.1016/j.jaad.2023.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/14/2023] [Accepted: 04/07/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Yng Sun
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Che E Lan
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tsung-Yu Tsai
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Radiology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Sheng Yiao Lin
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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Kumar Mukhopadhyay A. Delving into the depth: On the historical aspect of ingrown toenails from the ancient period till the 19th century. Indian J Dermatol Venereol Leprol 2024; 0:1-8. [PMID: 38595007 DOI: 10.25259/ijdvl_1034_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 11/13/2023] [Indexed: 04/11/2024]
Affiliation(s)
- Amiya Kumar Mukhopadhyay
- Department of Dermatology, 'Pranab skin, Clinic', Pranab Ismile (Near Dharmaraj Mandir) Asansol, West Bengal, India
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5
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Sindhuja T, Anand GRP, Gupta S. Radiofrequency-assisted lateral toenail onychotomy for ingrown toenail. J Am Acad Dermatol 2024; 90:e5-e6. [PMID: 35271938 DOI: 10.1016/j.jaad.2022.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 03/01/2022] [Indexed: 11/24/2022]
Affiliation(s)
- Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Gouri R P Anand
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
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6
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Sarı N, Kurtipek GS, Ünal M, Öztürk M, Sarı İF. Evaluation of Foot Deformities in Patients With Ingrown Nails. Dermatol Pract Concept 2024; 14:dpc.1401a49. [PMID: 38364392 PMCID: PMC10868958 DOI: 10.5826/dpc.1401a49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 02/18/2024] Open
Abstract
INTRODUCTION Ingrown nail is a condition caused by the perforation of the periungual soft tissues on nail folds by the sides of nail plaque, causing inflammation and severe pain. Recently, the role of foot anatomical disorders in ingrown nail development has been emphasized. OBJECTIVES The main objective of this study aimed to determine whether foot deformities played significant roles in ingrown nail development with objective radiological parameters. METHODS The study included 64 patients diagnosed with clinical ingrown nail and 71 patients as controls without any ingrown nail history. In both groups, we evaluated the bilateral foot radiographs of patients with ingrown nails for hallux valgus angle (HVA), interphalangeal angle (IPA), and intermetatarsal angle (IMA) associated with hallux valgus, and the calcaneal pitch angle (CPA), talohorizontal angle (THA), and talometatarsal angle (TMA) related to pes planus. RESULTS No significant difference was found in terms of hallux valgus radiological measurements of HVA, IPA and IMA as well as pes planus radiological measurements of CPA and TMA values, when compared to controls. THA was statistically significantly higher in the control group (P = 0.025). There was a moderate strength positive relationship between ingrown nail stage and measured TMA for pes planus diagnosis (rho = 0.326; P = 0.04), yet there are no significant correlations between ingrown nail stage and other angles. CONCLUSIONS Therefore, we do not recommend foot anatomy correction in the prevention and treatment of ingrown nails, unless there is an accompanying foot deformity; however, pes planus is a foot deformity that can accompany patients with severely ingrown nails.
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Affiliation(s)
- Nihal Sarı
- Bulancak State Hospital, Department of Dermatology, Giresun, Turkey
| | | | - Mehmet Ünal
- Associated Professor Mehmet Ünal Clinic, The Department of Dermatology, Konya, Turkey
| | - Mehmet Öztürk
- Selcuk University Faculty of Medicine, The Department of Pediatric Radiology, Konya, Turkey
| | - İlker Fatih Sarı
- Giresun University Faculty of Medicine, The Department of Physical Medicine and Rehabilitation, Giresun, Turkey
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Dharmawan N, Rachman PO, Nareswari A, Rinandari U, Fiqri A, Devinta E. Matricectomy with Electrocautery as Therapy for Recurrent Ingrown Toenail. Skin Appendage Disord 2023; 9:126-136. [PMID: 36937153 PMCID: PMC10015652 DOI: 10.1159/000528517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 11/25/2022] [Indexed: 01/20/2023] Open
Abstract
Introduction Ingrown toenails are one of the common nail problems generally occurs in the big toe area and most often occurs during productive ages. Treatment of ingrowing toenail can be chosen based on the clinical condition of the patient. Nonoperative therapy is not effective in advanced cases in terms of the severity. Improper handling will cause recurrence in this case. Case Presentation Six of 8 patients had the ingrown toenail recurrence previously treated using the nail avulsion (onychectomy) without matricectomy. One patient was reported to have hemophilia as comorbidity. The other one had pincer nail associated with inflammatory and degenerative processes. Most patients were at modified Mozena grades III and IV ingrown toenail. Post therapy evaluation revealed no recurrence in all patients. Conclusions Combination of wedge resection with matricectomy using electrocautery can be applied as therapy for recurrent ingrown toenail.
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Affiliation(s)
- Nugrohoaji Dharmawan
- Department of Dermatology and Venereology Faculty of Medicine, Universitas Sebelas Maret/Dr. Moewardi Hospital of Surakarta, Central Java, Surakarta, Indonesia
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8
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Surgical Matricectomy Versus Phenolization in the Treatment of Ingrown Toenails: A Randomized Controlled Trial. Dermatol Surg 2023; 49:231-236. [PMID: 36735804 DOI: 10.1097/dss.0000000000003692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Treatment of ingrown toenail includes various nonsurgical and surgical treatments. However, there is no consensus on the ideal first-choice treatment. OBJECTIVE To compare phenolization versus surgical matricectomy (SM) after lateral nail plate avulsion in terms of efficacy, recurrence rates, postoperative outcomes, and cosmesis. METHODS The authors enrolled 45 consenting patients and randomized them into 2 groups (Group 1 = phenolization and Group 2 = SM) using stratified block randomization and followed them up at 1 week, 1 month, and 6 months. RESULTS The median percentage improvement in pain visual analog scale (VAS) score was comparable between the 2 groups ( p = 0.793). The mean photo VAS showed significant improvement in Group 1 at 1 week ( p = 0.00) and 1 month ( p = 0.02) but not at 6 months ( p = 0.44). The median number of days for pain relief ( p = 0.169), for healing ( p = 0.192), and for resuming work ( p = 0.136) were not significantly different between the 2 groups. The time required to regain normal morphology was significantly longer in Group 2 ( p = 0.006). None of the patients in either group presented with recurrence at 6 months and 1 year. The authors observed failure of treatment in 1 patient in Group 2. CONCLUSION Both procedures were equally efficacious, had minimal complications, and showed no recurrence at 6 months and 1 year.
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9
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The Modified versus the Conventional Winograd Technique for the Treatment of Onychocryptosis: A Retrospective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137818. [PMID: 35805476 PMCID: PMC9266244 DOI: 10.3390/ijerph19137818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022]
Abstract
The Winograd technique is a common surgical treatment for ingrown toenails. Attempting to improve the results of this technique, two modifications were adopted: the incisional approach and the use of adhesive approximation strips. This study aimed to compare the conventional technique and the modified version based on (i) postoperative complications, (ii) healing time, (iii) recurrence rate, and (iv) overall patient satisfaction. A longitudinal, observational, and retrospective design was used, with a sample of 208 patients divided into the modified Winograd technique (n = 111) and the conventional Winograd technique (n = 97) in three clinics in Portugal, with follow-up periods of more than 15 years and 10 years, respectively. The modifications to the Winograd technique revealed fewer postsurgical complications, in terms of infections (1.8% vs. 20.62%, p < 0.010), recurrence rate (2.7% vs. 5.21%, p > 0.05), shorter recovery time (8.10 ± 0.76 vs. 14.51 ± 3.48 days, p < 0.001), and lower postoperative pain and better satisfaction with the functional and esthetic results, with the patient’s overall satisfaction, and with significant differences in relation to the conventional technique (p < 0.001). The modifications performed showed a lower rate of infection, decreased healing time, and better patient satisfaction, suggesting that it may be adopted in clinical practice for the treatment of stages II and III ingrown toenails.
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10
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Desai AD, Wang Y, Nadarajah CC, Lipner SR. Cross-Sectional Analysis of Paronychias in the National Electronic Injury Surveillance System 1999–2018. Skin Appendage Disord 2022; 8:454-461. [PMID: 36407642 PMCID: PMC9672864 DOI: 10.1159/000525032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Paronychia is the most common hand infection. Prior paronychia studies were limited by small patient numbers. We conducted a national-level analysis over two decades, analyzing demographics, etiologies, and trends in paronychia cases. Methods We conducted a retrospective analysis of paronychia cases in the 1999–2018 National Electronic Injury Surveillance System database. Sex, race, age, and cause were recorded and compared using χ<sup>2</sup>, ANOVA, and t tests. Multivariable linear regression analysis assessed changes in age, weight, and sex over time. Results We analyzed a total of 2,512 cases, with an average age of 27.6 ± 20.6 years, 45.5% females, and 25.6% white and 28.6% black patients. In multivariable linear regression, both age and weight significantly increased over time. Manicuring was the most common etiology (30.9%), increasing in incidence over time and with a higher frequency in adults (p < 0.0001) and females (p < 0.0001). There was a significant decrease in pediatric paronychia cases over time, particularly in 0- to 4-year-olds. Possible limitations include missed paronychia cases or additional non-paronychia cases due to improper coding, infrequent race reporting, and inability to analyze treatments or distinguish between paronychia subtypes. Conclusions Paronychia cases were associated with increased age and weight over time with different presentations by age. Manicuring represents the largest growing paronychia etiology.
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Affiliation(s)
- Amar D. Desai
- Rutgers New Jersey Medical School, Newark, New Jersey, USA
| | - Yu Wang
- Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Shari R. Lipner
- Department of Dermatology, Weill Cornell Medicine, New York, New York, USA
- *Shari R. Lipner,
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11
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[Translated article] V-Block of the Great Toe for Surgical Treatment of an Ingrown Nail. ACTAS DERMO-SIFILIOGRAFICAS 2022. [DOI: 10.1016/j.ad.2020.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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12
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Sánchez Hernández S, Giralt de Veciana E. Anestesia del primer dedo del pie mediante técnica en V en el tratamiento quirúrgico de la onicocriptosis. ACTAS DERMO-SIFILIOGRAFICAS 2022; 113:425-426. [DOI: 10.1016/j.ad.2020.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/28/2020] [Accepted: 08/22/2020] [Indexed: 10/20/2022] Open
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13
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Kashiyama K, Nakano M, Higashi A, Ashizuka S, Moriuchi Y, Iwao A, Tanaka K. Distal nail embedding treatment using autogenous nails. Dermatol Ther 2021; 34:e15163. [PMID: 34665925 DOI: 10.1111/dth.15163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 10/13/2021] [Indexed: 11/29/2022]
Abstract
A regrowing nail tip after nail avulsion may excessively curve and invaginate into the nail bed. This is treated as a type of ingrown toenail, and is known as distal nail embedding. In most cases, further growth restores the original shape evenly over the nail bed. However, it is often painful and such cases may require treatment. We report a surgical approach that we applied to six cases of distal nail embedding involving pain or deformity of nails caused by a nail tip invaginating into the nail bed and/or cessation of forward nail growth. As our method involves removing a portion of the embedded tip edge nail and inserting the removed nail into the remaining depressed portion, the nail can grow over the bulge. In all six patients in whom we applied this method, the pain and nail deformity resolved and there was no recurrence. We used autogenous nails, which can reduce the pressure imbalance on a nail bed, and this contributed to improving the morphology of nails and nail beds. In addition, the risk of a hypertrophied nail is reduced because half of the nail adheres to the nail bed. Special materials are unnecessary and this method can be conducted with simple outpatient department procedures. There were no cases of a fixed nail section detaching due to a bulge at the nail tip. The inserted nail was maintained in all cases for several months until the nail grew over the bulge.
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Affiliation(s)
- Kazuya Kashiyama
- Department of Plastic and Reconstructive Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan.,Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Motoi Nakano
- Department of Plastic and Reconstructive Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan
| | - Akihito Higashi
- Department of Plastic and Reconstructive Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan.,Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Shoko Ashizuka
- Department of Plastic and Reconstructive Surgery, Nagasaki Harbor Medical Center, Nagasaki, Japan.,Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Yuki Moriuchi
- Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Atsuhiko Iwao
- Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan
| | - Katsumi Tanaka
- Department of Plastic and Reconstructive Surgery, Nagasaki University Hospital, Nagasaki, Japan
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Villa Verde RB, Ramirez-Oliveros JF, Takamitsu HM, Leverone AP, Nakamura RC. Treatment of Nail Fold Hypertrophy by Combining Conservative Techniques. Skin Appendage Disord 2021; 7:373-376. [PMID: 34604327 DOI: 10.1159/000515185] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/09/2021] [Indexed: 11/19/2022] Open
Abstract
Introduction Hypertrophy of the nail folds is a common condition. It occurs by alteration of shape, partial loss, or absence of the nail, resulting in loss of the nail fold physiological limit. This can also occur by the friction of the nail with the nail fold. Consequently, there is an increase in the volume of the lateral or distal nail fold and a decrease in the space of the nail bed and the nail plate. Management of this onychodystrophy may be conservative or surgical. Case Presentation We present a case of distal nail embedding after trauma, submitted to conservative treatment. Combined techniques were required as trichloroacetic acid application, rolled cotton padding maneuver, artificial resin nail technique, and orthesis. After 14 months, good functional and aesthetic results were obtained, with correction of the anatomical shape of the nail unit. Conclusion The conservative techniques for hypertrophy of the nail folds are a useful option with good functional and aesthetic results. The indication must be precise, considering the history of the patient and after discarding bone alterations by image exams. The disadvantage of the method is the long treatment time and constant visits to the doctor's office.
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Affiliation(s)
- Renata Brandão Villa Verde
- Nail Study Center of the Institute of Dermatology Professor Rubem David Azulay, Santa Casa da Misericódia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joaquín Felipe Ramirez-Oliveros
- Nail Study Center of the Institute of Dermatology Professor Rubem David Azulay, Santa Casa da Misericódia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heloisa Maria Takamitsu
- Nail Study Center of the Institute of Dermatology Professor Rubem David Azulay, Santa Casa da Misericódia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andreia Pizarro Leverone
- Nail Study Center of the Institute of Dermatology Professor Rubem David Azulay, Santa Casa da Misericódia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Robertha Carvalho Nakamura
- Nail Study Center of the Institute of Dermatology Professor Rubem David Azulay, Santa Casa da Misericódia do Rio de Janeiro, Rio de Janeiro, Brazil
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15
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Jakubowska M, Wcisło-Dziadecka D. Conservative management of a severe case of onychocryptosis at a podiatric clinic-A case report. J Cosmet Dermatol 2021; 21:1093-1097. [PMID: 33983657 DOI: 10.1111/jocd.14222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 04/27/2021] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Onychocryptosis, also known as ingrown toenails or ungues incarnati, is a fairly frequent condition, with global prevalence of approximately 20%. OBJECTIVES This study is aimed at discussing possible conservative management of severe onychocryptosis, with a case report. METHODS Conservative approach is effective in reducing or even entirely correcting underlying nail deformities. Eliminating nail fold inflammation is necessary prior to the bracing procedure. The non-surgical approach combined with proper wound treatment of the involved nail folds is a promising alternative for a growing number of patients. RESULTS Nail plate deformities may be largely corrected or fully eliminated. As demonstrated by our case report, even advanced stages of onychocryptosis may be effectively treated with nonsurgical modalities. CONCLUSION Proper podiatric care facilitates conservative approach to management of ingrown toenails, improving the patient's overall wellbeing and eliminating pain. The prerequisite for nonsurgical correction of the nail plate is treating inflammation first. Conservative correction is more aesthetically pleasing and less emotionally disturbing to the patients than partial or complete surgical avulsion. Lesser invasiveness is an advantage especially in the case of patients with chronic comorbidities.
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Affiliation(s)
- Michalina Jakubowska
- Podiatry Clinic Michalina Jakubowska, Tarnowskie Góry, Silesia, Poland.,Department of Cosmetology, Chair of Cosmetology, School of Pharmaceutical Science in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Dominika Wcisło-Dziadecka
- Department of Cosmetology, Chair of Cosmetology, School of Pharmaceutical Science in Sosnowiec, Medical University of Silesia, Katowice, Poland
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16
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Lampasi M, Bandinelli D, Abati CN, Bettuzzi C, Salvatori G, Bassi A, Filippeschi C, Oranges T. Nail changes in children with idiopathic congenital clubfoot deformity. Pediatr Dermatol 2021; 38:617-622. [PMID: 33848026 DOI: 10.1111/pde.14609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND/OBJECTIVES Nail alterations are commonly seen in cases of idiopathic clubfoot and may cause parental concern. The nature of and whether these changes are congenital or develop secondary to treatment has been poorly investigated. The aim of this study was to evaluate toenail morphology in clubfoot patients at presentation, to re-evaluate them during the course of treatment for the clubfoot, and to analyze findings in the light of the few literature reports for healthy children of the same age. METHODS Thirty infants (21 males and 9 females) with idiopathic clubfoot were prospectively enrolled at the Anna Meyer Children's University Hospital. Nails of affected and non-affected feet were evaluated by a team of pediatric dermatologists at presentation and re-evaluated once per patient during the bracing period of Ponseti treatment. RESULTS Toenails of affected (47) and non-affected (13) feet were abnormal at presentation in 43.3% of patients, in both clubfeet (40.4%) and non-affected feet (38.5%), but most changes were physiologic or transitory alterations, commonly found in healthy children, with nail concavity (koilonychia) being the most common finding (29.7%). Changes were not related to clubfoot severity or laterality (P > .05). In most (76.9%) unilateral cases, there was concordance of nail changes between clubfoot and non-affected foot. At re-evaluation (follow-up time 410 ± 207 days), nail problems were more frequent (53.3%); ingrown toenail was the most common (21.6%). CONCLUSIONS The presence of nail alterations seems not to be caused by clubfoot pathology and could be related to unfavorable local condition in the brace.
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Affiliation(s)
- Manuele Lampasi
- Ortopediatria Center for Education, Research and Patient Care in Paediatric Orthopedics, Bologna, Italy
| | - Diletta Bandinelli
- Department of Orthopedics and Traumatology, University of Perugia, R. Silvestrini Hospital, Perugia, Italy
| | | | - Camilla Bettuzzi
- Department of Paediatric Orthopedics, Anna Meyer Children's Hospital, Florence, Italy
| | - Giada Salvatori
- Ortopediatria Center for Education, Research and Patient Care in Paediatric Orthopedics, Bologna, Italy.,Department of Paediatric Orthopedics, Anna Meyer Children's Hospital, Florence, Italy
| | - Andrea Bassi
- Dermatology Unit, Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
| | - Cesare Filippeschi
- Dermatology Unit, Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
| | - Teresa Oranges
- Dermatology Unit, Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
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Moellhoff N, Polzer H, Baumbach SF, Kanz KG, Böcker W, Bogner-Flatz V. [Unguis incarnatus-conservative or operative treatment? A practical treatment algorithm]. Unfallchirurg 2021; 124:311-318. [PMID: 33111185 PMCID: PMC7985053 DOI: 10.1007/s00113-020-00903-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/02/2022]
Abstract
Unguis incarnatus, an ingrown toenail, is a common condition in primary care, which is encountered by various medical professions. Inconsistent conservative treatment and nonindicated surgical treatment often result in complications and recurrence of the disease. Patients must be thoroughly informed about the complexity of the nail organ. This is a prerequisite to prevent trivialization of the disease and to achieve appropriate patient compliance for treatment. In this article a practical diagnostic and treatment algorithm for unguis incarnatus is presented. In mild cases of acute unguis incarnatus a consistent conservative treatment is the first-line strategy showing promising results. In cases of moderate to severe forms of acute unguis incarnatus, surgical procedures that preserve the nail matrix should be applied. For cases of chronic unguis incarnatus without an acute infection, elective partial matrixectomy can be indicated. Prior to any surgical intervention, detailed informed consent must be obtained from the patients.
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Affiliation(s)
- N Moellhoff
- Abteilung für Hand‑, Plastische und Ästhetische Chirurgie, Klinikum der Universität München, LMU München, Pettenkoferstr. 8a, 80336, München, Deutschland.
| | - H Polzer
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, München, Deutschland
| | - S F Baumbach
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, München, Deutschland
| | - K G Kanz
- Klinik und Poliklinik für Unfallchirurgie, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
| | - W Böcker
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, München, Deutschland
| | - V Bogner-Flatz
- Klinik für Allgemeine, Unfall- und Wiederherstellungschirurgie, Klinikum der Universität München, LMU München, München, Deutschland
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18
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Dąbrowski M, Litowińska A, Cieślak J. Efficacy of a tip of the big toe remodeling in the distal nail embedding with bone overgrowth of the distal phalanx. Ann Med Surg (Lond) 2020; 58:160-166. [PMID: 32983438 PMCID: PMC7498710 DOI: 10.1016/j.amsu.2020.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 08/24/2020] [Accepted: 08/25/2020] [Indexed: 11/25/2022] Open
Abstract
Introduction Distal nail embedding due to hyponychium hypertrophy can be caused by traumatic or surgical avulsion of the nail. As a consequence of these changes, the nail plate is blocked through the deformed tip of the toe. Changes that occur at the tip of the big toe are due to bone growth on the dorsal surface of the distal end of the distal phalanx. This study aimed to present a surgical technique for the treatment of hypertrophy of the tip of the toe and evaluate its effectiveness. Material and methods The surgical technique involved remodeling of the tip of the big toe, with removal of the hypertrophied bone of the distal phalanx. The procedure was assessed by using a questionnaire. Results We included the 108 distal embedded nails. A total of 85% of respondents were satisfied with the procedure. Nearly 80% of patients rated the cosmetic effect as good or very good. Conclusions The technique was an effective treatment and increased the quality of life of those with disorders of nail growth associated with hypertrophy of the tip and hyponychium, with bone overgrowth. Distal nail embedding (type of ingrown toenail) is correlated with overgrowth bone. The causing distal nail embedding with bone outgrowth is mechanical injury. This surgical technique is efficacy (restore normal nail growth) and safety.
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Affiliation(s)
- Mikołaj Dąbrowski
- Department of Spine Orthopedics and Biomechanics, Poznan University of Medical Sciences, Poznan, Poland.,Anmedica-Healthy Foot Center, Poznan, Poland
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19
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Zanatta M, Basile F, Basile G, Donati M. HOW TO MANAGE A REAL CLINICAL RARITY: PLURI-RECURRENT INGROWN FINGERNAIL. THE JOURNAL OF CLINICAL AND AESTHETIC DERMATOLOGY 2020; 13:12-13. [PMID: 33178374 PMCID: PMC7595362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Michela Zanatta
- Drs. Zanatta, Donati, and F. Basile are with the Department of Surgery and Medical-Surgical Specialties for the Surgical Clinic Unit at the University Hospital of Catania, University of Catania in Italy
- Dr. G. Basile is with the Department of Surgery and Medical-Surgical Specialties for the Emergency and Abdominal Surgery Unit at the University Hospital of Catania, University of Catania in Italy
| | - Francesco Basile
- Drs. Zanatta, Donati, and F. Basile are with the Department of Surgery and Medical-Surgical Specialties for the Surgical Clinic Unit at the University Hospital of Catania, University of Catania in Italy
- Dr. G. Basile is with the Department of Surgery and Medical-Surgical Specialties for the Emergency and Abdominal Surgery Unit at the University Hospital of Catania, University of Catania in Italy
| | - Guido Basile
- Drs. Zanatta, Donati, and F. Basile are with the Department of Surgery and Medical-Surgical Specialties for the Surgical Clinic Unit at the University Hospital of Catania, University of Catania in Italy
- Dr. G. Basile is with the Department of Surgery and Medical-Surgical Specialties for the Emergency and Abdominal Surgery Unit at the University Hospital of Catania, University of Catania in Italy
| | - Marcello Donati
- Drs. Zanatta, Donati, and F. Basile are with the Department of Surgery and Medical-Surgical Specialties for the Surgical Clinic Unit at the University Hospital of Catania, University of Catania in Italy
- Dr. G. Basile is with the Department of Surgery and Medical-Surgical Specialties for the Emergency and Abdominal Surgery Unit at the University Hospital of Catania, University of Catania in Italy
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20
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Kavoussi H, Ebrahimi A, Rezaei M, Salimi E, Rashidian H, Kavoussi R. A comparison of effectiveness and cosmetic outcome of two methods for ingrown toenail: partial nail matricectomy using CO2 laser versus lateral nail fold excision. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2020. [DOI: 10.15570/actaapa.2020.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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21
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Kuros F, Wcisło-Dziadecka D. A case of ingrown nail using buckle VHO-Osthold® Perfect as a method of conservative treatment. J Cosmet Dermatol 2020; 20:290-294. [PMID: 32428311 DOI: 10.1111/jocd.13495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/13/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Ingrowing Nail is an ailment in the toe area. This problem is observed in 20% of the population, in all age groups, but most often occurs in teenagers and young adults. The process of ingrowing nail stimulates natural defense mechanisms of the body in the form of inflammation and severe pain. AIMS The aim of this paper was to make the VHO-Osthold® Perfect buckle effective as an alternative to nail plate surgery and to determine the patient's comfort during this method of treatment. PATIENTS/METHODS A descriptive case study conducted in a 15-year-old patient who had ingrowing nails in the big toes of both feet. RESULTS It has been shown that the VHO-Osthold® Perfect buckle therapy constitutes an effective method for ingrowing nails and one in a few conservative methods in orthonyxia, as an alternative to surgery. CONCLUSIONS The study and clinical experience confirm that the therapy of ingrowing nails with the VHO-Osthold® Perfect buckle is painless and noninvasive. This treatment can be safely and effectively carried out by a qualified podiatrist or cosmetologist in podological practice.
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Affiliation(s)
- Faustyna Kuros
- Institute of Health Sciences Podhale State Higher Vocational School in Nowy Targ, Nowy Targ, Poland
| | - Dominika Wcisło-Dziadecka
- Department of Cosmetology, Chair of Cosmetology, School of Pharmaceutical Science in Sosnowiec, Medical University of Silesia in Katowice, Sosnowiec, Poland
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22
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Kilinc E, Buturak B, Alkan FA. Level of trace elements in serum and toenail samples of patients with onychocryptosis (ingrown toenail) and onychomycosis. J Trace Elem Med Biol 2020; 61:126509. [PMID: 32302924 DOI: 10.1016/j.jtemb.2020.126509] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 02/28/2020] [Accepted: 03/18/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Onychocryptosis (ingrown toenail) and onychomycosis are common pathologies of the toenail and affecting many people. Since levels of trace elements have been shown to vary in certain diseases, in the presented work, chromium (Cr), copper (Cu), iron (Fe), magnesium (Mg), manganese (Mn), selenium (Se), and zinc (Zn) levels of toenail and serum samples of healthy individuals and patients with onychocryptosis and onychomycosis were compared. METHODS Serum and toenail samples of 88 voluntary subjects (healthy n = 24; onychomycosis n = 24; onychocryptosis n = 40) aged between 19-80 years were collected. Levels of trace elements in the samples were analyzed by using an inductively coupled plasma-optical emission spectrophotometer (ICP-OES Thermo iCAP - 6000). The differences in medians between the groups for elements were evaluated with Kruskal -Wallis H test with post hoc for pairwise comparisons in SPSS 18. RESULTS Mg (p < 0.001) and Mn (p = 0.002) levels were significantly increased whereas Zn (p = 0.011) level was decreased in toenails of patients with onychomycosis compared to healthy subjects. Although Mg and Mn levels were higher in female subjects with onychomycosis (p = 0.001; p = 0.019), Mn was only increased in male subjects (p = 0.015). Mg was the only trace element found to be independent of sex, age, and smoking status in patients with onychomycosis. However, no significant difference has been found in serum trace element levels neither between any groups nor toenail trace element levels of patients with onychocryptosis and healthy subjects. CONCLUSION As a response of the human body to pathogens like fungi in toenails, Mg, Mn and Zn levels vary. Especially the role of Mg ions in onychomycosis needs to be investigated more specifically.
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Affiliation(s)
- Evren Kilinc
- Department of Biophysics, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Kayışdağı Caddesi No: 32, 34752, Ataşehir, Istanbul, Turkey.
| | - Birce Buturak
- Podology, Vocational School of Health Services, Acibadem Mehmet Ali Aydinlar University, Kayışdağı Caddesi No: 32, 34752, Ataşehir, Istanbul, Turkey
| | - Fatma Ates Alkan
- Department of Biophysics, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapaşa Cad. No: 34/E Fatih, Istanbul, Turkey
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23
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Liu Z. A preliminary study on high‐frequency ultrasonography and dermoscopy for grade 3 ingrown toenail. Skin Res Technol 2020; 26:762-765. [DOI: 10.1111/srt.12848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 03/03/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Ze‐Hu Liu
- Department of Dermatology Affiliated Hangzhou Third Hospital Anhui Medical University Hangzhou China
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CHANG HC, LIN MH. Comparison of Chemical Matricectomy with Trichloroacetic Acid, Phenol, or Sodium Hydroxide for Ingrown Toenails: A Systematic Review and Network Meta-Analysis. Acta Derm Venereol 2020; 100:adv00065. [PMID: 31776585 PMCID: PMC9128932 DOI: 10.2340/00015555-3379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2019] [Indexed: 11/16/2022] Open
Abstract
is missing (Short communication).
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Affiliation(s)
- Hua-Ching CHANG
- Department of Dermatology, Taipei Medical University Hospital, No. 252, Wuxing St, Xinyi District, Taipei City, 110
| | - Ming-Hsiu LIN
- Department of Dermatology, Taipei Medical University Hospital, No. 252, Wuxing St, Xinyi District, Taipei City, 110
- Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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25
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Efficacy of Nail Braces for Acute and Chronic Ingrown Toenails: A Prospective Study. Dermatol Surg 2020; 46:258-266. [DOI: 10.1097/dss.0000000000001905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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26
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Thakur V, Vinay K, Haneke E. Onychocryptosis – decrypting the controversies. Int J Dermatol 2020; 59:656-669. [DOI: 10.1111/ijd.14769] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/21/2019] [Accepted: 12/18/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Vishal Thakur
- Department of Dermatology, Venereology, and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology, and Leprology Postgraduate Institute of Medical Education and Research Chandigarh India
- Department of Dermatology Inselspital University of Bern Bern Switzerland
| | - Eckart Haneke
- Department of Dermatology Inselspital University of Bern Bern Switzerland
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27
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Sandhiya R, Rao R. "An Uncanny Kin of the Ingrown Toenail": Harpoon Nail and the Surgical Challenge in Its Management. J Cutan Aesthet Surg 2020; 13:142-144. [PMID: 32792774 PMCID: PMC7394108 DOI: 10.4103/jcas.jcas_99_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Ingrown toenails result from the painful conflict between the nail plate and the surrounding soft tissues. Ingrowing may be precipitated by improper nail cutting in most instances, and occlusive footwear and trauma, in others. The most common type of ingrown nail is the distal lateral variant. We report a relatively unique and rare case of ingrown nail-the harpoon nail, wherein the distal lateral spur arising from improper and incomplete trimming of the nail, pierced through the distolateral wall until it appeared over the tip of the toe. It is a cause of great morbidity to the patient and this report envisages the need for the correct surgical approach.
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Affiliation(s)
- Ramesh Sandhiya
- Department of Dermatology, Venereology, and Leprosy, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Raghavendra Rao
- Department of Dermatology, Venereology, and Leprosy, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India,Address for correspondence: Dr. Raghavendra Rao, Department of Dermatology, Venereology, and Leprosy, Kasturba Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India. E-mail:
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28
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Fonia A, Richert B. Onychalgia Causes and Mechanisms: The “GIFTED KID” and the “FOMITE”. Skin Appendage Disord 2020; 6:77-87. [DOI: 10.1159/000504347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Accepted: 10/23/2019] [Indexed: 11/19/2022] Open
Abstract
This article gives an account of the commonest causes of nail pain. The acronyms GIFTED KID and FOMITE will help aid doctors in a busy clinical setting to remember the main causes of onychalgia, respectively, on the fingers and toes. It includes a brief overview of the clinical characteristics and focuses on the type of pain for each condition as well as the mechanisms that cause it.
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29
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Wang HH, Tsai TY, Liu CW, Huang YC. A new 1-sided nail brace for ingrown toenails of lesser toes. J Am Acad Dermatol 2019; 81:1024-1025. [DOI: 10.1016/j.jaad.2019.03.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 02/26/2019] [Accepted: 03/02/2019] [Indexed: 11/16/2022]
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30
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Effectiveness of Leukocyte and Platelet-Rich Fibrin versus Nitrofurazone on Nail Post-Surgery Bleeding and Wound Cicatrization Period Reductions: A Randomized Single Blinded Clinical Trial. J Clin Med 2019; 8:jcm8101552. [PMID: 31569623 PMCID: PMC6832351 DOI: 10.3390/jcm8101552] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/16/2019] [Accepted: 09/24/2019] [Indexed: 01/24/2023] Open
Abstract
Background: Leukocyte and platelet-rich fibrin (L-PRF) may be considered a co-adjuvant intervention that may play a key role in blood coagulation and tissue repair after nail surgeries. The aim of this study was to determine the effectiveness of L-PRF versus nitrofurazone on the post-surgical bleeding and wound cicatrization period in patients with bilateral onychocryptosis during surgeries of chemical matrixectomies with 88% phenol solution. Methods: A randomized single-blind clinical trial was registered with the European Clinical Trials Database (EudraCT) with identification number 2016-002048-18. Twenty healthy participants with bilateral onychocryptosis (n = 40) were recruited and bilaterally received both protocols for both halluces. Patients with a mean age mean of 45.55 ± 12.19 years attended a specialized foot and ankle surgery clinic. Both halluces of each patient were randomized and allocated to receive L-PRF (experimental group; n = 20 halluces) or nitrofurazone (control group; n = 20 halluces) interventions in conjunction with surgery of chemical matrixectomies with 88% phenol solution for bilateral ingrown of toenail border (medial and lateral). Patients were blinded to their intervention in each hallux. The primary outcome measurement was post-surgical bleeding. The secondary outcome measurements were post-surgical pain intensity, inflammation, infection, analgesic intake, and wound cicatrization period. Results: Statistically significant differences (p < 0.001) were found between both groups showing a reduction for wound cicatrization period and post-surgical bleeding for the L-PRF intervention with respect to nitrofurazone treatment. The rest of the outcome measurements did not show any statistically significant differences (p > 0.05). Conclusions: L-PRF rather than nitrofurazone in conjunction with chemical matrixectomies performed with 88% phenol solution reduced the wound cicatrization period and bleeding after nail surgery. Thus, L-PRF may be considered a first-line co-adjuvant intervention for patients who suffer from nail problems, such as onychocryptosis, that require surgical procedures.
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Gera SK, PG Zaini DKH, Wang S, Abdul Rahaman SHB, Chia RF, Lim KBL. Ingrowing toenails in children and adolescents: is nail avulsion superior to nonoperative treatment? Singapore Med J 2019; 60:94-96. [PMID: 30843080 DOI: 10.11622/smedj.2018106] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Ingrowing toenail (IGTN) or onychocryptosis is not uncommon in children and adolescents. However, there is a dearth of evidence in the literature on the management of IGTN in this age group. This study aimed to compare the results of nonoperative treatment for IGTN with that of operative treatment among children and adolescents. METHODS All children and adolescents who were treated for IGTN at our institution between 2010 and 2014 were included for this retrospective study. Demographic data, treatment prescribed and outcome at six months after presentation were analysed. RESULTS Overall, 199 patients were recruited. There were 123 (61.8%) boys and 76 (38.2%) girls. Median age was 14 years. Among 199 toes, 162 (81.4%) were treated nonoperatively, with nail care advice, topical antibiotics and daily cleansing. Only 37 (18.6%) toes were treated operatively. In the operative group, 23 (62.2%) patients underwent wedge resections, while the remaining 14 (37.8%) had total nail avulsions; for all patients, germinal matrices were preserved. At the six-month follow-up, there were 5 (3.1%) cases of recurrence in the nonoperative group when compared to 3 (8.1%) recurrences in the operative group. CONCLUSION We recommend that IGTN in children and adolescents be treated in the first instance by nonoperative methods. Operative options can be considered for resistant cases or in case of recurrence of IGTN.
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Affiliation(s)
- Sumanth Kumar Gera
- Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore
| | | | - Shiyao Wang
- Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore
| | | | - Rui Fang Chia
- Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore
| | - Kevin Boon Leong Lim
- Department of Orthopaedic Surgery, KK Women's and Children's Hospital, Singapore
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Miao F, Nie S, Wang HW. B/S Brace as an Alternative Treatment for Ingrown Toenails. Chin Med J (Engl) 2019; 131:2373-2375. [PMID: 30246731 PMCID: PMC6166465 DOI: 10.4103/0366-6999.241807] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Fei Miao
- Department of Dermatology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
| | - Shu Nie
- Department of Dermatology and Venereal Diseases, School of Medicine, Shanghai Medical College, Fudan University, Shanghai 200032, China
| | - Hong-Wei Wang
- Department of Dermatology, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China
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Arica IE, Bostanci S, Koçyigit P, Arica DA. Clinical and Sociodemographic Characteristics of Ingrown Nails in Children. J Am Podiatr Med Assoc 2019; 109:272-276. [PMID: 31762314 DOI: 10.7547/17-089] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ingrown nail is a condition frequently seen in children and adolescents, the pain from which can affect their daily living activities and school performances. The purpose of this study was to determine the clinical and sociodemographic characteristics of ingrown nails in children. METHODS The clinical and sociodemographic characteristics of patients aged 0 to 18 years presenting with ingrown nail were evaluated retrospectively from clinic records. RESULTS Sixty-two patients aged 3 to 18 years (mean age, 15 years; male to female ratio, 1.06) were enrolled. A total of 175 ingrown nails were evaluated (all of them were in the halluces, 54.3% of them were on the lateral margin). A positive family history of ingrown nail was present in 15.7%. High prevalences of incorrect nail cutting (72.1%), trauma (36.1%), poorly fitting shoes (29%), hyperhidrosis (12.9%), obesity (9.7%), and accompanying nail disorders (9.7%) were determined among the patients. CONCLUSIONS This study revealed the clinical and sociodemographic characteristics of ingrown nails in children. These data will be useful in preventing the occurrence of ingrown nail by revealing and then eliminating predisposing factors.
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Affiliation(s)
- Ibrahim Etem Arica
- Department of Dermatology, Kanuni Education and Research Hospital, Trabzon, Turkey
| | - Seher Bostanci
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Pelin Koçyigit
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Deniz Aksu Arica
- Department of Dermatology and Venereology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey
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Carbonell Buj E, Farrell M. Permanent cessation of nail growth using multiple nail plate avulsions and phenolisation in a dog. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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35
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Arica IE, Bostanci S, Kocyigit P, Arica DA. Clinical and Sociodemographic Characteristics of Patients with Ingrown Nails. J Am Podiatr Med Assoc 2019; 109:201-206. [PMID: 31268783 DOI: 10.7547/17-023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Ingrown nail is a common health problem that significantly affects daily life due to its painful nature. The purpose of this study was to reveal the clinical and sociodemographic characteristics of ingrown nails. METHODS The clinical and sociodemographic characteristics of patients older than 18 years presenting with ingrown nail were investigated. RESULTS Two hundred six patients aged 18 to 77 years (mean age, 39 years; female to male ratio, 1.45) were included in the study. A total of 729 lesions were evaluated (718 ingrown nails were on the feet and 11 were on the fingers). A family history of ingrown nail was present in 7.6% of the participants. Of the 206 patients, 26.7% were treated with surgical methods for ingrown nails previously and experienced recurrence. Ingrown toenails were in the hallux in 81.3% of patients, and 52% were on the lateral margin. Incorrect nail-cutting habits (73.5%), poorly fitting shoes (46.2%), excessive angulation of the nail plate (35.8%), obesity (34.1%), trauma to the feet (24.3%), pregnancy (23.8% of women), hyperhidrosis (16.8%), and lateral deviation of the nail plate (9.9%) were closely associated with ingrown nails. CONCLUSIONS This study revealed the clinical and sociodemographic characteristics of ingrown nails. The study data will be useful in preventing the development of ingrown nail and recurrences after treatment by identifying and then eliminating conditions establishing a predisposition to it.
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Affiliation(s)
- Ibrahim Etem Arica
- Department of Dermatology, Kanuni Education and Research Hospital, Trabzon, Turkey
| | - Seher Bostanci
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Pelin Kocyigit
- Department of Dermatology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Deniz Aksu Arica
- Department of Dermatology and Venereology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey
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Singal A, Kaur I. Radio-frequency Ablation for Matricectomy in the Management of Ingrown Toenail: A Pilot Study. J Cutan Aesthet Surg 2019; 12:212-214. [PMID: 32001964 PMCID: PMC6967168 DOI: 10.4103/jcas.jcas_3_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Ingrown toenail is one of the most commonly encountered nail disorders that adversely affect the quality of life. The common surgical intervention includes partial nail avulsion with chemical matricectomy but it has a relatively longer recovery period. We attempted to study the efficacy and safety of radio frequency (RF) for matricectomy. Materials and Methods: Eight patients with total 10 ingrown toenails (grade 2) were recruited. Partial nail avulsion with RF ablation of matrix was performed. The radio-frequency electrode was placed over the lateral matrix horn for the duration of 3–5s, two to three times. Patients were followed up at regular interval. Outcome was measured in terms of ooze, erythema, pain, and swelling of the lateral nail folds. Results: Of the eight patients, six were males and two were females. Total 10 nails were treated as two patients had bilateral toenail involvement. Average number of days required for postprocedural healing was 7.5 days. Significant improvement was observed in terms of erythema, pain as well as swelling within 4 days of surgery. None of the cases showed any adverse effects or relapse within 3–5 months of follow-up. Conclusion: Matricectomy by radio-frequency ablation is a safe and effective method in the management of ingrown toenail with significant reduction in downtime.
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Affiliation(s)
- Archana Singal
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
| | - Ishmeet Kaur
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India
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Akkus A, Demirseren DD, Demirseren ME, Aktas A. The treatment of ingrown nail: Chemical matricectomy with NAOH versus wedge resection. Dermatol Ther 2018; 31:e12677. [PMID: 30134040 DOI: 10.1111/dth.12677] [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: 11/06/2017] [Revised: 01/13/2018] [Accepted: 07/10/2018] [Indexed: 11/27/2022]
Abstract
Ingrown nail is a common problem seen in the dermatology clinics. The aim of this study is to compare the wedge resection method and chemical matricectomy with NaOH in terms of operation time, postoperative pain severity, postoperative drainage, recurrence rates, recovery time, and the effects of these two methods on Dermatology Quality of Life Index. This study included 60 patients. About 42 nail edges of 30 patients were treated with NaOH for chemical matricectomy and wedge resection was performed for 33 nail edges of 30 patients. Operation time for chemical matricectomy and wedge resection was an average of 7.66 ± 3.65 and 19.25 ± 5.54 min (p < .001). Recovery time was an average of 17.27 ± 14.22 days for chemical matricectomy and an average of 28.85 ± 17.03 days for wedge resection (p = .004). Recurrence was detected in 5.4% of the nail edges treated with chemical matricectomy and 3.6% of the nail edges treated with wedge resection (p = 1.000). Absence of differences for the recurrence rates between wedge resection method and chemical matricectomy method with NaOH shows that effectiveness of these approaches are similar. It seems that quite short operation and recovery times in the chemical matricectomy are the main advantage of the method.
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Affiliation(s)
- Ayse Akkus
- Dermatology Clinic, Tunceli State Hospital, Tunceli, Turkey
| | | | - Mustafa Erol Demirseren
- Plastic and Reconstructive Surgery Clinic, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
| | - Akın Aktas
- Dermatology Clinic, Ankara Atatürk Training and Research Hospital, Ankara, Turkey
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Treatment of Ingrowing Toenails With Phenol 88% or Trichloroacetic Acid 100%: A Comparative, Prospective, Randomized, Double-Blind Study. Dermatol Surg 2018; 44:645-650. [PMID: 29701619 DOI: 10.1097/dss.0000000000001499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Phenol is the gold standard for chemical matricectomy in ingrowing toenail. Recently, trichloroacetic acid (TCA) was used as cauterant. Both agents have high success rates but a postoperative healing time claimed to be faster for TCA rather than phenol. OBJECTIVE Comparing the efficacy, the postoperative oozing time, the inflammatory reaction, and the postoperative pain. MATERIALS AND METHODS Comparative, prospective, randomized, double-blind study. Eighty-four patients with 96 ingrowing toenails were randomized in 2 groups. Forty-six ingrowing toenails were treated with phenol 88% and 50 with TCA 100% within a 4-month period. Patients were observed 4 times for the presence of oozing and for the degree of inflammation. Patients assessed also oozing and pain on a scale basis during 34 days. RESULTS Oozing was observed to be less with phenol treatment, as from the second week. Inflammation was also significantly inferior in the phenol group at Week 4. Patients evaluated the incidence of pain below 2/10 for both cauterants, while oozing was higher with TCA during 34 days. The overall success rates of both groups were similar with 100%. CONCLUSION Phenol and TCA are both effective but TCA does not offer any advantage in terms of postoperative morbidity compared with phenol.
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Borelli S, Lautenschlager S. [Nail diseases]. MMW Fortschr Med 2018; 160:52-57. [PMID: 29754380 DOI: 10.1007/s15006-018-0016-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Siegfried Borelli
- Dermatologisches Ambulatorium, Stadtspital Triemli Zürich, Herman-Greulich-Str. 70, CH-8004, Zürich, Schweiz.
| | - Stephan Lautenschlager
- Dermatologisches Ambulatorium, Stadtspital Triemli Zürich, Herman-Greulich-Str. 70, CH-8004, Zürich, Schweiz
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40
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Liu CW, Huang YC. Die Wirksamkeit einer neuen Nagelspange für die Behandlung von eingewachsenen Nägeln. J Dtsch Dermatol Ges 2018; 16:417-425. [DOI: 10.1111/ddg.13462_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/11/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Che-Wei Liu
- Abteilung für Orthopädie; Cathy General Hospital; Taipei City Taiwan
| | - Yu-Chen Huang
- Abteilung für Dermatologie; Wan Fang Hospital; Taipei Medical University; Taipeh Taiwan
- Abteilung für Dermatologie; School of Medicine; College of Medicine; Taipei Medical University; Taipeh Taiwan
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41
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Liu CW, Huang YC. Efficacy of a new nail brace for the treatment of ingrown toenails. J Dtsch Dermatol Ges 2018; 16:417-423. [DOI: 10.1111/ddg.13462] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 08/11/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Che-Wei Liu
- Department of Orthopedics; Cathy General Hospital; Taipei City Taiwan
| | - Yu-Chen Huang
- Department of Dermatology; Wan Fang Hospital; Taipei Medical University; Taipei City Taiwan
- Department of Dermatology; School of Medicine; College of Medicine; Taipei Medical University; Taipei City Taiwan
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43
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Ezekian B, Englum BR, Gilmore BF, Kim J, Leraas HJ, Rice HE. Onychocryptosis in the Pediatric Patient. Clin Pediatr (Phila) 2017; 56:109-114. [PMID: 27941086 DOI: 10.1177/0009922816678180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | - Jina Kim
- 1 Duke University Medical Center, Durham, NC, USA
| | | | - Henry E Rice
- 1 Duke University Medical Center, Durham, NC, USA
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44
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A new and simple suturing technique applied after surgery to correct ingrown toenails may improve clinical outcomes: A randomized controlled trial. Int J Surg 2016; 34:1-5. [DOI: 10.1016/j.ijsu.2016.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 07/22/2016] [Accepted: 08/04/2016] [Indexed: 11/21/2022]
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45
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Du JF, Xi XY, Liu ZH. Successful conservative treatment with cotton wisp for ingrown toenail with granulation. Dermatol Ther 2016; 29:486-487. [DOI: 10.1111/dth.12392] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Jun-Feng Du
- Huazhong University of Science and Technology
| | - Xiao-Yan Xi
- Huazhong University of Science and Technology
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Jellinek NJ, Vélez NF. Dermatologic Manifestations of the Lower Extremity: Nail Surgery. Clin Podiatr Med Surg 2016; 33:319-36. [PMID: 27215154 DOI: 10.1016/j.cpm.2016.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Nail surgery is a fundamental component of podiatric surgery. Nail disorders are common and may cause significant morbidity and occasionally mortality. Diagnosis of inflammatory and infectious conditions, and of benign or malignant tumors, often requires a biopsy of the nail unit. Excisional surgery may also be curative for certain tumors. This article reviews key elements of nail anatomy, surgical preparation, local anesthesia, and methods to achieve and maintain a bloodless field. A familiarity with these concepts should allow clinicians to develop a surgical plan and approach when patients present with a nail disorder requiring biopsy or surgical treatment.
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Affiliation(s)
- Nathaniel J Jellinek
- Dermatology Professionals, Inc, 1672 South County Trail, Suite 101, East Greenwich, RI 02818, USA; Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, RI, USA; Division of Dermatology, University of Massachusetts Medical School, Worcester, MA, USA.
| | - Nicole F Vélez
- Westmoreland Dermatology Associates, Monroeville, PA, USA
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Guler O, Tuna H, Mahirogullari M, Erdil M, Mutlu S, Isyar M. Nail Braces as an Alternative Treatment for Ingrown Toenails: Results From a Comparison With the Winograd Technique. J Foot Ankle Surg 2015; 54:620-4. [PMID: 25937564 DOI: 10.1053/j.jfas.2015.04.013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Indexed: 02/03/2023]
Abstract
Ingrown toenails are one of the most frequent nail disorders and can be treated with conservative or surgical approaches. Although discovered a long time ago, the available data are still very limited on the potential effectiveness of nail braces for ingrown toenail treatment. In the present retrospective study, we compared nail braces with surgical wedge excision using the Winograd technique with respect to the time to return to work, recurrence, interval to recurrence, and patient satisfaction. A total of 159 patients were divided into the nail brace (n = 74; mean age 29.51 ± 8.48 years) and Winograd technique (n = 85; mean age 26.95 ± 8.06 years) groups. In the nail brace group, the mean time to return to work (4.15 ± 1.07 days) was significantly shorter than that in the Winograd technique group (13.8 ± 2.26 days; p < .001). Patient satisfaction was significantly greater in the nail brace group (94.6%) compared with the Winograd technique group (82.4%; p = .018). Of the 159 patients, 6 (8.1%) in the nail brace group and 8 (9.4%) in the Winograd technique group developed recurrence; however, this difference was not statistically significant (p > .05). A statistically significant difference was observed in the mean interval to recurrence (12.46 ± 1.60 versus 13.24 ± 2.48 months, respectively; p = .031). The progression-free follow-up periods for the nail brace and Winograd technique groups were 15.45 ± 0.22 months (95% confidence interval 15.02 to 15.88) and 17.18 ± 0.29 months (95% confidence interval 16.61 to 17.84), respectively. We have concluded that the use of nail braces is an appropriate alternative treatment of ingrown toenails with high patient satisfaction, fast recovery times, and a low recurrence rate.
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Affiliation(s)
- Olcay Guler
- Assistant Professor, Department of Orthopedics and Traumatology, Medipol University, Medical Faculty, Istanbul, Turkey.
| | - Hamide Tuna
- Dermatologist, Department of Dermatology, Nisa Hospital, Istanbul, Turkey
| | - Mahir Mahirogullari
- Professor, Department of Orthopedics and Traumatology, Medipol University, Medical Faculty, Istanbul, Turkey
| | - Mehmet Erdil
- Associate Professor, Department of Orthopedics and Traumatology, Medipol University, Medical Faculty, Istanbul, Turkey
| | - Serhat Mutlu
- Orthopedic Surgeon, Department of Orthopedics and Traumatology, Kanuni Sultan Suleyman Training Hospital, Istanbul, Turkey
| | - Mehmet Isyar
- Assistant Professor, Department of Orthopedics and Traumatology, Medipol University, Medical Faculty, Istanbul, Turkey
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Abstract
BACKGROUND Ingrown nails are a painful problem that affects all ages, particularly the young, and it may become chronic if not treated. OBJECTIVE A new technique was used to treat patients with Stages 2 and 3 ingrown nails in whom conservative and surgical methods were attempted. MATERIALS AND METHODS A total of 30 patients presenting with Stages 2 and 3 ingrown nails to the clinic between 2010 and 2012 were included. A wedge excision of the upper and lower soft tissues of the nail was performed. The wound margins were simply sutured with 2/0 polypropylene. Approximately 8 to 10 knots were tied without cutting the stitches under the nail. These knots were used to push the soft tissue down and to raise the nail. This was achieved by placing a knot under the nail after the needle had been passed inside the nail, without cutting the suture before another knot was tied above the nail. Therefore, the ingrown part of the nail was raised. RESULTS Patients were followed up for 20 months (range, 10-24 months). Relapse was observed in only 1 patient. No infection was observed, and none of the patients required additional surgery. CONCLUSION Stages 2 and 3 ingrown nails can also be safely treated with this technique.
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Affiliation(s)
- Bilsev Ince
- *All the authors are affiliated with the Department of Plastic and Reconstructive and Aesthetic Surgery, Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkey
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50
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Blatière V. [Ingrown nails or onychocryptosis]. Presse Med 2014; 43:1230-9. [PMID: 25448121 DOI: 10.1016/j.lpm.2014.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 09/16/2014] [Accepted: 09/23/2014] [Indexed: 11/18/2022] Open
Abstract
Ingrown nails come down to a conflict between the nail plate and the periungual tissue, causing pain, morbidity and impairment. The feet are mainly affected. The treatments are numerous: medical, podiatric, or surgical. Surgical management has two approaches: the techniques focused on the periungual skin and those on the nail plate. Among the latter, partial nail avulsion followed by matrix phenolization, known as "Boll's technique", is still highly regarded.
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Affiliation(s)
- Véronique Blatière
- CHU de Montpellier, service de dermatologie, 191, avenue du Doyen-Gaston-Giraud, 34295 Montpellier cedex 5, France. ,
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