Nails, Ingrown

钉子,Ingrown
  • 文章类型: Case Reports
    背景:模仿肿瘤的慢性向内脚趾指甲继发的巨大增生性瘢痕形成是一种罕见的疾病。它不仅在外观上引起关注,但也阻碍了身体和社交的正常日常活动。在本文中,我们提出了一个不寻常的情况下,双侧向内生长的指甲与不同的阶段。一个导致由继发性至慢性向内生长的指甲刺激引起的大的肥厚性瘢痕。
    方法:一名44岁的男子,他的右大脚趾有一个巨大的质量(7×4×8.5厘米),左脚趾向内生长的指甲发炎。右脚趾的肿块呈不规则和奇怪的形状,远端有星状溃疡(2×2cm)。三年前,在轻微的重复性创伤下移除向内生长的指甲后,自我管理的伤口已经长成肿瘤样的肿块,导致难以忍受的不适。从外表上看,茎似乎起源于甲床的外侧,大脚趾向内的指甲显示出发炎的内侧和外侧沟,并引起发红和压痛。巨大的肥厚性瘢痕形成继发于慢性向内生长的脚趾指甲模仿肿瘤是一种罕见的疾病,不仅引起美容问题,但也阻碍了身体和社交的正常日常活动。
    结果:对两个大脚趾进行切除活检。活检证实慢性溃疡性炎症伴肥厚性瘢痕。手术后12个月,切除部位愈合并持续良好。
    结论:我们的不寻常病例表明,未经处理的向内生长的脚趾指甲的自然过程可能导致肥厚性瘢痕延伸至模仿肿瘤状况。
    BACKGROUND: A huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease. It is not only causing concerns cosmetically, but also hindering normal daily activities physically and socially. In this paper, we present an unusual case of bilateral ingrown nails with different phases. One resulted in a large hypertrophic scar caused by stimulation from secondary to chronic ingrown nail.
    METHODS: A 44-year-old man with a huge mass (7 × 4 × 8.5 cm) in his right great toe and inflamed ingrown nail in his left great toe visited the clinic. The mass in the right toe showed an irregular and bizarre shape with a stellate ulcer (2 × 2 cm) at the distal end. After removing an ingrown nail 3 years ago with minor repetitive trauma, self-managed wound has grown into a tumor-like mass, resulting in intolerable discomfort. In gross appearance, a stalk appeared to originate from the lateral side of the nail bed with the ingrown nail in the great toe showing inflamed medial and lateral gutter and causing redness and tenderness. Huge hypertrophic scar formation secondary to chronic ingrown toe nail mimicking tumor is a rare disease that is not only causing a cosmetic concern, but also hindering normal daily activities physically and socially.
    RESULTS: Excisional biopsy was performed for both great toes. Biopsy confirmed chronic ulcerative inflammation with a hypertrophic scar. The resection site healed and persisted well at 12 months after surgery.
    CONCLUSIONS: Our unusual case suggests that the natural course of an untreated ingrown toe nail may result in hypertrophic scar extending far to mimic tumorous conditions.
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  • 文章类型: Journal Article
    背景:甲癣的特征是指甲板向近端向内移动到近端甲折中。它总是与近端钉折叠下两个或多个重叠的钉板的存在有关,抗菌治疗难治性慢性近端甲沟炎的临床症状,和一个不长的黄色指甲。它主要影响年轻的女性成年人,到目前为止,文献中描述的儿科病例不到30例。
    方法:2020年12月至2022年1月在儿科皮肤科就诊的0至18岁临床和/或超声诊断为足甲的患者的回顾性观察性研究。
    结果:我们确定了9例retrenchia,7个女孩和2个男孩。在所有情况下,拇指指甲受影响,单侧5例,双侧4例。在体格检查中,我们观察到以下迹象:指甲板增厚和不透明(一名患者),黄色钉板(7名患者),双钉板(6例),红斑伴水肿,疼痛,和近端指甲褶皱化脓(7例)。对7例患者进行了超声检查,其中5例发现了足甲的具体发现。所有患者均接受局部治疗,并接受适当的手术治疗。迄今为止,只有一个病人做了指甲撕脱,随后完全恢复。
    结论:甲癣未被诊断,特别是在儿科人群中。我们介绍了一系列9例儿童甲癣,临床和超声检查结果与成人一致。我们强调承认这一实体的重要性,这将允许早期和适当的治疗。
    BACKGROUND: Retronychia is characterized by proximal ingrowing of the nail plate into the proximal nail fold. It is always associated with the presence of two or more overlapping nail plates under the proximal nail fold, clinical signs of chronic proximal paronychia refractory to antimicrobial treatment, and a yellowish nail that does not grow. It mainly affects young female adults, with less than 30 pediatric cases described in the literature so far.
    METHODS: Retrospective and observational study of patients between 0 and 18 years with a clinical and/or ultrasound diagnosis of retronychia attending a pediatric dermatology service between December 2020 and January 2022.
    RESULTS: We identified 9 patients with retronychia, 7 girls and 2 boys. In all cases, the hallux nails were affected with 5 unilateral and 4 bilateral cases. On physical examination we observed the following signs: thickened and opaque nail plate (one patient), yellowish nail plate (7 patients), double nail plate (6 patients), and erythema with edema, pain, and suppuration of the proximal nail fold (7 patients). Ultrasound was performed in 7 patients and specific findings of retronychia were found in 5 of them. All patients received topical treatment and were referred for the appropriate surgical treatment. To date, only one patient underwent nail avulsion, which was followed by complete recovery.
    CONCLUSIONS: Retronychia is underdiagnosed, particularly in the pediatric population. We present a series of 9 cases of retronychia in children, with clinical and ultrasonographic findings consistent with those of adults. We emphasize the importance of recognizing this entity, which will allow early and adequate treatment.
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  • 文章类型: Case Reports
    痣样黑色素瘤(NeM)是一种罕见的恶性黑色素瘤,其特征是轻微的细胞异型,多态性,不完全成熟它最常见于躯干和手臂,但很少发生在脚上。这里,我们报告了右臀部的NeM。一名65岁的男子在对向内生长的指甲进行自我治疗后,右大脚趾严重疼痛6个月。3个月前,他在紧急医疗中心接受了脚趾甲清创治疗。然而,这并没有减轻他的痛苦。患者还注意到在过去3个月中他的远端大脚趾变色。去除向内生长的指甲的一部分显示了从基质向远侧延伸的色素块。由于担心恶性肿瘤,对肿块进行了手术切除。NeM的诊断基于组织学分析以及增强的诊断方式。患者进一步接受大脚趾手术截肢和抗程序性细胞死亡-1治疗。患者在1年的随访中没有复发。痣样黑色素瘤是脚趾恶性黑色素瘤的一种罕见变体,需要与非典型痣区分开来,具有多种模式,包括细胞和分子谱分析。最佳治疗方法是截肢。
    Nevoid melanoma (NeM) is a rare variant of malignant melanoma characterized by slight cellular atypia, polymorphism, and incomplete maturation. It most frequently occurs on the trunk and arms but rarely on the foot. Here, we report a subungual NeM of the right hallux. A 65-year-old man presented with severe pain of 6 months\' duration to his right great toe following self-treatment for an ingrown nail. He was evaluated and treated with debridement of the toenail at an urgent medical center 3 months prior. However, this had not relieved his pain. The patient also noticed discoloration of his distal great toe over the past 3 months. Removal of part of the ingrown nail revealed a pigmented mass extending distally from the matrix. Surgical excision of the mass was performed because of the concern for malignancy. The diagnosis of NeM was based on histologic analysis along with enhanced diagnostic modalities. The patient was further treated with surgical amputation of the great toe and anti-programmed cell death-1 therapy. The patient had no relapse at 1-year follow-up. Nevoid melanoma is a rare variant of malignant melanoma on the toes, which needs to be differentiated from a nevus with atypia, with a variety of modalities including cellular and molecular profiling. The optimal treatment is amputation.
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  • 文章类型: Journal Article
    背景:部分切除和化学基质切除术被认为是治疗II-III期向内生长的脚趾甲(IT)的金标准。然而,很少有报道描述硝酸银在青少年IT管理中的使用。我们的目的是分析硝酸银进行基质消融的有效性,并将其与通过电灼进行的部分切除术进行比较。
    方法:对患有II-III期IT的青少年患者进行回顾性研究。比较了在大型门诊手术中心(A组)接受电灼基质切除术的人和在门诊接受硝酸银治疗的人(B组)。疗效由复发率和术后感染率决定。
    结果:共纳入两百零九例患者(A组86例;B组123例),共有382例部分检查(A组151例;B组231例)。B组患者的复发率(4.7%)低于A组(11.2%,p=.02),术后感染率较低(A组4.0%vs.B组1.7%;p=.18),虽然没有统计学意义。
    结论:男性部分切除术后的硝酸银化学基质切除术是治疗青少年IT的有效方法,术后并发症少,复发率低。因此,它应该被认为是一种可能的替代电灼矩阵切除术。
    BACKGROUND: Partial onychectomy with chemical matrixectomy is considered the gold standard treatment for stage II-III ingrown toenails (IT). However, there are scarce reports describing the use of silver nitrate in IT management in adolescents. Our aim is to analyze the effectiveness of matrix ablation with silver nitrate and compare it with partial onychectomy by electrocautery.
    METHODS: A retrospective study of adolescent patients with stage II-III IT was performed. Those who underwent electrocautery matricectomy in a major outpatient surgical center (Group A) and those who were treated with silver nitrate at an outpatient clinic (Group B) were compared. Efficacy was determined by recurrence and postoperative infection rates.
    RESULTS: Two hundred and nine patients were included (86 group A; 123 group B), with a total of 382 partial onychectomies (151 group A; 231 group B). Group B patients exhibited a lower recurrence rate (4.7%) when compared to group A (11.2%, p = .02), and had a lower postoperative infection rate (4.0% group A vs. 1.7% group B; p = .18), although not statistically significant.
    CONCLUSIONS: Silver nitrate chemical matricectomy after partial onychectomy is an effective treatment for IT in adolescents, with few postoperative complications and low recurrence rate. Therefore, it should be considered as a possible alternative to electrocautery matricectomy.
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  • 文章类型: Letter
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  • 文章类型: Case Reports
    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.
    OBJECTIVE: 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.
    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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  • 文章类型: Case Reports
    Pernio is an inflammatory condition of the skin associated with cold exposure. The dermatologic manifestations may vary, and this entity is frequently misdiagnosed. Its association with systemic disease underscores the importance of accurate diagnosis. The authors describe a case report in which a patient who, after initially presenting with a complaint of pain and an ingrown toenail, was eventually diagnosed with pernio as well.
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  • 文章类型: Case Reports
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  • 文章类型: Case Reports
    The primary objective of medical tattooing is to restore part of a patient\'s physical integrity. Moreover, the procedure seeks to assist in psychological recovery from the physical and/or psychological consequences of disease, surgery or trauma. The method described in this brief note marks a step forward in the field of such tattooing. The treatment simulates reconstruction of the nail bed, as the nails of the big toes had previously been removed through a surgical avulsion procedure. This treatment, agreed with the physician and performed by a tattooist with proven experience in medical tattooing, also involved the use of specific colour nuances that resulted in an extremely realistic outcome.
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  • 文章类型: Case Reports
    Eccrine poroma is a rare benign adnexal neoplasm originating from a portion of the intraepidermal eccrine sweat gland duct and the acrosyringium. Typically, the lesions are asymptomatic, slow-growing nodules, which may be found in any sweat gland-bearing area. Multiple red lacunae, glomerular vessels, hairpin vessels, flower- and leaf-like vascular patterns, a polymorphic vascular pattern, globule/lacunae-like structures, a frog egg-like appearance, and comedo-like openings have been defined as characteristic dermoscopic patterns of the disease. We report a case of eccrine poroma in an unusual periungual and subungual location mimicking ingrown toenails. The dermoscopic findings of the lesions were compatible with those of eccrine poromas located in areas other than the periungual area. Recurrence was observed after the first excisional biopsy. There was no recurrence 10 months after the second surgical intervention, and near-complete regrowth of the nail plate was achieved. Eccrine poroma should be considered as a differential diagnosis in the presence of slow-growing, erythematous, painful, hemorrhagic papular lesions located in the periungual area in conjunction with a prediagnosis of ingrown toenails and malignant processes.
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