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.