nail surgery

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  • 文章类型: Journal Article
    背景:Onychocryposis是一种需要临床干预的常见病理状况。根据患者的具体情况选择适当和有效的治疗方法至关重要。
    方法:我们比较了改良Noel's技术和基质酚化的有效性和安全性在107名患有甲癣的参与者中。参与者分为两组:75个指甲(73名患者)采用改良的Noel's技术(改良的Noel's组),而42指甲(34例)采用基质酚化治疗(酚组)。收集两组的临床治愈率和术后并发症的结果。此外,改良Noel技术的疗效在31例IV期甲癣患者中进行了评估。
    结果:18个月后,在其余102名患者中(110个指甲),改良的Noel组并发症较少(5.88%vs.45.2%,P<0.001),治愈率相似(P=0.62)。此外,改良Noel组的愈合时间较短(13.5±1.4vs.27.6±2.3天,P<0.001)。改良Noel组术后第一天疼痛明显(P<0.001),术后2周疼痛评分显著降低(P=0.407)。在苯酚组(33%)中观察到术后钉板变窄。此外,改良的Noel技术在IV期患者中实现了100%的治愈率。
    结论:改良的诺埃尔技术,提供精确切除增生性指甲褶皱和战略缝合,适用于IV期患者和在窄板后基质酚化后发现不可接受的显着美学影响的患者。
    BACKGROUND: Onychocryptosis is a common pathological condition requiring clinical intervention. Selecting an appropriate and effective treatment based on individual patient circumstances is crucial.
    METHODS: We compared the efficacy and safety of the modified Noel\'s technique and matrix phenolization in 107 participants with onychocryptosis. Participants were divided into two groups: 75 nails (73 patients) were treated with the modified Noel\'s technique (modified Noel\'s group), while 42 nails (34 patients) were treated with matrix phenolization (Phenol group). Outcomes on clinical cure rates and postoperative complications from both groups were collected. Additionally, the efficacy of the modified Noel\'s technique was assessed in 31 nails with stage IV onychocryptosis.
    RESULTS: After 18 months, among the remaining 102 patients (110 nails), the modified Noel\'s group exhibited fewer complications (5.88% vs. 45.2%, P < 0.001) with similar cure rates (P = 0.62). Furthermore, there was a shorter healing time in the modified Noel\'s group (13.5 ± 1.4 vs. 27.6 ± 2.3 days, P < 0.001). Postoperative pain was notable in the modified Noel\'s group on the first postoperative day (P < 0.001), with a significant decrease in the pain score 2 weeks after surgery (P = 0.407). Postoperative nail plate narrowing was observed in the Phenol group (33%). Moreover, the modified Noel\'s technique achieved a 100% cure rate in stage IV patients.
    CONCLUSIONS: The modified Noel\'s technique, offering precise excision of the proliferative nail fold and strategic suturing, is suitable for stage IV patients and for those who find significant aesthetic impact unacceptable following narrowed plate postmatrix phenolization.
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  • 文章类型: Journal Article
    背景:内胎趾甲是一种常见的病理。尽管一系列保守和手术措施被广泛用于这种情况,人们对它们在实践中的使用知之甚少。这项研究探索了英国足病医生对向内生长的脚趾甲的治疗或管理的现行做法。
    方法:横断面在线调查(Qualtrics,普罗沃,UT,USA)于2020年3月至6月之间进行,分发给在英国治疗或管理向内生长的脚趾甲的执业足病医生。
    结果:共有396名执业足病医生做出了回应(私营部门占60.1%)。大多数(88.6%)最常见的是(54.3%)每月少于5次进行指甲手术。几乎所有(95%)仅进行了有或没有化学基质切除术的指甲撕脱,普遍使用苯酚(97.2%)。施用时间和施用次数不同,但最通常施用三次(61.5%),共3分钟(75%)。公共部门和私营部门的善后护理差异很大,公共部门提供的后续任命较少。
    结论:尽管整个治疗途径的临床实践存在差异,几乎所有受访者都提供了苯酚基质切除术的指甲撕脱伤,而很少有人提供切开的指甲手术。此数据提供了英国足病医生如何进行甲癣的指甲手术的最全面描述。
    BACKGROUND: Ingrown toenails are a common pathology. Although a range of conservative and surgical measures are widely used for this condition, little is known about their use in practice. This study explored current practice relating to the treatment or management of ingrown toenails by podiatrists in the UK.
    METHODS: A cross-sectional online survey (Qualtrics, Provo, UT, USA) conducted between March to June 2020 was distributed to practicing podiatrists treating or managing ingrown toenails in the UK.
    RESULTS: A total of 396 practicing podiatrists responded (60.1% based in the private sector). The majority (88.6%) performed nail surgery most commonly (54.3%) less than five a month. Nearly all (95%) only performed nail avulsion with or without chemical matrixectomy, universally using phenol (97.2%). Application time and number of applications varied but was most commonly applied three times (61.5%) for a total of 3 minutes (75%). Aftercare varied considerably between public and private sectors, with public sectors offering fewer follow-up appointments.
    CONCLUSIONS: Although there is a variation in clinical practice throughout the treatment pathway, almost all respondents offered nail avulsion with phenol matrixectomy, whereas very few provided incisional nail surgery. This data provides the most comprehensive description of how UK podiatrists conduct nail surgery for onychocryptosis.
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  • 文章类型: Case Reports
    指甲下胆膜囊肿(SOC)是一种罕见的指甲异常,具有不同的临床表现,可以模仿不同的指甲恶性肿瘤。比如黑色素瘤,SCC,或者血管球瘤.皮肤科医生和皮肤病理学家有必要了解这种病理以进行适当的诊断和治疗。SOC是一种罕见的指甲异常,会影响甲床的真皮。SOC有不同的临床表现,包括甲营养不良,脊线,俱乐部,增厚,色素沉着,甚至是正常的外观。它可以模仿不同的指甲恶性肿瘤,比如黑色素瘤,SCC,或者血管球瘤.在这份报告中,我们描述了一名54岁的男性,患有单侧第二指甲甲甲营养不良和甲溶解1年。他最近没有任何创伤史,疼痛,或出血。经手术完全切除。指甲活检有助于SOC的早期诊断和改善治疗效果。
    Subungual Onycholemmal Cyst (SOC) is a rare nail abnormality with different clinical presentations which can mimic different nail malignancies, such as melanoma, SCC, or glomus tumor. It is necessary for dermatologists and dermatopathologist to be aware of this pathology to make the proper diagnosis and treatment. SOC is a rare nail abnormality which affects the dermis of the nail bed. SOC has different clinical presentations, including onychodystrophy, ridging, clubbing, thickening, pigmentation, or even normal appearance. It can mimic different nail malignancies, such as melanoma, SCC, or glomus tumor. In this report, we describe a 54-year-old man with unilateral second right finger nail onychodystrophy and onycholysis for 1 year. He did not have any history of recent trauma, pain, or bleeding. It was completely resected by surgery. Nail biopsy can contribute to the early diagnosis of SOC and improvement of treatment outcomes.
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  • 文章类型: Journal Article
    Bowen病是一种原位鳞状细胞癌,指甲最常见的恶性肿瘤。更频繁地出现在指甲里,常见的危险因素包括电离辐射,口服砷或杀虫剂,先天性角化障碍,和相当常见的不同亚型的HPV。我们报告了第一例儿科患者的多发性甲周色素沉着Bowen病。
    一个健康的13岁男孩,有9个月的历史,他的第3个右手指的近端指甲褶皱上有一个色素性红斑,没有相关症状。做了穿刺活检,并做出了Bowen病的诊断。患者接受光动力疗法和三个周期的咪喹莫特无反应,两个新的病变出现在第一和第二右手指上。对所有病变进行手术切除。聚合酶链反应检测到HPV16型。
    多发性甲周Bowen病很少见,最常见的危险因素是HPV感染和慢性免疫抑制。少于10%的病例表现为纵向黑甲。迄今为止,以前没有多发性色素性甲周Bowen病的报道。HPV诱导的Bowen病通常在22至89岁的成年人中表现为持续性疣。在这种情况下,koilocytosis和所有病变出现在右手的事实提示HPV感染。
    UNASSIGNED: Bowen\'s disease is a squamous cell carcinoma in situ, the most common malignancy of the nail unit. Presenting more frequently in the fingernails, common risk factors include ionizing radiation, oral exposure to arsenic or pesticides, dyskeratosis congenita, and quite commonly diverse subtypes of HPV. We report the first case of multiple periungual pigmented Bowen\'s disease in a pediatric patient.
    UNASSIGNED: A healthy 13-year-old boy presented with a 9-month history of a pigmented erythematous patch on the proximal nail fold of his 3rd right finger without associated symptoms. A punch biopsy was taken, and the diagnosis of Bowen\'s disease was made. The patient received photodynamic therapy and three cycles of imiquimod without response, and two new lesions appeared on the first and second right fingers. Surgical removal was performed on all lesions. A polymerase chain reaction detected an HPV type 16.
    UNASSIGNED: Multiple periungual Bowen\'s disease is rare, with the most frequent risk factors being HPV infection and chronic immunosuppression. Less than 10% of the cases present as longitudinal melanonychia. To date, there are no previous reports of multiple pigmented periungual Bowen\'s disease. HPV-induced Bowen\'s disease is usually present in adults aged between 22 and 89 years as persistent verrucae. In this case, koilocytosis and the fact that all lesions appeared on the right hand are suggestive of HPV infection.
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  • 文章类型: Journal Article
    鳞状细胞乳头状瘤是一种良性肿瘤,其发病机理通常与人乳头瘤病毒有关。尽管影响了几个器官,我们没有发现指甲报告的病例。
    一名67岁的女性出现了从2021年开始的右拇指指甲疼痛病变,红斑外观演变为黑色和扩张性生长。由于进化和症状,她选择了切除,鳞状细胞乳头状瘤的组织病理学报告。用咪喹莫特进行补充治疗,良好的愈合和疼痛控制。
    由于缺乏以前的报告,治疗基于位于其他区域的乳头状瘤的治疗选择.进行了切除术,随后应用咪喹莫特,反应良好。预后良好;然而,需要进一步的研究来阐明指甲鳞状细胞乳头状瘤的诊断和治疗。
    UNASSIGNED: Squamous cell papilloma is a benign tumor whose pathogenesis is generally related to the human papillomavirus. Despite affecting several organs, we did not find cases reported in the nails.
    UNASSIGNED: A 67-year-old female presented with a painful lesion in the nail of the right hallux that started in 2021, with an erythematous appearance evolving to black and expansive growth. Due to the evolution and symptoms, she opted for excision, with a histopathological report of squamous cell papilloma. Complementary treatment with imiquimod was performed, with good healing and pain control.
    UNASSIGNED: Due to the lack of previous reports, treatment was based on therapeutic options for papillomas located in other regions. Excision was performed, followed by application of imiquimod with good response. The prognosis is favorable; however, further studies are needed to elucidate the diagnosis and management of nail squamous cell papilloma.
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