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BACKGROUND: To date, there is no formal consensus on how to treat ingrown toenails. Despite the risk of causing irreparable damage to the nail, highly invasive procedures are still common. Less-invasive, matrix-directed techniques with shorter downtime and high cure rates exist, but, perhaps because of a lack of awareness, appear not to have been universally adopted. OBJECTIVE: The authors' study sought to generate data on common practices in the treatment of ingrown toenails. MATERIALS AND METHODS: The authors developed and conducted an online survey to ask dermatologists/ dermatosurgeons how they would proceed in 9 different cases of ingrown toenails based on photographs. RESULTS: The authors received 154 replies. Nonsurgical interventions, including advice on nail care/foot baths/ ointments/wraps/padding, were always the most frequently chosen option. Removal of the lateral nail plate followed by chemical partial matricectomy (phenolization) was the most or second-most frequently chosen surgical intervention. The answers were highly heterogeneous, and there was no unanimity based on morphology alone. CONCLUSION: Except for a preference for nonsurgical interventions, the authors could not identify any clear treatment standards. The heterogeneity of treatment approaches suggests the need for a guideline. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. 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. [ABSTRACT FROM AUTHOR]

BACKGROUND Nail braces are an alternative treatment for ingrown toenails. OBJECTIVE This study aimed to prospectively examine the efficacy of nail braces for treatment of acute inflamed (AI)-type and chronic dystrophic-type ingrown toenails. MATERIALS AND METHODS The authors conducted a prospective study of patients with ingrown toenails treated at Wan Fang Hospital between January 1, 2017, and July 31, 2018. Evaluation using physician global assessment scores and patient satisfaction questionnaires was performed at 1, 3, and 6 months after the start of treatment and during the final visit. Patient demographics, treatment courses, and outcomes were compared between the 2 types of ingrown toenails. RESULTS Chronic dystrophic-type and AI-type ingrown toenails were observed in 25 (61 sides) and 28 patients (35 sides), respectively. Of the affected sides, 80.9%, 94.9%, and 100% achieved an excellent or fair result at 1, 3, and 6 months, respectively. Treatment duration and follow-up period were 179.2 6 96.8 days and 281.6 6 120.9, respectively. The recurrence rate was 7.4%. The treatment course and response were different between the 2 types of ingrown toenails. CONCLUSION Ingrown toenails could be effectively treated with nail braces with excellent outcomes, favorable patient satisfaction, and low recurrence rates. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

BACKGROUND Chemical matricectomy is performed mainly by 2 agents, phenol and sodium hydroxide. Chemical matricectomy with phenol has a low recurrence rate and good cosmetic results, but it produces extensive tissue destruction and can result in drainage and a delayed healing time. These adverse effects havebrought forward the use of chemical agents such as sodium hydroxide and trichloroacetic acid for matricectomy. OBJECTIVE This prospective study aimed mainly to evaluate the efficacy of partial nail avulsion and selective chemical cauterization of the matrix using 90% bichloracetic acid (BCA) in the treatment of the ingrown nails. MATERIALS AND METHODS A total of 30 patients with 58 ingrown toenail edges were included in this study. All of the patients underwent chemical matricectomy with 90% BCA after partial nail avulsion. Adverse effects such as postoperative pain and drainage were minimal in most of the patients. RESULTS One patient who underwent matricectomy had recurrence in a single nail edge (1.8%) at the 12th month of the follow-up. No recurrence was observed in 29 patients during mean follow-up period. This was considered to be statistically significant (p < .001). CONCLUSION This is the first study to use BCA for the treatment of ingrown toenail. Partial nail avulsion followed by BCA matricectomy is a safe, simple, and effective method with low rates of postoperative morbidity and high rates of success. Therefore, partial nail avulsion and BCA matricectomy can be used as an alternative treatment method for the treatment of ingrown toenails. [ABSTRACT FROM AUTHOR]

We present a case of a 9-month-old boy with bilateral congenital nail malalignment of the great toenails (CMGTs) with hypertrophic lateral nail folds (Figure 1). Under general anesthesia, we proceeded to remove the hypertrophic nail folds of each great toe with subsequent detachment and rotation of the deviated nail plate and nail bed (Figure 2). Congenital nail malalignment of the great toenails with hypertrophic lateral nail folds is an uncommon and poorly recognized nail condition, which presents with lateral deviation of the nail plate along the longitudinal axis following the phalanx due to lateral rotation of the nail matrix.1 It is usually present at birth, but changes can be subtle and start being clinically apparent during early childhood. [Extracted from the article]

BACKGROUND Pincer nail is a deformity characterized by excessive transverse curvature of the nail plate that increases distally for which many conservative and surgical corrective modalities have been recommended. OBJECTIVE The purpose of this study is to investigate the outcomes and safety of modified double Z-plasty in the management of symptomatic pincer nail. MATERIALS AND METHODS Modified double Z-plasty has been performed on 20 great toes in 12 patients from January 2008 to December 2013. The mean age of patients was 43 (range: 20-65) years. Three men and 9 women were enrolled. Visual analogue scale (VAS) score for pain, transverse angle, and width indices were investigated at the initial and the last follow-up. The average follow-up period was 2.4 years. RESULTS All parameters showed significant improvement after surgery. Between the initial and last followup, the mean VAS score fell from 7.4 to 0.3, the mean transverse angle improved from 50 to 166°, and the mean width index improved from 65.4% to 97%. In all patients, the deformity was successfully eliminated with no recurrences. No complications were identified. CONCLUSION Modified double Z-plasty provides a long-standing effective treatment for pincer nail deformity with an excellent esthetic result. [ABSTRACT FROM AUTHOR]

The article discusses the treatment of ingrown toenails which includes surgery and patients quality of life.

The article presents a case study of 70-year old man with nail lesion which includes dermatoscopy based diagnosis and patient's quality of life.

BACKGROUND Chemical matricectomy with sodium hydroxide is a method being used successfully in the treatment of ingrown toenail. OBJECTIVE In this study, it was aimed to evaluate long-term recurrence rates after chemical matricectomy using sodium hydroxide application of different durations. MATERIALS AND METHODS Two hundred two patients with ingrown nail edges were treated with either 1-minute (Group 1) or 2-minute (Group 2) applications of sodium hydroxide matricectomy. All patients were followed for at least 2 years. RESULTS Chemical matricectomy with sodium hydroxide was applied to a total of 585 nail edges of 202 cases. The overall recurrence rates in Group 1 and Group 2 were 6.4% and 7.1%, respectively, during the average 7.5-year follow-up period. No statistically significant differences were detected in terms of recurrence between the 2 groups (p = .73). CONCLUSION Chemical matricectomy with sodium hydroxide is an easy method in the treatment of ingrown nails, with low morbidity and high success rates. There was no difference between 1-minute and 2-minute applications in terms of recurrence during the long-term follow-up. Chemical matricectomy with 1-minute application of sodium hydroxide showed high success in terms of long-term follow-up results. [ABSTRACT FROM AUTHOR]

Background A phenolization approach is often chosen for treatment of ingrown toenails. Many reports describe lavage of the wound with alcohol to neutralize any residual phenol. The aim of our study was to compare the suitability and effectiveness of a solution consisting of alcohol plus chlorhexidine with that of alcohol alone in a lavage step during the treatment of ingrown toenails using a phenolization procedure. Methods We performed an in vitro study using human matrix and a diffusion cell apparatus to measure the amount of phenol remaining after various lavage washes. The effect of phenol evaporation was also examined. Results When phenol was irrigated with alcohol alone, total phenol recovered was 29.9 ± 4.8 mg (62.9% of the initial amount). When the phenol was irrigated with isopropyl alcohol plus 0.5% chlorhexidine, 39.8 ± 1.7 mg (83.8%) of phenol was recovered. Conclusion A lavage step including alcohol and chlorhexidine is more effective than alcohol alone for removal of excess phenol. The addition of chlorhexidine also contributed to inhibition of the action of phenol. This approach provides a suitable and effective means of diluting and removing any excess or residual phenol from the exposed area. [ABSTRACT FROM AUTHOR]

Background The treatment of ingrown toenail is usually bothersome for patients and doctors. Objectives To compare two treatment techniques of ingrown toenails-phenol matricectomy ( PM) and nail-splinting using a flexible tube ( FT)-in terms of efficacy, postoperative pain, postoperative cosmetic satisfaction, amount of tissue damage, and recurrence. Methods and Materials One hundred twenty ingrown toenails were randomized and divided into PM and FT groups. All cases were evaluated 2 days and 1 and 6 months after treatment. Postoperative pain, cosmetic satisfaction, time to recovery, and recurrence rate were measured. Results Postoperative pain was less and cosmetic satisfaction was good in both groups ( p <.001). Our recurrence rate was 8.4%. There were no statistical differences between groups in these measures. Tissue improvement rate was 6% in the PM group and 93% in the FT group 2 days after the procedures ( p <.001). Conclusions Although FT provides faster recovery and less postoperative morbidity than PM, the techniques are equally effective in treating ingrown toenails. [ABSTRACT FROM AUTHOR]

Background Ingrown toenail is a common disease that causes pain and discomfort. There are conservative and surgical treatments, but many have the drawbacks of recurrence and long recovery time. Objective To analyze for the first time the results of a technique called nail splinting using a flexible tube secured using a suture ( FTSS) performed on a series of patients with ingrown toenails. Methods and Materials A retrospective descriptive study of 71 pediatric patients operated on using the FTSS technique between 2001 and 2009 was performed. The data were collected using medical record review or telephone survey. The main outcomes were high percentage of success and shorter recovery time than with partial matrix excision. Results Sixty-two patients (87.3%) were cured using a single procedure, with an average follow-up of 13.1 months. Recurrence occurred in nine patients (12.6%); three required the classic technique with resection of the matrix and nail bed plastic surgery, and in 6, FTSS was repeated with good results. Conclusion Flexible tube secured using a suture has a lower recurrence rate than matricectomy. Additional advantages are the speed with which complaints can be monitored and quick return to school because recovery may be as short as 48 hours. [ABSTRACT FROM AUTHOR]

Background Phenol cauterization is a chemical equivalent often chosen for treatment of ingrown toenails. Many reports describe intraoperative irrigation, or lavage, of the wound with various types of alcohol to neutralize any remaining phenol. There are conflicting reports in the literature as to whether true neutralization or merely effective removal of excess phenol is needed. Objective The aim of our study was to analyze the suitability and effectiveness of ethyl alcohol versus sterile saline when used in a lavage step after phenol application in the treatment of ingrown toenails. Methods We performed an in vitro study using human skin and a diffusion cell apparatus to measure the amount of phenol recovered after lavage with ethyl alcohol or sterile saline. Results When the wound was irrigated with ethyl alcohol, the total phenol recovered after two irrigation washes was 55.7% of the original amount initially used in treatment, compared with 80.4% when sterile saline solution was used for irrigation. Conclusion Alcohol and sterile saline solution do not neutralize phenol but dilute it and aid in its removal. We found that saline solution recovered more phenol than when washing with alcohol and recommend its use instead of alcohol for irrigation purposes after chemical matrixectomy. [ABSTRACT FROM AUTHOR]

Ingrowing toenail is one of the most common nail complaints. Although many surgical treatments are described for complicated nails, frequent recurrence of pain and postoperative disability necessitate finding an appropriate treatment. In a clinical trial, we compared the Winograd and sleeve (gutter) surgical methods to find a simple, painless, and practical alternative. Of 100 patients (mean 27.8) included in the study, 50 underwent Winograd surgery and the rest the sleeve method. Postoperative infection occurred in four (8%) patients in the sleeve and three (6%) in the Winograd group. The condition reoccurred in five (10%) patients who underwent sleeve surgery and six (12%) who underwent Winograd. Recurrence rate was higher in female patients, although the difference was not statistically significant. Mean surgery duration for Winograd and sleeve methods was 15.7 minutes and 9.4 minutes, respectively, and postoperative work day loss was 2.0 weeks and 1.1 weeks, respectively. The sleeve method seems to be more practical and appropriate for patients planning to go back to work sooner and better fulfills the main characteristics for the primary treatment of choice. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

Pincer nail is a kind of nail deformity characterized by a transverse overcurvature of the nail that increases along the longitudinal axis. Many conservative and surgical treatment modalities have been reported. Widening the nail bed and use of aspiration tube splint in pincer nail surgery. Pincer nail was treated by surgery with splinting in 11 patients. In this procedure, the nail bed is enlarged in a transverse direction using incisions on the nail bed. The postoperative follow-up ranged from 12 to 19 months (mean 15 months). Excellent results were obtained in all patients. No further complications were reported. The splint can prevent contracture of the nail matrix and nail bed. Widening and flattening the nail bed using an aspiration tube splint provided a longstanding effective treatment of pincer nail deformity and pain relief. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND Several options for the treatment of ingrowing toenails are available, ranging from simple conservative approaches to extensive surgical procedures. OBJECTIVE To evaluate in a long-term follow-up (36 months) the efficacy of chemical matricectomy with phenol for the treatment of ingrowing toenails. METHODS AND MATERIALS A total of 197 phenol ablations were performed in 139 patients with stage 2 and 3 disease. Each patient was examined weekly until full wound healing was achieved and was followed for 36 months to assess the long-term efficacy of the treatment. The healing period after surgery ranged from 2 to 4 weeks; few postoperative complications were seen. RESULTS Only three recurrences were observed (after 2, 4, and 11 months). Short-term results were excellent. No severe complications occurred during the 36-month follow-up period. Cosmetic results were remarkable. The success rate was 98.5%. CONCLUSIONS Phenol cauterization is an excellent surgical method for the treatment of ingrowing toenails, being simple and associated with low morbidity and a high success rate, even over the long term (36 months). The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND A common problem associated with toenail removal surgery is the accompanying bacterial infection that often ensues. The foot has a particularly difficult anatomy to prepare antiseptically for surgery, which contributes to this wide-spread problem. OBJECTIVE To compare the antiseptic efficacy of two skin pretreatment methods before toenail avulsion surgery. METHODS Two presurgical methods were performed on 24 patients each (48 patients total). Swab samples were taken from each patient at five distinct stages (pretreatment, post-treatment, after surgery, after saline solution irrigation of the nail bed, and after phenol application) throughout the surgical procedure, and bacterial culture analysis was performed (total inocula count and identification of specific microorganisms). RESULTS We found both methods to be effective at reducing the initial bacterial load when used at pretreatment, but the reduction in bacterial load was lost after the nail avulsion surgery, achieving values similar to the initial bacterial load before the presurgical scrub, from 5.17 and 5.04 log10 colony-forming units (CFU)/cm2 to 4.86 and 5.07 log10 CFU/cm2, respectively. An interoperative irrigation step was effective in reducing the bacterial load by 95.2% and 95.3%, respectively. STUDY LIMITATIONS Our patients underwent phenol-based nail avulsion, resulting in no bacterial load after complete nail removal because of the intrinsic antiseptic nature of the phenol. CONCLUSIONS Incorporation of intraoperative irrigation of sterile saline solution after nail avulsion surgery reduces potential bacterial load. Every effort should be made to lower the risk of contamination after nail plate avulsion. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND Ingrown toenails have a tendency for recurrence. Operative interventions can be successful, and several procedures are in use. OBJECTIVE Retrospective evaluation, to reveal differences in postoperative pain, time to recovery, and satisfaction with the cosmetic outcome in patients treated with a phenol (PCM) or surgical matricectomy (SM). MATERIALS & METHODS All matricectomy patients at the Dermatology Department of the Ludwigshafen City Hospital between 2004 and 2008 were interviewed over the telephone. Of 72 evaluable patients with a total of 112 ingrown nail sides, 33 were treated with PCM and 39 with SM. The patient group consisted of 40.3% women, the median age was 31. RESULTS Patients after PCM indicated two points less postoperative pain on an analogue scale from 0 to 10 ( p<.001). In the PCM group, more patients recovered from the operation in less than 1 week ( p=.007). Patient evaluation of cosmetic outcome was not different between the groups ( p=.76), but recurrence rates were significantly higher in the PCM group (31.5%, vs 6.9% in the SM group, p=.006) CONCLUSION Both matricectomies have advantages and disadvantages. We should discuss these issues with our patients to help them decide on the kind of matricectomy. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND In instances of pincer nail deformity, patients complain of pain associated with walking, wearing shoes, or light touching. Cosmetic concerns and difficulties in terms of nail clipping also arise. Achievement of a satisfactory nail form remains elusive. OBJECTIVE To introduce our original surgical procedure and present the satisfactory results. MATERIALS & METHODS The zigzag nail bed flap method was used on 71 toenails in 49 patients displaying pincer nails (11 male, 38 female; age range 12–88, mean, 48.6). This investigation evaluated 70 nails from the great toe and one nail from a second toe. RESULTS No postoperative complications, including pain, infection and conspicuous scars, were evident. The degree of improvement was determined objectively with the width and height indices, revealing the accuracy of this therapeutic measure. CONCLUSION The authors recommend surgical intervention consequent to the vicious cycle corresponding to anatomical abnormalities associated with the nail plate–nail bed–phalanges relationship. Therefore, these architectures should be treated in conjunction rather than singularly. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND Treatment of ingrown toenails using chemical matricectomy in patients with diabetes has been difficult, because delayed wound healing, wound infections, and digital ischemia can interfere with the procedure. Chemical matricectomy with 10% sodium hydroxide is an effective treatment for ingrown toenails in a normal population. OBJECTIVES Investigation of the effectiveness and safety of chemical matricectomy with 10% sodium hydroxide solution for ingrown toenails in patients with diabetes. MATERIAL AND METHODS Thirty patients with diabetes with 40 ingrown toenails and 30 patients without diabetes with 41 ingrown toenails were enrolled in the study. After partial avulsion of the affected edge, germinal matrix was treated for 1 minute with 10% sodium hydroxide. Patients were observed on alternate days until complete healing was achieved and followed for up to 24 months for recurrence. RESULTS Assessment of the treatment in both groups for complete healing, postoperative pain, tissue damage, drainage, infections, and rate of recurrences revealed no statistically significant difference. CONCLUSIONS The partial avulsion of the affected edge and the treatment of the germinal matrix for 1 minute with 10% sodium hydroxide preceded by matrix curettage is an effective and safe treatment modality for ingrown toenails in people with diabetes. The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND Ingrown toenails are common and lead to significant morbidity. OBJECTIVE This retrospective study was aimed at evaluation of our new surgical technique of lateral foldplasty with limited lateral matrix resection in some cases for the management of ingrown toenails with regard to recurrence rates, spicule formation, local infection, partial flap necrosis, and cosmetic outcome. METHODS & MATERIALS Thirty-two patients with 52 ingrown nails were included in this study. Lateral foldplasty procedure alone was preferred for the surgical treatment of 18 ingrown toenails of mild to moderate severity. Lateral foldplasty with limited lateral matrix resection was performed in 34 ingrown nails in patients with broad nail plates or for moderate to severe cases with significant granulation tissue formation. RESULTS Relapse rate, local infection rate, and partial flap necrosis rate were very low. Spicule formation was not observed. The cosmetic appearance of the nail did not disturb any patient treated with this procedure. CONCLUSION The lateral foldplasty procedure alone or combined with limited lateral matrix resection is a cheap, simple, and satisfactory technique for the treatment of ingrown toenails with a low risk of relapse. This technique also has good cosmetic results. [ABSTRACT FROM AUTHOR]

BACKGROUND Phenol is commonly used in chemical matrixectomies to treat ingrown toenails. Although many studies have documented the safety of phenol matrixectomy for the patient, few studies have investigated the procedure's safety for the physician and auxiliary health care personnel. OBJECTIVE This study was undertaken to evaluate the safety of phenol vapor inhalation for health care personnel during performance of chemical matrixectomy. METHODS The environmental concentrations of phenol in the respiration zones of the physician and an assistant were measured during an in-office surgical procedure consisting of two partial chemical matrixectomies using a 95% phenol solution. The samples were analyzed using gas chromatography with a flame ionization detector. RESULTS The phenol concentration measured in the physician's respiration zone was close to Spain's established environmental limit of daily exposure, with an index of exposure of 60%. The concentration measured in the assistant's respiration zone was well below the environmental limit of daily exposure, with an index of exposure of only 10%. CONCLUSION The performance of chemical matrixectomies is safe for health care personnel when they are exposed to the vapor of phenol solutions of up to 95% concentration for up to 21 minutes. The degree of safety would be greater with lower phenol concentrations and shorter exposure times. [ABSTRACT FROM AUTHOR]

OBJECTIVE. Sodium hydroxide matricectomy is a successful method for the treatment of ingrown toenails. This study was designed to evaluate the optimal sodium hydroxide application period providing high success rates with minimal postoperative morbidity. MATERIALS AND METHODS. Sixty-six patients with 225 ingrown nail edges were treated in three groups receiving 30-second, 1- minute, and 2-minute applications of sodium hydroxide. Each patient was reviewed postoperatively for pain, drainage, and tissue damage. The median long-term follow-up period was 14 months. RESULTS. The success rate of the therapy was 70.9% in the first group, 92.7% in the second group, and 94.4% in the third group. In all groups, about half of the patients experienced minimal pain within 48 hours following the operation, but only in the third group, 20% of the patients had minimal pain, which continued about 1 week. Drainage and tissue damage were minimal or mild in all groups and disappeared within 3 weeks in the first and second groups but were prolonged to 6 weeks in the third group. CONCLUSION. The success rate of 30-second application is significantly lower than 1-minute and 2-minute applications. Although the success rates of the latter two procedures are similar, the prolonged healing time is the disadvantage of the 2-minute application. We conclude that 1-minute application of 10% sodium hydroxide is simple, safe, and highly effective for the treatment of ingrown nails. [ABSTRACT FROM AUTHOR]

BACKGROUND. Ingrown toenail is a common nail disease that causes pain, discomfort, and difficulty in walking. It is treated with either conservative therapy or surgery. OBJECTIVE. To present a new surgical approach to ingrown toenail. MATERIALS AND METHODS. For 19 ingrown toenail borders of 14 toes in 14 patients (1 male and 13 females), the nail matrix was stained with methylene blue and then partial matricectomy was performed with a CO2 laser. RESULTS. There was no recurrence at 18 nail borders after a mean follow-up period of 13.4 months, whereas a spike grew at one border but caused no walking pain. No serious complications occurred. Cosmetic improvement was also satisfactory. CONCLUSIONS. Partial nail matricectomy with a CO2 laser after staining the nail matrix with methylene blue allows visual confirmation of the completeness of cauterization. [ABSTRACT FROM AUTHOR]

Subungual osteochondromas are relatively rare. The objective was to evaluate the clinical, histologic, radiologic, and therapeutic features of subungual osteochondroma. We retrospectively analyzed 27 cases of subungual osteochondroma evaluating the clinical manifestations, the radiologic and histologic features, and the treatment. There were 20 females and 7 males. The first toe was the most commonly involved. Previous trauma was recalled in 40.7% of the cases. Subungual osteochondromas appeared as firm, exophytic tumors beneath the ungual plate. Twenty-five patients had pain. The radiologic films demonstrated the presence of a juxtaephiphyseal radiodense cap surrounded in some cases by cortical bone. A Dubois-like excision was performed to expose the tumor and cut it through the base, followed by curettage of the bony bed. Radiologic controls were taken 30 and 60 days after surgery and in cases of symptomatology. There were three cases of recurrence and two cases of incomplete excision. Subungual osteochondroma should be distinguished from other subungual masses. The diagnosis of subungual osteochondroma is clinicoradiologic. HERIBERTO VÁZQUEZ-FLORES, MD, JUDITH DOMÍNGUEZ-CHERIT, MD, MARÍA ELISA VEGA-MEMIJE, MD, AND MARIMAR SÁEZ-DE-OCARIZ, MD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [ABSTRACT FROM AUTHOR]

Primary subungual squamous cell carcinoma (SCC) of the toe is seldom reported in the literature, with most described cases occurring on the fingernails. To describe the clinical, histopathologic, and laboratory findings of cases of invasive subungual SCC of the toe. All cases of SCC of the toes retrieved from our database in the last 3 years were reviewed. A search for human papillomavirus (HPV) DNA from paraffin-embedded sections was performed with polymerase chain reaction. Three patients, all male, with a subungual SCC (two welldifferentiated and one poorly differentiated) of the toe were identified. Treatment consisted of surgical amputation in all cases. One patient with poorly differentiated SCC and lymph node metastases also underwent inguinal lymphadenectomy. Polymerase chain reaction search for HPV DNA was negative in all samples. Unlike Bowen's disease and SCC of the fingernails, a causative role of HPV infection in the development of in situ and invasive subungual SCC of the toe seems unlikely. M. R. NASCA, MD, PHD, D. INNOCENZI, MD, AND G. MICALI, MD HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [ABSTRACT FROM AUTHOR]

The article focuses on the surgical technique for the treatment of ingrown toenails using banana peel. It mentions that a nail bed was created by incising the banana peel and flexible acetate plates were used for the creation of the nail plate and matrix. It adds that the simulation model for the treatment of ingrown toenails can lead to a new surgical technique for the management of other nail problems.

The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

The article discusses the use of phenol and sodium hydroxide in treating ingrown nail. As indicated, sodium hydroxide is as effective and safer as phenol in ingrown toenails treatment in diabetics. Meanwhile, it notes that postoperative complications such as prolonged healing time and infections are most felt by people with diabetes than those without.

The authors have indicated no significant interest with commercial supporters. [ABSTRACT FROM AUTHOR]

BACKGROUND The treatment of ingrown toenail complicated with granulation tissue is usually partial or total nail avulsion with or without matricectomy. It costs loss of occupational power, however, because most patients cannot go to work or school for some time after surgery, and it is a costly and uncomfortable procedure for most patients. OBJECTIVE This study aimed to find an easy, painless, and inexpensive alternative. MATERIALS AND METHODS Seven patients with ingrown toenails complicated with granulation tissue are included. A small apparatus was applied on the nails, granulation tissue was chemically cauterized, and a foot bath was recommended twice daily. They were followed on a weekly basis or every other week until recovery. None of the patients received systemic treatment. RESULTS All seven patients were completely cured without requiring surgery and/or systemic treatment. The procedure did not have any effect on their daily life. The follow-up examination of the patients at 6 months revealed that they were totally cured, and there were no recurrences. CONCLUSION Patients with ingrown toenails complicated by granulation tissue might have an inexpensive and pain-free treatment alternative, although new studies with more patients are required. [ABSTRACT FROM AUTHOR]

The article focuses on a study on a new form of an ingrowing toenail, wherein the lateral offending nail spur harpoons the lateral wall. It states that the development of the ingrown toenail is caused by an epidermal breakage in lateral nail sulcus and constant pressure from nail plate against soft tissues. It mentions the possibility of the formation of a chronic form if the ingrown is not treated.

The article offers the author insights regarding their surgical technique for treating pincer nails and the comment of C-T Lin and T-M Chen. He states that the treatment which involves the removal of lateral matrix horns is often sufficient for mild cases. He mentions that Lin and Chen request that treatment of the fungal nail infections should be the first step.

A letter to the editor is presented regarding the treatment of ingrown toenail using a device composed of shape-memory alloy K-D®.

The article focuses on the diagnosis of the women suffering from tender lesion of the left great toenail. The diagnosis reveal that the woman had a subungual exotosis. Roentgenography shows a broad-based, trabeculated outgrowth without a discernible cortex projecting from the dorsal and medial aspect of distal phalanx of the great toe. The distal fibrocartilage cap is radiolucent and therefore is not seen. No foci of calcification or destructive changes are visualized. On radiographic exam, subungual osteochondromas appear as well-circumscribed, sessile or pedunculated outgrowths of both trabecular and cortical bone arising from the juxtaepiphysial region of the distal phalanx

A letter to the editor is presented in response to the article "Comparison of two surgical methods (Winograd and sleeve method) in the treatment of ingrown toenail," by H. Peyvandi and colleagues in the 2011 issue.

This article focuses on the treatment of ingrown toenails. The ingrown nail acts as a foreign body, thus invoking a primary inflammatory reaction and sometimes a secondary infection. If active infection is not present, one may add, in addition to warm saline soaks, application of a mid- or high-potency topical corticosteroid two to three times a day for 1 to 2 weeks. It is helpful to decrease secondary inflammation or infection before surgery. In earlier disease, application of a topical urea preparation, 30 to 50 percent twice a day, can be applied to the nail plate to decrease the rigidity of the nail plate, thus decreasing the splinter effect of the nail plate. Sodium hydroxide or phenol can be applied by using a urethral swab rather than a cotton-tipped swab.