Ingrown Toenails During Chemotherapy and Stem Cell Transplantation in Children With Hematologic Malignancies and Solid Tumors.

BACKGROUND: At our institution, we noted that children with hematologic malignancies and solid tumors often suffered from ingrown toenails (IGTNs) during hospitalization for chemotherapy and stem cell transplantation. However, only few reports have dealt with IGTNs in the above setting. PROCEDURE: Between August 2007 and July 2017, 180 children who received treatment for hematologic malignancies and solid tumors at our institute were enrolled in this study. Twelve patients with insufficient data and 7 patients with past histories of IGTNs were excluded. A total of 161 patients were analyzed. Median age at admission was 7.9 years (range, 1.0 to 25.4 y), with 92 males and 69 females. Diagnoses were hematologic diseases in 128 patients, including acute lymphoblastic leukemia (ALL) in 75 patients, and solid tumors in 33 patients. RESULTS: A total of 22 patients (13.7%) suffered from IGTNs (or toe paronychia) during hospitalization. Multivariable analysis disclosed a strong correlation between the occurrence of IGTNs and older age (over 9.0 y) and ALL. CONCLUSIONS: Patient-related factors, such as age over 9 years and ALL were associated with IGTNs. This is the first report of a survey on IGTNs in patients with hematologic malignancies and solid tumors hospitalized for chemotherapy and stem cell transplantation.

Review of onychocryptosis: epidemiology, pathogenesis, risk factors, diagnosis and treatment.

Ingrown toenail, or onychocryptosis, is a highly prevalent nail condition that occurs when the nail edge grows into the periungual dermis. It most frequently affects the hallux and has a biphasic presentation, being most common in the second and fifth decades. It is often painful and may be debilitating in severe cases. Risk factors include trauma, weight changes, poor nail-cutting technique, and hyperhidrosis. Both conservative and surgical treatments have been described, and choice of therapy is dependent on patient co-morbidities, severity, and associated symptoms. This review covers the epidemiology, risks factors, pathogenesis, evaluation, and staging of ingrown toenails, as well as, treatment options. Although there is an unmet need for clinical trials comparing therapies, current recommendations are to treat conservatively and then proceed to surgical therapies if symptoms persist.

Relationship between the presence of abnormal hallux interphalangeal angle and risk of ingrown hallux nail: a case control study.

BACKGROUND: Many risk factors have been identified to be associated with ingrown toenail. Internal pressure by the distal phalanx of the hallux and the second toe and external compression from the shoes has been proposed as a reason for the pathology. The main objective of the study was to analyze the existence of a correlation between the presence of pathological hallux interphalangeal angle (HIA) and risk of ingrown hallux nail. METHODS: One hundred and sixty-five subjects (312 ft) were enrolled in a cross-sectional, analytical and observational case-control study. A radiographic computerized system was used to measure HIA in both groups. The angle was considered as the sum of three angles, obliquity, asymmetry and joint deviation. RESULTS: The mean HIA in case group subjects (patients with hallux ingrown nail) was significantly higher than that obtained in control group subjects (17.39 ± 6.0° versus 13.47 ± 4.6°, p = .036). A total of 73.71 and 46.79 % of feet presented an angle equal or greater than 13.47° in the onychocryptosis and control group, respectively. CONCLUSIONS: The results show a correlation between the variables analysed. The presence of an HIA greater or equal than 14.5° may be a predisposing factor for developing onychocryptosis of the hallux. Clinicians treating individuals with pathology in hallux might use a baseline cutoff of HIA equal than 13.5°.

Physics of nail conditions: why do ingrown nails always happen in the big toes?

Although surgical treatment of nail conditions can be traced back centuries to the writings of Paul Aegineta (625-690 AC), little is known about the physical laws governing nail growth. Such a poor understanding together with the increasing number of nail salons in the high street should raise legitimate concerns regarding the different procedures applied to nails. An understanding of the physics of nail growth is therefore essential to engage with human medicine and to understand the aetiology of nail conditions. In this context, a theory of nail plate adhesion, including a physical description of nail growth can be used to determine the transverse and longitudinal curvatures of the nail plate that are so important in the physical diagnosis of some nail conditions. As a result physics sheds light on: (a) why/how nails/hooves adhere strongly, yet grow smoothly; (b) why hoof/claw/nail growth rates are similar across species; (c) potential nail damage incurred by poor trimming; (d) the connection between three previously unrelated nail conditions, i.e. spoon-shaped, pincer and ingrown nails and; last but not least, (e) why ingrown nails occur preferentially in the big toes.

Conservative management of a severe case of onychocryptosis at a podiatric clinic-A case report.

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.

Onychocryptosis - decrypting the controversies.

Onychocryptosis, or ingrown toenail, is a frequent, painful condition affecting young individuals. Controversies still exist regarding its etiopathogenesis and treatment options, including conservative and surgical techniques. The choice of treatment method depends on the stage of disease as conservative measures are mostly effective in early stages and surgical procedures are required in the later stages. Among surgical techniques, phenol cauterization of lateral nail matrix has been the most effective, safe, and commonly performed method. Other more destructive surgical procedures are rarely done nowadays. In this review, we briefly discuss the etiopathogenesis, clinical features, and different treatment options of ingrown toenail.

Clinical and Sociodemographic Characteristics of Patients with Ingrown Nails.

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.

Clinical and Sociodemographic Characteristics of Ingrown Nails in Children.

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.

Retronychia of the toenails: a review with emphasis on pathogenesis, new diagnostic and management trends.

Retronychia is a condition, first described in 1999, characterized by the embedding of the proximal nail plate into the proximal nail fold and the stacking of a multiple generations of nail plates beneath the proximal nail fold. The disease affects frequently the toenails and is associated with stress-relevant situations including repetitive trauma, ischemic etiologies, postpartum, and compartment syndrome. Predisposing factors including static disorder of the feet may be underestimated. The paucity of data regarding the predisposing factors is because existing studies are limited to small case reports, case series, and retrospective studies. The diagnosis is clinical, which could be challenging because retronychia can easily mimic other nail disorders with chronic paronychia. Since the first description, significant advances have been made regarding diagnostic criteria including ultrasonography. We performed a systematic review of the literature on retronychia from inception to April 2018 with an emphasis on the pathogenesis and new diagnostic and management trends.

Paronychia with Sporangium Formation Causing an Ingrown Toenail A Rare Case Report.

Ingrown toenail, or onychocryptosis, is a common inflammatory disease of the hallux. It results from the alteration of fit of the nail plate in the lateral nail fold. Ingrown toenails are usually seen in adolescents and young adults and can affect daily activities and social life. Generally, ingrown toenails are classified into three stages, including the inflammatory stage, the abscess stage, and the granulation stage. In this article, we present the rare case of a man with a diagnosis of paronychia with sporangium formation causing an ingrown toenail.

Posttraumatic Retronychia of the Foot with Clinical and Ultrasound Correlation.

Retronychia, the posterior embedding of the nail bed into the proximal nail fold, can be a complex clinical dermatologic diagnosis that may mimic other inflammatory ungual diseases or tumors of the nail. It has been related to a history of severe systemic conditions that secondarily affect the nail matrix and is commonly associated with onychomadesis. We present a case of retronychia of the foot with a purely traumatic origin, nonconcomitant with onychomadesis, that was diagnosed by color Doppler ultrasound in a long-time practitioner of martial arts who was otherwise healthy. Color Doppler ultrasound is an excellent imaging technique for supporting the diagnosis of retronychia. It provides information on the exact location and morphology of the nail plate as well as the presence of inflammatory signs in the ungual and proximal periungual regions. Additionally, this imaging technique can support the differential diagnosis with other nail conditions. Since there are many sports or activities that can potentially injure the toenails, retronychia may be an underestimated entity and the present case can raise the awareness of this condition and show the usefulness of color Doppler ultrasound.

Relation Between Nail Consistency and Incidence of Ingrown Toenails in Young Male Runners.

BACKGROUND: This study examines the possible influence of factors such as nail shape and consistency, sex, and sports activity on the development of the most common nail disorders in a population of young people. METHODS: The nail plates of 140 young people (66 females and 74 males) were studied. Of these 140 participants, 72 were runners who trained more than 10 hours a week and competed regularly, and 68 did not habitually do any sports activity. Nail shape, consistency, and disorders were examined, taking into account the sex of the participants and their sports activity. RESULTS: A hard nail consistency is more frequent in runners (74.4%) than in people who do no sports activity (25.6%). In contrast, a soft nail consistency is more prevalent in participants who do no sports activity (70%) than in runners (30%). It was also shown that onychocryptosis is related to sex, as females had a higher prevalence of this nail disorder (57.8%, P = .016). However, young male runners showed the highest and most significant percentage of the presence of onychocryptosis (74.1%; P = .002). CONCLUSIONS: Sports activity by young male runners whose nails have a hard consistency seems to be directly related to the high incidence of onychocryptosis in this population.

Toenail disorders.

The nail unit provides clues to neoplasms and systemic disease. It also may be prominent as a site for fungal and bacterial infections. Primary dermatologic disorders present a broad spectrum of nail changes. The complete physician, regardless of his field, needs to be alert to the often significant manifestations of the abnormal nail as a signal to important pathology.

Ingrowing toenails: is there a nail abnormality? A prospective study.

Ingrowing of the nail of the hallux has been ascribed to an abnormality of the shape of the nail; our prospective study was planned to test this association. Twenty-three consecutive patients and 23 age-matched controls were assessed by caliper measurement and standard photographs, before a first operation for ingrowing toenail. We found no differences in shape between the toenails of the patients and those of the controls, both groups showing great variation. Our results suggest that the ingrowth is not commonly associated with an abnormal shape of the nail.

Practical therapy for ingrown toenails.

The etiology, prevention, and previous therapies for ingrown toenails are presented. A simple, quick, relatively painless method for treating ingrown toenails is described, in which a cotton wick saturated with iodine tincture is inserted into the affected sulcus, separating the nail plate from the skin. Granulation tissue is treated with a cotton applicator saturated with a 50 percent silver nitrate solution. This method works on more than 80 percent of the ingrown toenails seen by this dermatologist, and is well tolerated by the patient.

Self-induced trauma to the nails.

Both frequent and rare deformities of the nails have been reported that are due to self-inflicted damage. Some of these disorders may be confused with common diseases such as psoriasis, lichen planus, onychomycosis, or industrial injury. Awareness of the common patterns, inspection of the periungual tissues, observation of the patient's attitude toward his or her nail disorder, and inclusion of self-trauma in the differential diagnosis will lower the incidence of ineffective treatments and unnecessary laboratory tests.

Relationship between onychocryptosis and foot type and treatment with toe spacer. A preliminary investigation.

The relationship between onychocryptosis and foot type was investigated in a series of 512 patients. Of these patients, 124 had signs or a history of onychocryptosis. Among the nine foot types identified by digital and metatarsal formulas, the Greek index minus and squared index minus types showed the strongest association with onychocryptosis, which was present in more than one-third of such feet. When anteroposterior radiographs of each type of foot were taken after binding the first and second toes together to simulate a tight shoe, the enlargement of bony structures of the second toe at the distal interphalangeal level in the Greek and squared index minus feet moved toward the distal enlargement of the distal phalanx of the first toe where the ingrowing occurs. Ten cases of stage I and four cases of stage II onychocryptosis were treated by placing a toe spacer between the first and second toes; all healed in about 3 weeks, suggesting that counterpressure of the second toe in tight shoes is a factor in the development of onychocryptosis.

[Retronychias]. / Rétronychies.

Retronychia usually affects young female (between 20 and 30 years old). It starts with the disruption of the longitudinal growth of the nail, because of a microtraumatic insult. Others diagnostic criteria: proximal nail plate rose upward proximal nailfold, pachyonychia and dyschromia, paronychia. Management consists of total nail avulsion.

[Ingrown nails or onychocryptosis]. / L'ongle incarné ou onychocryptose.

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.