Treatment of ingrown toenail with proximolateral matrix partial excision and matrix phenolization.

PURPOSE: Ingrown toenail is one of the most common nail conditions. Although many surgical treatments are described for complicated cases, recurrence of pain and postoperative disability are common. We evaluated the long-term efficacy of proximolateral matrix partial excision followed by chemical matricectomy with phenol. METHODS: We performed 348 proximolateral partial matricectomies and phenol ablations in 225 patients with stage 2 or 3 ingrown toenail. Patients were examined weekly until full wound healing was achieved and were observed for 24 months to assess the long-term efficacy of the treatment. RESULTS: Short-term results were good. We observed only 1 recurrence during the 24-month follow-up period, at 8 months. The success rate was therefore 99.7%. No severe complications occurred. Cosmetic results were remarkably good. CONCLUSIONS: Proximolateral partial matricectomy with phenol ablation is an excellent surgical method for the treatment of ingrown toenails, having low morbidity and a high success rate, even in the long term.

Generalized pustular eruptions due to terbinafine.

Terbinafine, a widely used antifungal agent, may rarely cause cutaneous side effects with an incidence of 2.7%. Generalized pustular eruptions are quite uncommon but severe adverse cutaneous reactions of terbinafine have been reported. The main pustular eruptions due to terbinafine include acute generalized exanthematous pustulosis and drug induced pustular psoriasis. In this report, two cases of acute generalized exanthematous pustulosis and one case of generalized pustular psoriasis triggered with terbinafine are presented.

Discrete papular dermal mucinosis with Hashimoto thyroiditis: a case report.

The cutaneous focal mucinoses are a group of connective tissue disorders characterized by deposition of mucin found either focally or diffusely in the dermis. A 47-year-old woman presented with asymptomatic flesh-colored papules on the neck, inguinal area, intergluteal area, vulvar area, and extremities of 5 months' duration. There was no history of preceding trauma or insect bites. The patient had undergone a subtotal thyroidectomy 21 years prior but had not used any thyroid medication before she was referred to our clinic. Thyroid ultrasonography was consistent with Hashimoto thyroiditis. During dermatologic examination, flesh-colored, well-defined, smooth papules that measured approximately 1.5 x 1 cm in size on the genital region, fingers, face, and scalp were seen. Histopathologic examination of a lesional biopsy revealed no abnormalities in the epidermis. Alcian blue staining showed that abundant deposits of dermal mucin had replaced collagen in the dermis.

Safety and complications of absorbable threads made of poly-L-lactic acid and poly lactide/glycolide: Experience with 148 consecutive patients.

BACKGROUND: Thread lifting is a minimally invasive procedure for lifting and repositioning tissues. Few articles with absorbable sutures exist in the literature. Furthermore there is no study focusing on complications of absorbable sutures. OBJECTIVE: To describe complications of thread lifting using a totally absorbable suture composed of poly-L-lactic acid affixed with poly lactide/glycolide cones. METHODS: Data regarding complications were analyzed retrospectively for 148 patients underwent thread lifting between June 2014 and February 2017. RESULTS: A total of 321 pairs of sutures used in the 148 patients studied. Overall 40 (27%) patients had complications regarded as minimal or moderate without permanent sequela. The most common complication was skin dimpling and irregularity (n = 17, 11.4%) followed by ecchymosis (n = 12, 8.1%), suture extrusion (n = 4, 2.7%), and pain (n = 4, 2.7%) Except one patient, dimpling, and irregularity resolved in all patients after 3-7 days spontaneously. Suture migration was observed in 2 (1.35%) patients. Hematoma and infection were seen in 2 patients one for each. CONCLUSIONS: The procedure using sutures made of absorbable poly-L-lactic acid and poly lactide/glycolide is a relatively safe procedure without major complications.

Nail changes secondary to hand-foot-mouth disease.

Hand-foot-mouth disease (HFMD) is a viral disease that is characterized by palmoplantar vesicular eruption and erosive stomatitis. Beau's line and onychomadesis can be observed as late findings following HFMD due to arrest in nail matrix. We aimed to draw attention to HMFD and nail changes, which have been seen more frequently. Demographic characteristics and nail findings of 15 children, who were diagnosed with HFMD in the dermatology clinic of Beykoz State Hospital between August 2015-October 2015 were evaluated. Mean age of the patients was 5.13 years (1-13 years), 66.6% were boys (n=10), and 33.4% were girls (n=5); 53.3% were diagnosed in August (n=8). Dermatologic examinations revealed palmar and plantar vesicular eruptions in all cases, additionally one patient had vesicular eruptions also on hip, legs, and arms. Erosive stomatitis was present in oral mucosa of 60% of patients (n=9). Nail findings were determined after a mean of 4.06 weeks following HFMD. Onychomadesis and Beau's line were present in 66.6% (n=10) and 33.4% of the patients, respectively. Hand-foot-mouth disease is a viral infection of childhood, which may be seen as isolated cases or epidemics, and characterized with palmoplantar vesicular eruption and erosive stomatitis. Being aware that Beau's line and onychomadesis can be seen as late findings of HFMD and should relieve without treatment, will prevent unnecessary diagnostic and invasive interventions.

Clinical and mycological analysis of twenty-one cases of tinea incognita in the Aegean region of Turkey: a retrospective study.

Tinea incognita is a dermatophyte infection with atypical clinical features modified by the improper use of corticosteroids or calcineurin inhibitors. The aim of this study was to analyze clinical and microbiological features of patients with tinea incognita. A total of 6326 patients referred to mycology laboratory between January 2008 and January 2011 for mycological examination with a diagnosis of tinea incognita were reviewed retrospectively. Twenty-one patients, 13 (61.9%) women and 8 (38.1%) men, mean age 42.2±36.8, were included in the study. Of them, lesions were localized in 15 (71.4%) patients and widespread in six (28.6%) patients. The mean duration of the disease was 9.5 (range 1-120) months. All patients had a history of treatment with steroids. Before admission, most of them had been misdiagnosed as eczema or psoriasis. Microscopic examination revealed hyphae and spores in most of the cases (n=17, 80.95%). Mycological cultures were positive in 19 (90.5%) patients. The most frequently isolated dermatophyte was Trichophyton rubrum (n=14, 66.7%). This case series revealed Trichophyton rubrum as the most frequent agent of tinea incognita. To the best of our knowledge, this is the largest case series from Turkey describing clinical features and mycological agents of tinea incognita.