Frontal Examination of the Distal Nail Unit. / Visión frontal distal de la uña.

Clinical findings in many nail disorders are not usually pathognomonic. An accurate diagnosis therefore relies on inspection of the nail unit from different angles. We review clinical features of different nail disorders that can be observed during frontal examination of the distal edge of the nail plate and the hyponychium and correlate these with features observed when the nail is viewed from above. Frontal examination of the distal nail unit can help establish a clinical diagnosis in routine practice.

[Translated article] Frontal Examination of the Distal Nail Unit.

Clinical findings in many nail disorders are not usually pathognomonic. An accurate diagnosis therefore relies on inspection of the nail unit from different angles. We review clinical features of different nail disorders that can be observed during frontal examination of the distal edge of the nail plate and the hyponychium and correlate these with features observed when the nail is viewed from above. Frontal examination of the distal nail unit can help establish a clinical diagnosis in routine practice.

Efficacy of laser treatment for onychomycotic nails: a systematic review and meta-analysis of prospective clinical trials.

Laser therapy for onychomycosis is emerging but its efficacy remains unestablished. To examine current evidence on efficacy of laser treatment of onychomycosis. A systematic review and one-arm meta-analysis, including all prospective clinical trials, identified on PubMed, Cochrane Library, and EMBASE databases. Trials with participants as unit of analysis (UOA), n = 13, were analyzed separately from trials with nails as UOA, n = 7. Summary proportions and 95% confidence intervals (95% CI) were calculated. Outcomes were mycological cure, clinical improvement, or complete cure. Twenty-two prospective trials (four randomized controlled trials and 18 uncontrolled trials) with a total of 755 participants were analyzed. Summary proportions with 95% CI for participants as UOA were mycological cure 70.4%, 95% CI 52.2-83.8%; clinical improvement 67.2%, 95% CI 43.2-84.7%; and complete cure 7.2%, 95% CI 1.9-23.5%. High statistical heterogeneity was detected (mycological cure I2 = 88%, P < 0.01; clinical improvement I2 = 69%, P < 0.01; complete cure I2 = 60%, P = 0.11). The current level of evidence is limited and with high heterogeneity, making it difficult to assess the true efficacy of laser treatment for onychomycosis. Larger randomized controlled trials with well-defined methodology are warranted.

Comparative efficacy of modified Noel's technique and matrix phenolization on onychocryptosis: a retrospective study.

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.

Surgical repair for deformities of the nail unit.

The nail apparatus is the largest and most complex skin appendage. Defects in this unit can result in significant functional insufficiency and cosmetic disfigurement. Common nail deformities include split nail, short nail, onycholysis, nail malalignment, hooked nail, and absent nail. Currently, surgical repair is the primary treatment for such deformities. Based on the etiological and anatomical classifications, one or more appropriate operations can be selected to repair nail unit deformities. These include autologous fat grafting, longitudinal cicatrectomy, Z-plasties, nail bed elongation, split-thickness sterile matrix grafting, volar V-Y advanced flap reconstruction, sterile matrix particle grafting, germinal matrix flaps, and germinal matrix grafting. This review discusses the fundamental classification of nail unit deformities, common reconstructive surgical techniques, and their features.

Visión frontal distal de la uña / Frontal Examination of the Distal Nail Unit

Los signos clínicos que acompañan a muchas alteraciones ungueales habitualmente no son patognomónicos de ninguna enfermedad concreta. Por tanto, la exploración del aparato ungueal desde diferentes ángulos de visión es fundamental para realizar un diagnóstico acertado. En el presente artículo se revisan los signos clínicos que pueden obtenerse mediante la exploración frontal del borde distal de la lámina ungueal y el hiponiquio, y se correlacionan con los signos de la exploración aérea. Dicho abordaje permite facilitar el diagnóstico clínico de la enfermedad ungueal en la práctica diaria (AU)

Clinical findings in many nail disorders are not usually pathognomonic. An accurate diagnosis therefore relies on inspection of the nail unit from different angles. We review clinical features of different nail disorders that can be observed during frontal examination of the distal edge of the nail plate and the hyponychium and correlate these with features observed when the nail is viewed from above. Frontal examination of the distal nail unit can help establish a clinical diagnosis in routine practice (AU)

[Translated article] Frontal Examination of the Distal Nail Unit / Visión frontal distal de la uña

Clinical findings in many nail disorders are not usually pathognomonic. An accurate diagnosis therefore relies on inspection of the nail unit from different angles. We review clinical features of different nail disorders that can be observed during frontal examination of the distal edge of the nail plate and the hyponychium and correlate these with features observed when the nail is viewed from above. Frontal examination of the distal nail unit can help establish a clinical diagnosis in routine practice (AU)

Los signos clínicos que acompañan a muchas alteraciones ungueales habitualmente no son patognomónicos de ninguna enfermedad concreta. Por tanto, la exploración del aparato ungueal desde diferentes ángulos de visión es fundamental para realizar un diagnóstico acertado. En el presente artículo se revisan los signos clínicos que pueden obtenerse mediante la exploración frontal del borde distal de la lámina ungueal y el hiponiquio, y se correlacionan con los signos de la exploración aérea. Dicho abordaje permite facilitar el diagnóstico clínico de la enfermedad ungueal en la práctica diaria (AU)

Surgical repair for deformities of the nail unit / 中华皮肤科杂志

Nail unit is an important structure for both aesthetic appearance and functional capability of the fingers and toes, and any defect or lesion at this anatomical site would lead to nail unit deformity. Surgical repair is the main treatment for such deformity. According to etiological and anatomical classification, appropriate surgical procedures can be chosen to repair the nail unit deformity, including autologous fat grafting, split-thickness nail bed grafting, full-thickness nail matrix grafting, nail bed elongation, palmar V-Y advanced flap reconstruction and so on. This review systematically summarizes classification of the nail unit deformity and associated surgical repair techniques.

Surgical repair for deformities of the nail unit / 中华皮肤科杂志

Nail unit is an important structure for both aesthetic appearance and functional capability of the fingers and toes,and any defect or lesion at this anatomical site would lead to nail unit deformity.Surgical repair is the main treatment for such deformity.According to etiological and anatomical classification,appropriate surgical procedures can be chosen to repair the nail unit deformity,including autologous fat grafting,split-thickness nail bed grafting,full-thickness nail matrix grafting,nail bed elongation,palmar V-Y advanced flap reconstruction and so on.This review systematically summarizes classification of the nail unit deformity and associated surgical repair techniques.