Ingrown Toenails Research Articles

Effects of a Training Course for Andalusian Podiatrists on Antibiotic Management in Ingrown Toenail Infections: A Pilot Study.

The use of antibiotics (ABs) for the prevention and management of infections has been widespread for decades and, at this time, AB resistance is a global health crisis. The available evidence highlights the need to reduce the prophylactic and therapeutic use of ABs to avoid associated risks. A preliminary study with a total sample of 56 Andalusian (Spain) podiatrists was surveyed. The purpose of this study was to identify whether there were changes in prescription habits from a situation before a subsequent training course on AB indications for the management of infections associated with ingrown toenails. An ad hoc questionnaire of 15 items related to therapeutic and prophylactic prescriptions of ABs was developed for this purpose, and the evaluation was carried out before and after the training course. The responses obtained before and after training were compared. The training activity led to improvements in the prescription habits of the participants, producing significant changes in the prescription pattern of the professionals in 10 of the 15 items. The results of this preliminary study show that the podiatrists surveyed improved the rational use of systemic AB therapy in ingrown toenails infections.

Winograd Wedge Resection Matrixectomy versus Partial Nail Avulsion with Chemical Cautery: A Tertiary Institution's Clinical Outcomes and Proposed Triaging Protocol.

Onychocryptosis, or ingrown toenail, is a common condition affecting patients of varying age groups, although usually, younger patients are affected. We compared two techniques used in our institution: Winograd wedge resection with matrixectomy (WG-M) versus partial nail avulsion with phenolization of the nail matrix (PNA-P). Primary outcomes of interest were presence of nail regrowth and patient satisfaction postoperatively. Secondary outcomes were postoperative pain (within the first 2 weeks and after 2 weeks), postoperative inflammation, and healing time. A total of 65 patients were included in this study: 44 patients (19 female and 25 male patients), with a mean age of 45.7 years (range, 16-83 years) underwent WG-M in the orthopedic surgery department, whereas a total of 21 patients (10 female and 11 male patients), with a mean age of 44.5 years (range, 13 to 75 years) underwent PNA-P in the podiatry department. In patients who underwent WG-M, there was one case of regrowth (2.3%) compared with no regrowth cases (0%) in the PNA-P group. There was no significant difference in regrowth rate between the two procedures (P = .494). The satisfaction rate was high for both procedures: 100% patients in the WG-M group rated themselves better than before surgery, compared with 95.7% in the PNA-P group. From our study, we conclude that both techniques (WG-M and PNA-P) are able to achieve similar clinical outcomes, with the PNA-P procedure being less invasive and less resource intensive, and also achieving a shorter healing time.

Effect of Nail Disorders on Quality of Life Scale Scores: A Prospective, Cross-sectional Study from a Tertiary Referral Center.

To investigate the relationships among nail disorders, various clinical factors, and commonly used quality of life scales. A prospective cross-sectional study was conducted on 188 patients older than 18 years who applied to the Dermatology and Venereology Department of Ufuk University Hospital (Ankara, Turkey). The Turkish Quality of Life instrument, the Hospital Anxiety and Depression Scale, and the 36-Item Short-Form Health Survey were used for the analyses. Eight groups were formed based on 1) sex, 2) age (18-45 years, >45 years), 3) duration of nail disease (≤1 year, >1 year), 4) number of affected nails (1, 2, ≥3), 5) type of nail disease (nail thickening, ingrown toenail, pincer nail, and other nail diseases), 6) presence of onychomycosis, 7) fingernail involvement, and 8) pain score (0-5, 6-10), and the quality of life scales were compared between these groups. In addition, correlation analyses were performed between age, number of affected nails, duration of disease, presence of onychomycosis, chronic diseases and medications, and body mass index and the quality of life scale scores. Nail disorders were associated with decreased quality of life in affected individuals. Moreover, age, duration of disease, type of nail disorder, body mass index, comorbid conditions, and pain scores had significant effects on quality of life scale scores. Management of nail disorders is challenging, and generally, a long period is necessary to achieve favorable outcomes. Both physcians and patients should be persistent during the treatment process. In addition, emotional and social support should be provided to patients.

Evaluation of Foot Deformities in Patients With Ingrown Nails.

Ingrown nail is a condition caused by the perforation of the periungual soft tissues on nail folds by the sides of nail plaque, causing inflammation and severe pain. Recently, the role of foot anatomical disorders in ingrown nail development has been emphasized. The main objective of this study aimed to determine whether foot deformities played significant roles in ingrown nail development with objective radiological parameters. The study included 64 patients diagnosed with clinical ingrown nail and 71 patients as controls without any ingrown nail history. In both groups, we evaluated the bilateral foot radiographs of patients with ingrown nails for hallux valgus angle (HVA), interphalangeal angle (IPA), and intermetatarsal angle (IMA) associated with hallux valgus, and the calcaneal pitch angle (CPA), talohorizontal angle (THA), and talometatarsal angle (TMA) related to pes planus. No significant difference was found in terms of hallux valgus radiological measurements of HVA, IPA and IMA as well as pes planus radiological measurements of CPA and TMA values, when compared to controls. THA was statistically significantly higher in the control group (P = 0.025). There was a moderate strength positive relationship between ingrown nail stage and measured TMA for pes planus diagnosis (rho = 0.326; P = 0.04), yet there are no significant correlations between ingrown nail stage and other angles. Therefore, we do not recommend foot anatomy correction in the prevention and treatment of ingrown nails, unless there is an accompanying foot deformity; however, pes planus is a foot deformity that can accompany patients with severely ingrown nails.

Onychocryptosis: A review of epidemiology, risk factors, classification, complications and effective therapeutic strategies.

Abstract: Ingrown toenails, clinically known as onychocryptosis, represent a prevalent nail pathology. The clinical manifestation involves symptoms typical for a foreign body reaction and in severe cases, tissue hypertrophy with complications may occur. Key risk factors include improper nail care, trauma, obesity, tight footwear, poor foot hygiene, and genetic predisposition. The condition predominantly affects individuals between the first and the third decades of life and older adults, with a predilection for the great toe, especially the lateral skin fold. The Heifetz and Scholz classifications delineate the stages of ingrown toenails based on severity. Therapeutic approaches range from conservative procedures, such as taping, dental floss, gutter treatment, cotton nail cast, braces and super elastic wire to surgical interventions like partial or total nail avulsion, matricectomy and advanced techniques like the Vandebos procedure or the Winograd procedure. Although many studies have analysed available treatment methods, there is no consensus among specialists regarding the best therapeutic strategy. Complications include paronychia, infection, and scarring. A comprehensive therapeutic approach should consider clinical severity, patient preferences, and both conservative and surgical interventions, emphasizing the importance of larger randomized clinical trials to establish definitive guidelines.

Anatomical Rationale for the Choice of Surgical Intervention for an Ingrown Nail

BACKGROUND. An ingrown toenail is one of the reasons for surgical intervention: it accounts for up to 20 % of all operations in clinics. At the same time, conservative and surgical approaches to treatment are not reliable enough: up to 70% of cases are complicated by relapses. AIM OF STUDY. To study the topographic location and ratio of cells in the growth zone of the nail plate, necessary for planning the volume of intervention in the treatment of ingrown toenails. MATERIAL AND METHODS. The material for conducting our own research was samples of the cadaver nail complex, without identified pathologies, from 20 objects of different ages and genders. Studies were carried out using histological, immunofluorescent and microscopic methods. The results were compared with available literature data, clarifying the most important structural features. The data obtained will make it possible to reasonably plan the volume of intervention during operations for ingrown nails, as well as to reduce the number of unsatisfactory results of operations on the nail complex in case of injury and nail diseases.

Surgical Strategies for Ingrown Toenails: A Comprehensive Review of Techniques, Outcomes, and Advancements.

Ingrown toenail (IGTN), known as onychocryptosis or unguis incarnatus, is a painful condition affecting the big toe, with symptoms including pain, inflammation, and infection. This review explores surgical options for IGTN, categorized into altering the nail plate or diminishing periungual tissues. Conservative treatments alleviate early-stage symptoms, while surgical interventions are reserved for severe cases. Various surgical techniques are discussed, such as the Winograd technique, Vandenbos procedure, chemical matricectomy, radiofrequency ablation, bipolar diathermy, carbon dioxide laser ablation, Zadik's procedure, Howard-Dubois procedure, Super U procedure, Noël's procedure, knot technique, and toenail paronychium flap. The choice of procedure depends on the severity and recurrence of IGTN.

Treatment of Ingrown Toenail with a Minimally Invasive Nail Fixator: Comparative Study with Winograd Technique.

Many surgical techniques have been reported for treatment of ingrown toenails. Occurrence of infection after matricectomy procedures could cause clinicians to prefer using external braces in the treatment of ingrown toenails. This study compares patients with ingrown toenails who underwent the nail fixation technique and the Winograd technique. Patients who underwent ingrown toenail surgery were reviewed retrospectively. The patients' demographic characteristics (ie, age, gender, body mass index morphology according to Heifetz classification, surgical technique, visual analogue scale values, time to return to daily activities [days], complications, and satisfaction levels) were all recorded. Seventy patients were included in the study. Of the patients, 33 underwent nail fixation and 37 underwent the Winograd technique. No significant statistical differences were found in terms of patients' age, gender, body mass index, preoperative clinical features, long-term satisfaction, and ingrown toenail recurrence rates between the two groups, but time to return to daily activities and visual analogue scale values were statistically significantly lower in patients treated using nail fixation compared with the Winograd technique. Nail fixation can be an effective surgical treatment option for ingrown toenail.

Treatment of ingrown toe nail by homoeopathic approach

Treatment of ingrown toe nail by homoeopathic approach

Treatment of ingrown toenail with proximolateral matrix partial excision

Treatment of ingrown toenail with proximolateral matrix partial excision

Efficient analysis of adverse drug events and toxicological mechanisms of newly marketed drugs by integrating pharmacovigilance and network toxicology: selumetinib as an example.

To integrate pharmacovigilance and network toxicology methods to explore the potential adverse drug events (ADEs) and toxic mechanisms of selumetinib, and to provide a reference for quickly understanding the safety and toxicological mechanisms of newly marketed drugs. Taking selumetinib as an example, this study integrated pharmacovigilance methods based on real-world data and network toxicology methods to analyze its ADE and its potential toxicological mechanism. First, the ADE reports of selumetinib were extracted from the US Food and Drug Administration (FDA) adverse event reporting system (FAERS), and the ADE signals were detected by reporting odds ratio (ROR) and UK medicines and healthcare products regulatory agency (MHRA) methods. The ADE signals were classified and described according to the preferred terms (PTs) and system organ class (SOC) derived from the Medical Dictionary for Regulatory Activities (MedDRA). The network toxicology method was used to analyze the toxicological mechanism of the interested SOCs. The specific steps included predicting the potential targets of selumetinib using TOXRIC, STITCH, ChEMBL, CTD, SwissTargetPreditcion, and Super-PRED databases, collecting the targets of SOC using GeneCards database, conducting protein-protein interaction (PPI) analysis through STRING database, conducting gene ontology (GO) and Kyoto encyclopedia of genes and genomes (KEGG) analysis through DAVID database, and testing the molecular affinity using AutoDock software. A total of 1388 ADE reports related to selumetinib were extracted, and 53 positive signals were detected by ROR and MHRA methods, of which 20 signals were not mentioned in the package insert, including ingrowing nail, hyperphosphatemia, cardiac valve disease, hematuria, neutropenia, etc. Analysis of the toxicological mechanism of six SOCs involved in positive ADE signals revealed that the key targets included EGFR, STAT3, AKT1, IL6, BCL2, etc., and the key pathways included PI3K/Akt pathway, apoptosis, ErbB signaling pathway, and EGFR tyrosine kinase inhibitor resistance, etc. Molecular docking assays showed spontaneous binding of selumetinib to key targets in these pathways. The pharmacovigilance analysis identified some new potential ADEs of selumetinib, and the network toxicology analysis showed that the toxic effects of selumetinib may be related to PI3K/Akt pathway, apoptosis, ErbB signaling pathway, EGFR tyrosine kinase inhibitor resistance and other pathways.

Analysis of Gender Usage Characteristics of Korean Medical Nail Care

Purpose: This study aims to analyze the treatment usage characteristics of consumers in Korea who use medical nail care, which is a noninvasive combined treatment.Methods: The study examined three symptoms, namely, onychomycosis, ingrown toenails, and pincer toenails in a group of 500 people in December 2022. A survey was conducted, and data were analyzed by gender.Results: In terms of the type of problem toenails, onychomycosis was higher in men, and women displayed high rates of pincer toenail. Current toenail conditions exhibited slightly negative response rates for men and women. Moreover, men tend to prefer hospitals, and women perform self-care to manage these issues. The usage rate of general nail salons was higher for women than that for men. The reasons for opting to use medical nail care demonstrated high response rates of improvement in problem for men and women. For procedures, the usage rate of laser or medication for treating onychomycosis was higher for men, whereas that of the resin gel procedure for ingrown and pincer toenail was higher for women. The monthly expenditure cost was less than 100,000 won for men and women, and the period of effect did not significantly differ across two and three months for both groups.Conclusion: The findings of this study have implications for understanding consumers with problematic toenails and rethinking the medical nail care system.

Оніхокриптоз у дітей: огляд літератури та узагальнення досвіду лікування на базі клініки дитячої хірургії Вінницького національного медичного університету імені М.І. Пирогова

Onychocryptosis in children is a medico-social problem, since the suffering associated with this pathology affects the general state of health and the formation of children's psyche, which significantly worsens the quality of life in pediatric practice. Purpose - to highlight the problem of treatment of an ingrown toenail in children to determine the optimal therapeutic and diagnostic tactics. The article analyzes the possible causes and risk factors of ingrown toenails, describes the symptoms of this disease. The experience of treating onychocryptosis in children is considered, namely, the methods of surgical intervention, taking into account the frequency of relapses, treatment terms, levels of trauma, and cosmetic results. The work summarizes the experience of treating 167 patients with onychocryptosis who were treated in the pediatric surgery clinic of the National Pirogov memorial Medical University from 2011 to 2020. A clinical case of operative treatment of onychocryptosis using the Schmiden method is demonstrated. Conclusions. The appearance of an ingrown toenail in children is explained by various congenital and acquired causes. Onychocryptosis occurs mainly in adolescence. The choice of the method of surgical treatment depends on the severity of local pathological changes and the presence of complications, the frequency of relapses, and the duration of treatment. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

역핀칭하드젤 관리가 내성발톱 개선에 미치는 효과

This study attempted to broaden the scope of foot care fields including ingrown toenail care with professionalism. For this, the concept of an ingrown toenail and ways to take care of the problem were examined. Then, this study investigated changes in toenail width, angle and pain after ingrown toenail care, using reverse pinching hard gel, one of ingrown toenail care techniques. It is anticipated that the study results would be available as basic data needed to take care of various nail conditions such as ingrown toenails in nail salons.
 For this, an experiment was performed against 4 testees who were suffering from a ‘C’-shaped ingrown toenail on both big toes from August to October, 2022, using reverse pinching hard gel. The treatment was given to a right big toe once over 2 months and to a left foot twice for the same period. Then, changes in toenail width, angle and pain were examined before and after the treatment, and the results found the followings:
 First, concerning subjects’ general characteristics about toe and toenail care, all four testees said that they stand for 5-8 hours or longer a day. With regard to hereditary aspects, they responded that all their family members but only one person are suffering from an ingrown toenail. In other words, even though ingrown toenails can be influenced by working or daily life conditions, they are considerably genetic. Second, reverse pinching hard gel broadened the width and angle of ingrown toenails despite just one-time treatment. When the treatment was given twice, the width and angle of the problematic toenails were further widened, compared to the results of the one-time treatment. Third, in terms of the degree of pain after the reverse pinching hard gel treatment, it was ‘8’ in average before the treatment. It dropped to ‘1’ right after the treatment. When it was given twice, the score was ‘0’, meaning ‘no pain’. When the gel was removed after the treatment was given once and twice, there was no pain (‘0’).

Dermatologic conditions in dancers: a statewide survey.

Performing artists, such as dancers, singers, actors and musicians, rely on their physical bodies to successfully execute their artforms. However, literature regarding dermatologic conditions that impact dancers is lacking. An anonymous REDCap® secure survey was distributed by email to Dance Majors, Dance Minors, and Dance Instructors/Professors at five Virginia undergraduate institutions. Responses regarding demographics, style of dance, and dermatological diseases were recorded over a 2month period. When asked about developing skin disease, 57 (59%) of survey participants reported experiencing skin diseases, such as acne, eczema, hyperhidrosis, and plantar warts. When asked about skin diseases exacerbated or believed to be caused from dancing, 56 (59%) reported blisters, callouses, skin splitting, nail/foot infection, ingrown nails, and floor burns. This study demonstrates two main findings: dancing may exacerbate current skin disorders and some skin conditions may be caused by dancing. Additionally, the common practice of dancing barefoot likely contributes to the development of certain skin conditions. Limitations include sample size, response bias, and lack of validation of the survey.

Evaluation of the Efficacy of the VHO-Osthold® Perfect Orthonyxic Buckle While Treating Ingrown Nails and Its Effect on the Clinical Picture of the Nail Apparatus

Background: An ingrown nail (IN—ingrowing nail) is a very troublesome condition that mainly affects the big toe in all age groups and involves the ingrowth of part of the nail plate into the soft periungual tissues, causing an inflammatory reaction, pain, and even a bacterial infection. As a result of the evolution of inflammation, highly vascularized and painful granulation tissue is formed, visible in the side walls, which causes difficulties in walking, while reducing the quality of life of patients in everyday functioning. The aim of the study was to evaluate the effectiveness of the VHO-Osthold® Perfect orthonyxic buckle while treating ingrown nails and its effect on the clinical picture of the nail apparatus. Methods: A prospective observational study was conducted on 39 patients with ingrown toenails in Scholz stage 3a–5b who underwent therapy with the use of a VHO-Osthold® Perfect orthonyxic brace. An original questionnaire form was used to assess the therapy, consisting of several parts concerning the type and stage of the ingrown nails, the location and aetiopathogenesis of the ingrown nails, pain, and the patients’ life quality before and after therapy. Results: All elements improved significantly after treatment (p < 0.05 each). Twelve months after the end of therapy, none of the probands reported disease relapse. The predominant location of ingrown nails was both big toes (69.2% for each foot). The most common group of reasons was outer pressure—all patients experienced at least one issue, with frequent mechanical injuries being the most common (59.0%), followed by wearing too-small shoes (46.2%). Almost half of the patients declared no worries during treatment (48.7%). Life quality assessment grew from 1.82 ± 1.02 to 6.41 ± 0.72 on a scale from 1 to 7, p < 0.001. Conclusions: The VHO-Osthold® Perfect clamp eliminates pain after application to the ingrown toenail and allows for a safe and conservative approach to the treatment of ingrown toenails, improving the clinical picture of the nail apparatus, general well-being, and the quality of life of patients with advanced ingrown toenails.

A Comparison of Curettage Only and Curettage with Electrocautery After Partial Matrixectomy for Ingrowing Toenail

Aim: Ingrowing toenail is a very common disease which causes workforce losses. Although different techniques have been described in surgical treatment, one of the most frequently preferred methods is partial matrixectomy. The aim of this study was to compare the two techniques of curettage only and curettage together with electrocautery(C&E) used in addition to partial matrixectomy in ingrowing toenail surgery. 
 Methods: Patients who were operated for ingrown nails between 2018 and 2022 were evaluated retrospectively. Two groups were formed of 43 patients applied with curettage only and 35 patients applied with C&E. The groups were compared in respect of operating time, postoperative complications and clinical results. 
 Results: No significant difference was determined between the groups in respect of age, gender, affected side, classification, follow-up time, surgical duration and recovery time. Recurrence rate was higher in the curettage group (p=0.020) It occurred in 9 (20.9%) cases in the curettage group, while it occurred in 1 (2.9%) case in the C&E group. In the curettage group, the duration of erythema was observed to be significantly longer (p

New, Effective and Minimally Invasive Technique for the Treatment of Ingrown Toenails: Our Application Experiences

New, Effective and Minimally Invasive Technique for the Treatment of Ingrown Toenails: Our Application Experiences

A fact-finding survey on pre-ulcerative lesions of foot in patients with diabetes: analysis using the Diabetes Study from the Center of Tokyo Women's Medical University 2018 (DIACET 2018).

We aimed to identify the frequency and risk factors of pre-ulcerative lesions of foot in Japanese individuals with diabetes. This was a single-center cross-sectional observational study. We conducted a questionnaire survey of 5029 individuals with diabetes (mean age 63years; 2185 women; 1015 individuals with type 1 diabetes and 4014 individuals with type 2 diabetes) who (a) participated in the Diabetes Study from the Center of Tokyo Women's Medical University: DIACET 2018, and (b) responded to the presence of pre-ulcerative lesions of foot. A pre-ulcerative lesions of foot was defined as a calluses, ingrown nails, or symptoms of fungal infection. The associations between pre-ulcerative lesions of foot and commonly available clinical information were examined using the logistic regression analysis. 412 of 1015 (40.6%) individuals with type 1 diabetes and 1585 of 4014 (39.5%) individuals with type 2 diabetes reported having any type of pre-ulcerative lesions of foot. The frequency of calluses, ingrown nails, and symptoms of fungal infection, respectively, were 16.8%, 15.8%, and 21.9% in type 1 diabetes and 10.5%, 18.5%, and 24.7% in type 2 diabetes. In the separate analysis by type of diabetes, common risk factors found to be significantly correlated with pre-ulcerative lesions of foot were female gender, numbness in the feet and foot deformation. Proactive foot screening by health care professionals was considered important, especially in individuals with type 1 and type 2 diabetes with advanced complications and foot deformation. The online version contains supplementary material available at 10.1007/s13340-023-00649-7.

A Subungual Nevoid Melanoma of the Right Hallux from a 65-Year-Old Man: A Case Report.

Nevoid melanoma (NeM) is a rare variant of malignant melanoma characterized by slight cellular atypia, polymorphism, and incomplete maturation. It most frequently occurs on the trunk and arms but rarely on the foot. Here, we report a subungual NeM of the right hallux. A 65-year-old man presented with severe pain of 6 months' duration to his right great toe following self-treatment for an ingrown nail. He was evaluated and treated with debridement of the toenail at an urgent medical center 3 months prior. However, this had not relieved his pain. The patient also noticed discoloration of his distal great toe over the past 3 months. Removal of part of the ingrown nail revealed a pigmented mass extending distally from the matrix. Surgical excision of the mass was performed because of the concern for malignancy. The diagnosis of NeM was based on histologic analysis along with enhanced diagnostic modalities. The patient was further treated with surgical amputation of the great toe and anti-programmed cell death-1 therapy. The patient had no relapse at 1-year follow-up. Nevoid melanoma is a rare variant of malignant melanoma on the toes, which needs to be differentiated from a nevus with atypia, with a variety of modalities including cellular and molecular profiling. The optimal treatment is amputation.