Ingrown Toenails Research Articles

A Prospective Study on the Local Injection of Glucocorticoid and Gentamicin for Treating Ingrown Nails

Background. Ingrown nails are a type of nonspecific inflammation of nail folds. Intralesional injection is a rarely reported nonsurgical therapy for ingrown nails. Objective. To observe the efficacy of treating ingrown nails with intralesional injection, and to evaluate at which stage ingrown nails are applicable for this therapy. Methods. Ingrown nails were randomly divided into treatment (n = 87) and control (n = 37) groups. The treatment group received local injections combined with basic nursing, whereas the control group was only treated with basic nursing. Patients were followed up at 1 week, 1 month, 3 months, and 6 months after the first treatment. Results. A statistically significant difference of the efficacy rates was observed between the two groups (P < 0.05). The overall satisfaction rate was 83.91% in the treatment group and 64.86% in the control group (P = 0.019). Conclusion. Intralesional injection is an effective therapy for ingrown nails, especially in the short term. This therapy is more applicable for Martinez‐Nova stage I and IIA ingrown nails and can be used as a symptomatic treatment to relieve the acute inflammation of ingrown nails at stages IIB, III, and IV.

A New Perspective on Partial Nail Avulsion: Surgical Pearl.

Ingrown nail or onychocryptosis is a common and prevalent condition associated with pain and discomfort resulting from recurrent inflammation. It is further categorized into 3 grades on the basis of severity as per classification by Heifetz and Mogensen, grade 1 can be easily managed with medical treatment; whereas grades 2 and 3 often requires surgical treatment; the most common surgical technique employed for ingrown nail is the simple nail avulsion by using a nail clipper. we have observed that due to the force of the nail clipper small amount of detachment in between nail plate and nail bed in addition to longer downtime post-procedure, so we proposed a new surgical modification of nail avulsion by using 11 no. surgical blade instead of nail clippers leading to very less trauma to nail bed and fine post-procedure outcomes.

The effectiveness of matrix ablation with silver nitrate in the treatment of ingrown toenails. A single-center case-control study.

Partial onychectomy with chemical matrixectomy is considered the gold standard treatment for stage II-III ingrown toenails (IT). However, there are scarce reports describing the use of silver nitrate in IT management in adolescents. Our aim is to analyze the effectiveness of matrix ablation with silver nitrate and compare it with partial onychectomy by electrocautery. A retrospective study of adolescent patients with stage II-III IT was performed. Those who underwent electrocautery matricectomy in a major outpatient surgical center (Group A) and those who were treated with silver nitrate at an outpatient clinic (Group B) were compared. Efficacy was determined by recurrence and postoperative infection rates. Two hundred and nine patients were included (86 group A; 123 group B), with a total of 382 partial onychectomies (151 group A; 231 group B). Group B patients exhibited a lower recurrence rate (4.7%) when compared to group A (11.2%, p= .02), and had a lower postoperative infection rate (4.0% group A vs. 1.7% group B; p= .18), although not statistically significant. Silver nitrate chemical matricectomy after partial onychectomy is an effective treatment for IT in adolescents, with few postoperative complications and low recurrence rate. Therefore, it should be considered as a possible alternative to electrocautery matricectomy.

Batık Tırnak Tedavisinde Winograde Ve Vandenbos Cerrahi Tekniklerinin Heifetz Evresine Göre Karşılaştırılması

Abstract
 Background: In ingrown toenail, classifications and the treatment approaches according to staging has been clearly reported in the literature. However, there are not enough data about the selection of the appropriate surgical technique according to the stage. In this study, we compared two different surgical techniques in patients with Heifetz stage 2 and 3 in means of surgical results, recovery time, patient comfort and cosmetics.
 Methods: Between January 2019 and January 21, patients who applied with the complaint of ingrown toenails who were treated with two mentioned surgical techniques in two centers with at least 1 year follow-up were included. The patients were evaluated preoperatively in means of the Heifetz classification. In group 1 (n:54) matrix excising Winograd and in group 2 (n:51) matrix preserving Vandenbos techniques were used. Postoperative recovery time, complication rates, functional and cosmetic patient satisfaction were evaluated in tall cases. 
 Results: 105 cases of ingrown toenails treated surgically were included in the study. 62 (59%) cases were Heifetz stage 2, 43 (41%) cases were Heifetz stage 3. No statistically significant difference was found between Heifetz stage 2 and stage 3, regardless of surgical technique, in complication, recurrence, patient functional/cosmetic satisfaction rates, and recovery time. In overall analysis regardless of Heifetz staging, recovery time was shorter with Winograd method (p:0.0001), complication and recurrence rates were lower with Vandenbos method (p:0.0001), and VAS cosmetic satisfaction was higher in Vandenbos (p:0.002).
 Conclusion: Winograd and Vandenbos in Heifitz stages 2 and 3 have low complication rates and high patient satisfaction. Earlier healing could be achieved with the Winograd technique, while low complication/recurrence rates and high cosmetic satisfaction could be achieved with the Vandenbos technique. Early recovery/high cosmetic expectation should be considered instead of Heifetz staging in determining the surgical technique.

Artículo traducido] Cauterización de la matriz con nitrato de plata para el tratamiento de las uñas encarnadas en los dedos de los pies en niños: estudio piloto

BackgroundAlthough partial onychectomy with chemical matricectomy has been described asthe treatment of choice, there is sparse evidence in the literature regarding the use of silvernitrate for matricectomy. Our aim is to describe the effectiveness of silver nitrate for matrixcauterization after partial onychectomy. MethodsA prospective observational study was performed on patients with ingrown toenailsstage 2–3 who underwent partial onychectomy with silver nitrate chemical matricectomy during 2018–2019 in our institution. All patients were evaluated in the outpatient clinic on the 7th and 30th post-operative day and a telephone evaluation was performed every 6 months afterthe surgical procedure to date. ResultsOne hundred and twenty-three patients, who underwent 231 partial onychectomies with silver nitrate chemical matricectomy were included, with a median follow-up of 21 months (interquartile range, 12–29). The procedure had an effectiveness of 95.3%, with only 11 recur-rences (4.7%) reported so far on follow-up. Postoperative infections were observed in 4 patients (1.7%). Adverse effects, such as pain and postoperative drainage, were irrelevant in mostpatients. ConclusionsSilver nitrate matricectomy after partial onychectomy is an effective and safealternative for the treatment of ingrown toenail in children, with scarce postoperative morbidityand low recurrence rate.

The management of ingrown toenails with soft tissue/periungual resection without nail resection or matricectomy: A scoping review.

Background: Most authors cite that an ingrown toenail is caused by an ingress of the nail plate into the periungual soft tissues, though a minority of authors believe that soft tissue pathology is primarily responsible. Consequently, when nail surgery is indicated, there is a dichotomy in the treatment approach aimed at either nail/nail matrix resection or soft tissue debridement. Aim: The aim of this research is to collate, code and chart data regarding ingrown toenails managed with soft tissue procedures - without nail or nail matrix resection. Methods: A scoping review of the literature on soft tissue resection techniques for the management of ingrown toenails without nail or nail matrix resection was carried out using current scoping review practice and PRISMA-ScR guidelines. Results: 25 articles were included in the review. Most of these papers were case studies or case series. Multiple surgical techniques were found but with no clear best technique identified due to low-quality research using heterogeneous methodologies. Conclusions: The evidence for the soft tissue management of ingrown nails is lacking in quality but warrants further consideration. High quality, perspective studies need to be performed to be eligible for future Cochrane reviews.

The Use of Cryotherapy in Cosmetology and the Influence of Cryogenic Temperatures on Selected Skin Parameters—A Review of the Literature

Cryotherapy is becoming an increasingly popular method used in medicine, physiotherapy, and cosmetology. It is used in the form of whole-body cryotherapy (WBC) and local cryotherapy. It is a tool for achieving analgesic and anti-inflammatory effects. Since the beginning of its use, its influence on the mental state has also been pointed out. The aim of this study was to analyze the available literature on the effect of cryogenic temperatures on the skin and the mechanisms induced by such a stimulus and its influence on well-being. A literature search of keywords or phrases was performed in PubMed®. Various effects of WBC on skin characteristics (hydration, pH, level of transepidermal water loss), mechanisms of anti-inflammatory effects, and effects on adipocytes were shown. Research on the impact of individual skin characteristics is not consistent. Positive effects on the reduction of inflammation and oxidative stress have been noted. Cryotherapy is also successfully used in dermatology to treat lentil spots, actinic keratosis, and ingrown toenails, remove viral warts, or relieve itching in atopic dermatitis. The results of the review also indicate the effectiveness of WBC as an adjunctive treatment for obesity. The number of papers available on the direct effects of WBC on the skin is still limited, despite the fact that it represents the first contact of the human body with cryogenic temperatures. Available data show that cold as a physical stimulus can be a safe and useful tool in cosmetology.

Current therapeutic insights regarding problematic fingernails and toenails in the Republic of Korea.

Problematic nails and toenails are infected by germs and increasingly have many causes. To investigate the types and treatment of problematic nails and toenails, we focused on bacteria that may appear in problematic nail toenail symptoms. We have searched for PubMed and Google Scholar and correlated the words Onychomycosis, Tinea ungium, Melanonychia, and ingrown toenail related to symptoms. To measure onychomycosis, KOH tests and fungal culture tests will be used. Treatment can be treated with full-body treatment using anti-fungal agents and local treatment (laser therapy) that can minimize the side effects. A biopsy should be performed when Melanonychia is diagnosed with brown or black pigments on the patient's fingernail plate. Moreover, ingrown toenail surgical treatment can be improved by acquired lifestyle. There are many different types of treatments, but many studies show that problematic nail and toenail improvement periods are long and treatment success rates are low.

내향성 발톱 교정을 위한 크랄레젤의 적용법에 따른 효과성 연구

As a study on the effectiveness according to the application of kralle gel for the correction of ingrowing nail. this study suggests the measures for utilizing the kralle gel for the correction of ingrowing nail as follows, focusing on the results of comparatively analyzing the effectiveness for 28 days according to the application of kralle gel(the number of application). 1. When the nail is cared without the application of kralle gel recover, the ingrowing nail disease could be caused or worsen, which requires attention. 2. If the kralle gel recover is applied once and kept for 28 days, the ingrowing nail disease could be prevented. 3. If the kralle gel recover is applied twice and kept for 28 days, it could not only prevent the ingrowing nail, but also improve the ingrowing nail of people with ingrowing nail disease. 4. If the kralle gel recover is applied three times and kept for 28 days, the ingrowing nail of people with ingrowing nail disease could be improved and corrected. 5. If the kralle gel recover is applied four times and kept for 28 days, the ingrowing nail of people with ingrowing nail disease could be corrected. 6. If the kralle gel recover is applied five times and kept for 14 days, the ingrowing nail of people with ingrowing nail disease could be quickly corrected. Hopefully, the data of this study could be much helpful for the prevention of ingrowing nail and people with ingrowing nail disease.

31876 Usefulness of noninvasive management with the gutter method for epidermal growth factor receptor inhibitor-induced paronychia, pyogenic granuloma-like lesion, and ingrown nail

Background: Nail complications such as paronychia, pyogenic granuloma-like lesions, and ingrown nail are common adverse events of epidermal growth factor receptor (EGFR) inhibitors. They frequently cause severe pain and are refractory. The gutter method is a nonsurgical treatment for ingrown nail in which a plastic tube is inserted between the nail plate and the nail fold. Reports on its effectiveness for EGFR inhibitor-induced nail complications are quite limited.

33824 Skin of color representation in Google image searches of common nail conditions

Introduction: Online resources in dermatology lack sufficient diversity in skin tones, which has been documented for common skin conditions. Representation of skin of color in online images of nail conditions is not well characterized. Methods: Common nail conditions were searched on Google images. The first 50 photographs for each condition were visually analyzed, rated on the Fitzpatrick scale, and categorized as Fitzpatrick I-II, Fitzpatrick III-IV, Fitzpatrick V-VI, or indeterminate, when categorization was not possible. Results: 34 nail conditions were searched on Google images. A total of 1826 photographs were evaluated, with 55% displaying Fitzpatrick skin types I-II, 31% displaying Fitzpatrick skin types III-IV, 7% displaying Fitzpatrick skin types V-VI, and 7% categorized as indeterminate. 5.9% (2/34) of searches displayed no photographs with Fitzpatrick skin types V-VI (nail pitting and onychomycosis, specifically). The conditions with the highest proportion of images displaying Fitzpatrick skin types V-VI are as follows: anonychia (32.7%), Darier disease (19.6%), longitudinal melanonychia (18.3%), and onychomadesis (15.7%). The conditions with the lowest proportion of images displaying Fitzpatrick skin types V-VI are as follows: brittle nails (1.9%), green nail syndrome (1.9%), ingrown nail (1.9%), nail psoriasis (1.9%), and pincer nail (1.9%). Conclusion: Skin of color is underrepresented in online searches of common nail conditions. With the increased reliance on the internet, especially Google, by patients and physicians to acquire medical information, there is an urgent need to include images representative of all skin tones in online medical content.

Does Electrocauterization of the Matrix After the Wedge Resection of the Toe-Nail Affect Recurrence in Discrete Age Groups Differently? A Retrospective Analysis

The onychocryptosis, also known as ingrown toe-nails, is a painful, common disorder which is less common in children than in adults. The purpose of the present study was to focus on the effect of electrocautery matricectomy on recurrence rate and clinical outcomes in different age groups. We performed a retrospective assessment of 189 consecutive ingrown toe-nails surgeries. Electrocautery matricectomy was performed in 68 (49.2%) of 138 (73%) adults, 25 (49%) of 51 (27%) adolescents. Recurrence was observed in 11 (21.5%) adolescent patients, while recurrence was observed in 12 (8.6%) adult patients. Recurrence was observed in 9 (9.6%) of 93 patients in whom cautery was used, while 14 (14.5%) recurrences were observed in 96 patients who did not use cautery. When the adolescent patient group was evaluated separately, recurrence was observed in 2 (8%) of 25 patients in the cautery group, while recurrence was observed in 9 (34.6%) of 26 patients in the other group. EM addition to the wedge excision does not affect the results in adult patients, but it significantly reduces recurrence in adolescent patients. Especially in younger patients, it is recommended to complete the matricectomy with electrocoagulation.

Necrosis of the Right Hallux Secondary to Local Anesthesia by Lidocaïne 2% with Adrenaline: A Rare and Preventable Complication

Recent scientific studies support the safe use of lidocaïne with adrenaline for anesthesia of the extremities (fingers, toes, nose, ear, penis), these studies push back the myth that advises against the use of local anesthetic substances with adrenaline in these areas [1-3]. Ingrown toenail is a common condition of the big toe. Surgery is often necessary. Ingrown toenail surgery is relatively straightforward and is usually performed under local anesthesia [3]. We report here a rare case of hallux necrosis secondary to local anesthesia by lidocaine 2% with adrenaline. The objective of this presentation is to warn practitioners about the observance of precautions before using local anesthetics with adrenaline for anesthetic procedures of the extremities.

Matrix Cauterization With Silver Nitrate in the Treatment of Ingrown Toenails in Children: Pilot Study

BackgroundAlthough partial onychectomy with chemical matricectomy has been described as the treatment of choice, there is sparse evidence in the literature regarding the use of silver nitrate for matricectomy. Our aim is to describe the effectiveness of silver nitrate for matrix cauterization after partial onychectomy. MethodsA prospective observational study was performed on patients with ingrown toenails stage 2–3 who underwent partial onychectomy with silver nitrate chemical matricectomy during 2018–2019 in our institution. All patients were evaluated in the outpatient clinic on the 7th and 30th post-operative day and a telephone evaluation was performed every 6 months after the surgical procedure to date. ResultsOne hundred and twenty-three patients, who underwent 231 partial onychectomies with silver nitrate chemical matricectomy were included, with a median follow-up of 21 months (interquartile range, 12–29). The procedure had an effectiveness of 95.3%, with only 11 recurrences (4.7%) reported so far on follow-up. Postoperative infections were observed in 4 patients (1.7%). Adverse effects, such as pain and postoperative drainage, were irrelevant in most patients. ConclusionsSilver nitrate matricectomy after partial onychectomy is an effective and safe alternative for the treatment of ingrown toenail in children, with scarce postoperative morbidity and low recurrence rate.

The Modified versus the Conventional Winograd Technique for the Treatment of Onychocryptosis: A Retrospective Study.

The Winograd technique is a common surgical treatment for ingrown toenails. Attempting to improve the results of this technique, two modifications were adopted: the incisional approach and the use of adhesive approximation strips. This study aimed to compare the conventional technique and the modified version based on (i) postoperative complications, (ii) healing time, (iii) recurrence rate, and (iv) overall patient satisfaction. A longitudinal, observational, and retrospective design was used, with a sample of 208 patients divided into the modified Winograd technique (n = 111) and the conventional Winograd technique (n = 97) in three clinics in Portugal, with follow-up periods of more than 15 years and 10 years, respectively. The modifications to the Winograd technique revealed fewer postsurgical complications, in terms of infections (1.8% vs. 20.62%, p < 0.010), recurrence rate (2.7% vs. 5.21%, p > 0.05), shorter recovery time (8.10 ± 0.76 vs. 14.51 ± 3.48 days, p < 0.001), and lower postoperative pain and better satisfaction with the functional and esthetic results, with the patient’s overall satisfaction, and with significant differences in relation to the conventional technique (p < 0.001). The modifications performed showed a lower rate of infection, decreased healing time, and better patient satisfaction, suggesting that it may be adopted in clinical practice for the treatment of stages II and III ingrown toenails.

A Comparison of Clinical Outcomes Between the Winograd and Modified Winograd Methods for Ingrown Toenails: A Retrospective Study of the Importance of Suturing Techniques.

Aim: This study aimed to compare the effects of the Winograd and modified Winograd methods for nail bed suturing on clinical outcomes in patients with nail ingrown.Methods: In total, 45 patients who underwent surgery for ingrown toenails between December 2019 and December 2020 were randomised retrospectively. In this study, different methods applied by the authors were studied, and the methods applied by each author were divided into two separate groups. All patients had partial germinal matrix and nail bed excisions. Thirty (53.6%) of the nails were dressed in gauze, leaving the excised area of ​​the nail unsutured (group 1). Then, the remaining 26 nails (group 2) were sutured with the mattress suturing technique to ensure that the skin was under the nail. Clinical outcomes, visual analogue scale (VAS) scores, and verbal satisfaction status were statistically evaluated.Results: In our study, 56 nails of 45 patients were evaluated retrospectively. The patients were followed up for an average of 13 (10­19) months. The mean age was 27.13 (15-­48) years. In total, 31 (68.9%) of the patients were men, and 14 (31.1%) were women. The incidence of postoperative bleeding and granulation tissue development decreased in the sutured group. In group 1, the development of hypertrophic granulation tissue after surgery had a significantly negative impact on VAS score and recovery time. In the sutured group, patients returned to work or performed activities of daily living for a shorter period. Approximately 95% of patients were satisfied or extremely satisfied.Conclusion: Partial matrix excision using the appropriate suturing technique is associated with a fast recovery, low recurrence rate, high patient satisfaction, and earlier return to work activities of daily life among patients treated for ingrown toenails.

A new, quick, effective and minimally invasive treatment technique applied to ingrown toenails

Objectives: Existing surgical and conservative treatment techniques applied to ingrown toenails remain controversial. In this study, a new minimally invasive technique for the treatment of ingrown toenails is described which was found to provide rapid healing and effective results. Methods: The presented study includes 39 patients with ingrown toenails treated with the newly developed technique. The technique is a minimally invasive procedure in which a half groove-shaped piece obtained from the intravenous drip set plastic was placed between nail and dermis and fixed on the nail. Results: The patients treated with this technique were followed up after one week, one month and six months. According to six-month follow-up results of the patients, achievement rate of the presented technique was found to be quite high at 80%. Conclusions: This new technique has many advantages compared to existing ingrown toenail treatment methods. It was revealed that this method is very effective and successful by not requiring dressing, ensuring low pain, rapid recovery from the first day of the treatment, uninterrupted return to daily life, and low recurrence rate. One of the most important advantages of the technique is that it ensures high patient satisfaction by providing good functional and aesthetic results.

Retrospective Evaluation of Ingrown Toenails in a Tertiary Reference Center.

We evaluated the clinical characteristics of ingrown toenails in one of the biggest reference centers in Turkey. This retrospective cohort study was conducted on patients admitted to Ufuk University Hospital with ingrown toenail between January 1, 2014, and December 31, 2019. Clinical characterstics and demographic features of all of the participants were evaluated, and then the study population was divided into two groups: group 1 (patients ≤20 years old) and group 2 (patients >20 years old). These groups were compared in terms of clinical findings. Disease duration, body mass index, rate of medications for chronic diseases, and rate of joint diseases were significantly higher in group 2. Rates of hyperhidrosis and sudden weight gain were significantly higher in group 1 (P < .05). Severity of ingrown toenail was significantly different between groups (P = .006). Stage 1 was the most common stage in both groups, and rate of stage 3 was higher in group 1. Onycoshisis and was more common in group 1, and nail thickening was more common in group 2 (P < .05). Nail wire and aluminum chloride were the most common treatment modalities in groups 2 and 1, respectively (P < .05). Periungual edema, presence of pus, hypertrophy, and granulation were more common in group 1 (P < .05). Thin nail plate was more common in group 1, and normal and thick nail nail plates were more common in group 2 (P < .05). Clinical characteristics of ingrown toenail vary between younger and older populations. Thus, an individualized approach is preferred in the management of ingrown toenail for different age groups.

Usefulness of Noninvasive Management With the Gutter Method for Epidermal Growth Factor Receptor Inhibitor–Induced Paronychia, Pyogenic Granuloma–Like Lesion, and Ingrown Nail

Usefulness of Noninvasive Management With the Gutter Method for Epidermal Growth Factor Receptor Inhibitor–Induced Paronychia, Pyogenic Granuloma–Like Lesion, and Ingrown Nail

"Ingrown Toenail Device Therapy Using Remote Correction"

"Ingrown Toenail Device Therapy Using Remote Correction"