A Clinical Study of Efficacy of Surgical Management for Pincer Nails / 대한피부과학회지

BACKGROUND: A pincer nail deformity is characterized by the presence of an excessively curved and distorted nail across the transverse dimension, particularly at the distal part of the nail plate. A multitude of therapeutic modalities has been implemented to treat this condition with limited efficacy. OBJECTIVE: We sought to evaluate the efficacy of surgery of a pincer nail deformity with the use of the modified Haneke's method. METHODS: Six patients (seven toenails and two fingernails) with pincer nail deformities were treated with the modified Haneke's method. Objective assessment was evaluated by use of the width index (width of the nail tip/width of the nail root) and height index (height of the nail tip/width of the nail root). Subjective assessment was evaluated by use of a visual analogue scale declared by patients. In addition, wound complications and recurrence were described. RESULTS: The width index and height index were improved (width index: 15.4%-->7.1%, height index: 63.9%-->1.9%). Relief of pain could be determined in 100% of the cases. For subjective assessment, all of the patients were satisfactory (more than "satisfactory": 100%). There was no recurrence during a 14 to 24 month period (mean time: 19.2 months). CONCLUSION: The modified Haneke's method as a surgical approach might be effective and the procedure is easy to perform for a pincer nail deformity.

VEGF Expression of Cultured Keloid Fibroblasts from Different Donor Sites Under Normoxic and Hypoxic Conditions / 대한피부과학회지

BACKGROUND: The pathophysiological events resulting in keloid formation remain unclear. Overabundant levels of VEGF have been reported to contribute to excessive wound healing. There have been many studies describing the relationship between keloids and VEGF expression. However, there have been no reports about VEGF expression related to donor sites. OBJECTIVE: We investigated VEGF expression of cultured normal and keloid fibroblasts obtained from different body areas under normoxic and hypoxic culture conditions. METHODS: Normal fibroblasts from the earlobe (n=2), shoulder (n=2) and chest (n=2) as well as keloid fibroblasts from the earlobe (n=3), shoulder (n=3) and chest (n=3) were collected and cultured. VEGF expression of fibroblasts at 6 hours, 12 hours, 24 hours and 48 hours for cells maintained under normoxic and hypoxic conditions was measured by the use of RT-PCR. Paraffin-embedded tissues (normal and keloid tissue) were assayed by immunohistochemical staining. RESULTS: For the cultured normal fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition, irrespective of the donor site and time. However, for the cultured keloid fibroblasts, VEGF expression for cells in the hypoxic condition was higher as compared to VEGF expression in cells in the normoxic condition for cultured shoulder fibroblasts. For each donor site, VEGF expression was highest in the shoulder, followed by the chest and earlobe for cultured normal fibroblasts, irrespective of time. For the cultured keloid fibroblasts, the highest VEGF expression occurred at 6 hours for cells in the normoxic condition and the highest VEGF expression occurred at 6 hours and 12 hours for cells in the hypoxic condition. Based on immunohistochemical staining, VEGF expression of paraffin-embedded normal tissue was lower as compared to paraffin-embedded keloid tissue. For each donor site in paraffin-embedded keloid tissue, VEGF expression was highest in the shoulder, followed by the chest and earlobe. CONCLUSION: Oxygen tension and the nature of fibroblasts from different donor sites are involved in keloid pathogenesis.