Evaluation of the efficacy of complete nail plate avulsion in the treatment of five cases of retronychia / 中华皮肤科杂志

Objective:To evaluate the efficacy of complete nail plate avulsion in the treatment of retronychia.Methods:From June 2018 to November 2019, 5 patients with retronychia (5 toes) were collected from the Department of Dermatology, Shanghai Ninth People′s Hospital, Shanghai JiaoTong University School of Medicine, and treated with complete nail plate avulsion. In some cases, redundant skin tissues at the distal end of the great toe were removed. After the surgery, artificial nails were placed on the surface of the nail bed followed by the suturing.Results:In the 5 patients, the neonatal nail plate gradually grew over the nail bed, and pain was completely relieved. Within the follow-up of 6-12 months, the nail plates of the 5 patients all returned to normal.Conclusion:Complete nail plate avulsion is effective for the treatment of retronychia, and worthy of clinical promotion.

Great Toenail Dystrophy: A Single-Center Experience and Review of the Literature / 가정의학회지

BACKGROUND: There have been a few reported cases of congenital great toenail dystrophy (GTND), described as a congenital malalignment of the great toenails. However, acquired GTDN is rare, and has not been documented extensively. This study aimed to describe the clinical features of 21 patients with acquired GTND. METHODS: Twenty-one patients with acquired GTND who visited Yeouido St. Mary's Hospital between June 2005 and August 2012 were retrospectively reviewed. RESULTS: The mean patient age was 43.1 years (range, 17 to 88 years), and the cohort predominantly comprised women (18/21). In our experience, all acquired GTND patients presented with yellow or yellow-brownish chromonychia, onychotrophy, and onycholysis. Conservative treatment with tape methods and grinding, as well as nail extraction, was provided and yielded little improvement in any case. CONCLUSION: This study provides initial data on the nail changes affecting the great toenail, such as yellowish chromonychia, onychomadesis, and onycholysis. These data may help physicians to distinguish various nail disorders, including onychomycosis, congenital malalignment of the great toenails, and yellow nail syndrome.

Retronychia, a Proximal In-growth of the Nail Plate / 대한피부과학회지

Retronychia is a process of a nail embedding itself into the proximal nail fold due to an incomplete shedding of the nail, and this usually occurs after physical trauma. Retronychia causes persistent paronychia and defective nail growth on the patients. Simple avulsion of the superimposed nail is curative. A 17-year-old man presented with tender erythema and swelling on the proximal nail fold of the right 3rd and 4th fingers for 2 months after an operation that was performed due to metacarpal bone fracture. The second patient was a 25-year-old male who presented with a 1-month history of persistent paronychia on his right great toe after blunt trauma. For both patients, simple avulsion of the damaged nail was curative and underlying new nails were revealed. We report here on two cases of retronychia that could be easily overlooked and such cases have not been previously reported in the Korean dermatologic literature.

Three Cases of Retronychia / 대한피부과학회지

Retroncyhia shows ingrowth of the nail toward the proximal nail folds. Initial events start from minor trauma of the digital pulp that disturbs longitudinal nail growth. This disturbed growth of the nail changes the growth direction to the proximal nail folds, leading to persistent paronychia, formation of granulation tissue, and other nail changes. Simple avulsion is curative and can improve most symptoms. There are few reports about retronychia in the English literature, and we report 3 cases of retronychia here.

A Case of Retronychia on Toenail

PURPOSE: Retronychia is the embedding of the nail into proximal nail fold. Retronychia starts with disruption of the longitudinal growth of the nail. With the growth of a new nail, the old one is pushed upwards and backwards. This leads to embedding of the top nail into the ventral aspect of the proximal nail fold and results with chronic paronychia. We present a case of retronychia that was rarely reported in the literature. METHODS: A 46-year old female presented with a 3-month history of painful right first, 2nd, 3rd toenail changes. Although she was initially treated with broad spectrum antibiotics, she did not response to therapy. Later, she presented to our department because of progressively worsening pain that impaired her walking. Physical examination revealed with proximal nail fold erythema, painful swelling, yellowish nail discoloration, and distal onycholysis. Bacterial and fungus culture showed no organism. Treatment was surgical nail avulsion under local anesthesia. RESULTS: The postoperative course was uneventful. 10 months later, the patient had a normal growing nail and was free of symptoms. CONCLUSION: We report a case of retronychia on toenail. Retronychia is a proximal nail plate ingrowth into the proximal nail fold which is associated with multiple generations of nail plate misaligned beneath the proximal nail. Management consisted of simple avulsion of superimposed nail. Retronychia is suspected with a persistent paronychia, particularly in the setting of trauma. Avulsion of the top nail confirms the diagnosis and may be curative if the underlying nail appears healthy.