AAD
Author: Willhemenia Loremipsum Special session: Lorem ipsum dolor sit amet Category: Lorem ipsum View all results

Please login or create an account. If you do not have access to this content, you will be shown a 30 second preview and licensing options.

  • Presentation

Pincer and Ingrown Nail Therapies

Description

The discussion focuses on therapies for pincer and ingrown nails, particularly toenails. Pincer nails, also known as trumpet nails, may be hereditary or acquired due to factors like gait changes or medical conditions such as psoriasis or diabetes. Patients typically seek treatment due to pain or cosmetic concerns. Conservative approaches include nail trimming, bracing, or topical treatments; however, recurrence is common when underlying bone deformities aren't addressed. Surgical options, including the zigzag technique for correcting bony deformities, may be necessary. The importance of radiography in evaluating bony exostosis is emphasized.



Ingrown toenails, or onychocryptosis, often arise from improper trimming or shoe pressure, and may lead to infections like osteomyelitis. Differential diagnoses are important to rule out other conditions such as melanoma. Surgical interventions, using tools like the English anvil for minimal trauma, are preferred to alleviate pain and prevent recurrence. Post-operative care is critical, often involving specific ear drops and antibiotic ointments to promote healing without soaking the area. The presentation highlights the significance of a thorough evaluation and tailored treatment plans for these common nail disorders.

View more

Conclusions

  • Pincer nails can be hereditary or acquired, and are typically characterized by transverse overcurvature of the nail plate.
  • Acquired pincer nails may develop due to various factors including medical conditions like onychomycosis or behaviors related to reduced ground reaction force.
  • Conservative therapies for pincer nails often yield high recurrence rates due to underlying bony deformities not being addressed.
  • Surgical interventions, such as targeted bony excision and techniques like the zigzag nail bed flap method, aim to correct the underlying deformities and improve outcomes.
  • Collaboration with other healthcare professionals may enhance management strategies for pincer nails and ingrown toenails.
  • Ingrown toenails can be classified into different stages based on severity, with treatment options varying from conservative measures to surgical removal.
  • It is crucial to obtain radiographs to rule out underlying bone issues like osteomyelitis in patients presenting with ingrown toenails.
  • Proper nail care and management of shoe gear may prevent the development of ingrown toenails and related complications.
  • Cornelius, T. R., & Shelley, W. B. (1968). Pincer Nail: A Result of Transverse Overcurvature of the Nail Plate. Dermatol Surg, 27, 261-266.
  • Plast Reconstr Surg Glob Open. (2014). Mechanobiology of Nails. 2, e115.
  • Mycoses. (2014). Onychomycosis: A Review. 57(7), 389-393.
  • Plast Reconstr Surg Glob Open. (2016). Conservative Therapies for Nail Disorders.
  • Case Rep Dermatol. (2020). Conservative: Tazarotene 0.1% Gel for Nail Disorders. 12, 114-118.
  • J Cosmet Dermatol. (2021). Conservative: Nd:YAG Laser for Nail Disorders. 20, 2512-2514.
  • Dermatol Surg. (2020). Suture Technique for Toenails. 46(4), 573.
  • JAAD. (2018). Dental Correction Principles in Nail Treatments. May, 1002.
  • Arch Plast Surg. (2015). Zigzag Nail Bed Flap Method. 42, 207-213.
  • Haneke, E. (2012). Controversies in the Treatment of Ingrown Nails. Dermatol Res Pract, 2012, 783924. Epub 2012 May 20.
  • Vlahovic, T. (2020). Permanent Ingrown Toenails: Chemical and Surgical Procedures. In Evidence-Based Podiatry, A Clinical Guide to Diagnosis and Management (pp. 1-10).
  • J Am Podiatr Med Assoc. (1985). Post-Operative Care in Nail Procedures. 75(1), 31-33.