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
Doctor Tracy Vlahovic discussed pincer and ingrown nail therapies, highlighting the biomechanical reasons for pincer nails in patients who are no longer ambulatory. She reviewed studies on conservative treatments, such as using 10% acetylcysteine to soften nails followed by nail braces, achieving variable success in reshaping the nails. Vlahovic also mentioned alternative conservative methods she has explored, including topical treatments like tezeratine gel, YAG laser treatments, and surgical options that target underlying bony deformities. She emphasized the importance of radiographs to identify traction osteophytes before treatment. Surgical interventions include partial nail avulsion and chemical matrixectomy, with an approach to minimize pain and ensure thorough removal of nail debris. For ingrown nails, Vlahovic covers treatment strategies, emphasizing that surgical solutions often yield the best results due to the high recurrence rates associated with conservative methods. Lastly, she suggested using unconventional treatments for postoperative care that are effective and promote healing, notably avoiding traditional soaking methods.
View moreConclusions
- Pincer nails can develop in patients who are non-ambulatory due to mechanobiological factors.
- Acquired conditions such as onychomycosis, psoriasis, and other systemic diseases can lead to the development of pincer nails.
- Conservative treatment options, such as the use of 10% acetylcysteine, showed that a significant percentage of patients experienced improvement in nail curvature.
- Thinner nails respond better to conservative treatments compared to thicker nails.
- Multiple conservative therapies have been proposed, but they are associated with high rates of recurrence and may not provide long-term solutions.
- Surgical intervention may be necessary to address underlying deformities in pincer nails, as conservative approaches often fail over time.
- Nail avulsion is not recommended due to the risk of developing complications like an absent nail bed.
- Surgical options should focus on correcting any bony abnormalities to prevent relapse of nail deformities.
- Combination therapies may be effective for patients without underlying bony deformities.
- The risk of misdiagnosing conditions such as melanoma must be considered during treatment of ingrown nails.
- Plast Reconstr Surg Glob Open 2014;2:e115
- Mycoses. 2014 Jul;57(7):389-93
- Saito M, Ikoma A, Fujikawa A, Tanaka K. J Dermatol. 2024 Jan;51(1):23-29.
- Case Rep Dermatol 2020; 12: 114-118
- J Cosmet Dermatol 2021; 20:2512-2514.
- Derm Surg 46; 4: April 2020, pg 573
- JAAD May 2018 pg 1002
- Arch Plast Surg 2015;42:207-213.
- Haneke E. Controversies in the treatment of ingrown nails. Dermatol Res Pract. 2012;2012:783924. Epub 2012 May 20.
- J Am Podiatr Med Assoc. 1985 Jan;75(1):31-3.