Background: Pincer nail deformity and its causes can pose a therapeutic challenge. Ill-fitting shoes and subungual exostosis of the toes may be attributed to pincer nail formation. However, in some cases, the causes of pincer nail deformity could not be determined. The role of mechanobiology in nail configuration and deformities has rarely been considered. Objective: The present study investigated the effectiveness of surgical procedures to correct pincer nail deformity, in terms of anatomical changes measured by radiographs. Methods: Two surgical procedures, nail bed widening with matrixectomy or a dermal graft, were used on 30 nails in 20 patients with pincer deformity. Changes in the width, height, and curvature indices were assessed. Radiographs were obtained to evaluate the presence of osteophytes and measure the interphalangeal angle in terms of mechanobiology in nail configuration. Results: Preoperative and postoperative assessment results revealed marked improvement objectively and subjectively. The mean width index was greater after surgery than that before surgery (84.4% vs. 64.8%). Both mean height and curvature indices were smaller after surgery than before preoperative (23.0% vs. 76.7% and 1.3% vs. 2.2%, respectively). Conclusion: Nail bed widening with matrixectomy, which corrects anatomical alterations in pincer nails, is suggested to be suitable for patients with pincer nail deformity. (Ann Dermatol 31(1) 59∼65, 2019

Pancreatic panniculitis is a rare complication characterized by subcutaneous fat necrosis associated with pancreatic disease. It has been postulated that pancreatic panniculitis is caused by the systemic activity of pancreatic enzymes that lead to microcirculatory disturbances. We report a 41-year-old heavy alcoholic woman with pancreatic panniculitis that coexisted with acute and chronic pancreatitis. She was diagnosed with chronic pancreatitis and alcoholic liver cirrhosis 5 years ago. She presented with multiple, tender, erythematous, subcutaneous nodules with heat sensation on both lower legs. Laboratory evaluation revealed an increase in the serum blood amylase and lipase. Histopathologic findings showed fat necrosis with inflammation around the necrotic subcutaneous fat tissue. The lesions subsided gradually with an improvement of acute pancreatitis.

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Lichen planus of the lip (LPL) is not common, and only a few cases have been reported. Medical treatment modalities for LPL are not always effective. Therefore, treatment of this presentation is difficult and challenging. A 41-year-old man was referred to the dermatology clinic with a chronic, painful erosion on the lower lip and buccal mucosa. Treatment with topical steroids, systemic cyclosporine, dapsone, and systemic steroids failed. We performed surgical excision and mucosal advancement flap treatment, with complete response noted after 6 months. Surgical excision with mucosal advancement flap treatment may be effective for the treatment of refractory LPL.