Summary
This review focuses on nail changes that do not belong to the group of benign or malignant nail tumors. These common afflictions of the nail include structural changes in and under the nail plate as well as inflammation around and in the nail bed. They include onychomycoses, nail psoriasis, onychodystrophies, subungual hematoma, paronychia, ingrown nails and pincer nails. Due to the peculiar anatomy and physiological growth conditions of the nail, the pathology does not necessarily stem from the site of the clinical problem and calls for careful inspection and interpretation.
The ingrown toenail is a common, painful and inflammatory clinical presentation, especially, but not exclusively, in adolescent patients. Numerous conservative treatment methods are available. Usually, however, the surgical treatment is at the end of a chain of suffering. While classified as obsolete, the so-called Emmert plasty is still used for surgical treatment. As a gentle alternative, selective treatment of the lateral matrix horn by resection or phenol caustics is increasingly used. The latter methods offer numerous benefits with little postoperative pain and faster recovery to normal quality of life.
Disorders of anatomical variants of the nails are often seen in clinical practice. Their correction identification and interpretation are essential dermatological skills. The increasing emphasis on aesthetic considerations in dermatology means that even the slightest nail changes may assume significance for their patients. In order to skillfully evaluate nails, one must be familiar with the terminology and classification of nail disorders. The nail plate, nail bed and periungual tissue may also be affected. Longitudinal melanonychia is especially important as a possible clue to subungual melanoma.
This method provides better anatomic information, especially in deep structures such as the axilla or pelvis. With accurate three-dimensional preoperative information, intraoperative access is quicker and less invasive for the patient.
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