Predisposing Factors, Treatment, and Pathophysiology of Retronychia in China: A Retrospective Study of 107 Cases

Abstract

BACKGROUND Retronychia, a condition marked by abnormal nail growth, is frequently underdiagnosed and misinterpreted, with a few reported cases in the literature. OBJECTIVE To investigate the pathophysiology, identify contributing factors, and assess the outcomes of surgical and nonsurgical treatments for retronychia. METHODS AND MATERIALS A retrospective review of 107 retronychia cases diagnosed at the center between January 2021 and July 2022 was conducted. RESULTS Predisposing factors were identified in 93.46% of cases, with 88.79% of patients reporting a habit of wearing socks during sleep before symptom onset. Noninvasive treatments targeting these factors led to full recovery in 79.55% of cases, while 13.64% experienced partial improvement, inducing reduced proximal nail fold inflammation. Nail avulsion, which involves removing the entire nail, achieved a relapse-free cure rate of 90.91%. When the innermost nail plate was preserved, the cure rate rose to 96.67%. CONCLUSION Chronic mechanical forces, frequently overlooked, play a pivotal role in retronychia onset and progression. Conservative management targeting these mechanical factors is recommended for patients with mild cases.