Retronychia of the toenails: a review with emphasis on pathogenesis, new diagnostic and management trends

Litaiem, Noureddine; Drissi, H.; Zéglaoui, Faten; Khachemoune, Amor

doi:10.1007/s00403-019-01925-w

Cited by 24 publications

(24 citation statements)

References 27 publications

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“…Retronychia is characterized by a combination of proximal nail plate ingrown in the proximal nail fold associated with one or multiple nail plates misaligned beneath the proximal nail plate 2 . In the 117 published cases, trauma is the most frequent predisposing factor 3 …”

Section: Discussionmentioning

confidence: 99%

“…These may be in the form of tight‐fitting footwear, shoes with high heels, and activities such as running, hiking, mountaineering, dancing, and gym. Other factors include causes of interruption of nail matrix growth, such as ischemia, distal edema, thrombophlebitis, etc 3,4 . Podiatric predisposing factors like Egyptian foot type and great toenail congenital malalignment may also play a role.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 The principal predisposing factor is microtraumas. 3 The diagnosis is clinical and characterized by the triad of arrested nail growth, proximal paronychia due to the elevation of the proximal portion of the nail plate over the level of the proximal nail fold, and nail plate discoloration. Other diagnostic criteria include the presence of pyogenic granuloma, inflammation of the nail folds, and thickened nail.…”

Section: Introductionmentioning

confidence: 99%

“…Young female patients are the most commonly affected, usually at the great toenail 1,2 . The principal predisposing factor is micro‐traumas 3 …”

Section: Introductionmentioning

confidence: 99%

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Intralesional steroid treatment for the intermediate stage of retronychia: A pilot study

Alessandrini

Sechi

Merli

et al. 2020

Dermatologic Therapy

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Retronychia describes the proximal ingrowing of the nail plate. In the early stage, topical steroids are the gold standard therapy, while in the late stage surgical treatment is mandatory. We identified an intermediate severity stage of retronychia, where the topical treatment alone is ineffective and surgery is avoidable. Intralesional steroids turn the best treatment in these patients. A pilot study consisting of a 3-month treatment period and 9-month follow-up time was designed to evaluate the treatment outcome to intralesional steroid injections in patients affected by the intermediate-stage of toenail retronychia. The complete recovery of retronychia-associated nail abnormalities was observed in 27/28 recruited patients at the end of the treatment phase. Paronychia, nail plate discoloration, proximal nail fold (PNF) elevation, and discharge were reduced (P < .01) after one steroid administration, while nail regrowth became significant after two sessions. No significant difference in terms of clinical outcome was found, while pain VAS score and intra-operative pain evaluated with Wong-Baker faces scale were higher in the female group (P < .01). Limitation Lack of control group of patients. Despite its temporary effect, the intralesional triamcinolone injection is an effective, cheap, and safe treatment especially for the intermediate stage of retronychia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Young female patients are the most commonly affected, usually at the great toenail 1,2 . The principal predisposing factor is micro‐traumas 3 …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Intralesional steroid treatment for the intermediate stage of retronychia: A pilot study

Alessandrini

Sechi

Merli

et al. 2020

Dermatologic Therapy

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“…Thickening and decreased echogenicity of the nail bed, upward displacement and irregularities in the nail plate nail plate (retronychia). 56,57 There are ultrasound criteria for diagnosing unilateral and bilateral retronychia, which include a decrease of the distance between the origin of the nail plate and the base of the distal phalanx, the presence of a hypoechoic halo surrounding the origin of the nail plate, and thickening and decreased echogenicity of the dermis of the proximal nail fold. 41,[57][58][59] The vascularity of the nail bed and the periungual region may be variable according to the degree of inflammation (Figures 14 and 15).…”

Section: Subungual Inflammationmentioning

confidence: 99%

Ultrasound in Sports and Occupational Dermatology

Wortsman

Ferreira-Wortsman

2020

J of Ultrasound Medicine

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Chronic exposure to trauma, friction, or extreme conditions can generate cutaneous or ungual lesions in sports and certain occupations. Although some of these dermatologic conditions are diagnosed with a naked-eye examination, there are cases in which the provision of the underlying anatomic alterations can be helpful for the diagnosis and management. In comparison with computed tomography or magnetic resonance imaging, ultrasound has the highest axial resolution, which is critical for the observation of anatomic changes in the skin and nail. We review the ultrasound characteristics of frequent cutaneous and ungual lesions related to sports and occupations with a clinical correlation. The ultrasound features in some particular conditions such as "biker's and surfer's panniculitis," "fiddler's neck," piezogenic papules, and lipoatrophy semicircularis, among others, are discussed.

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Current Applications and Advances in Nail Ultrasound Imaging

Wortsman

2021

Advances in Nail Disease and Management

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Retronychia of the toenails: a review with emphasis on pathogenesis, new diagnostic and management trends

Cited by 24 publications

References 27 publications

Intralesional steroid treatment for the intermediate stage of retronychia: A pilot study

Intralesional steroid treatment for the intermediate stage of retronychia: A pilot study

Ultrasound in Sports and Occupational Dermatology

Current Applications and Advances in Nail Ultrasound Imaging

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