Ultrasonographic Criteria for Diagnosing Unilateral and Bilateral Retronychia

Fernández, Javier D.; Reyes‐Baraona, Francisco; Wortsman, Ximena

doi:10.1002/jum.14464

Cited by 28 publications

(23 citation statements)

References 22 publications

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“…7 In doubtful cases, the investigation is needed to confirm the diagnosis, and ultrasound can be used with specific criteria. 10 Treatment of retronychia varies depending on the degree of signs and duration of the disease.…”

Section: Discussionmentioning

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%

“…Various differential diagnoses that need to be considered include nail psoriasis, subungual tumors, cysts, and several common causes of nail dystrophy 7 . In doubtful cases, the investigation is needed to confirm the diagnosis, and ultrasound can be used with specific criteria 10 …”

Section: Discussionmentioning

confidence: 99%

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

Alessandrini

Sechi

Merli

et al. 2020

Dermatologic Therapy

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“…La avulsión ungueal total es en la actualidad el tratamiento comúnmente empleado para el tratamiento de la retroniquia dado que es una opción diagnóstica confirmatoria a la par que resolutiva. La literatura muestra que en torno al 80% de los casos de retroniquia descritos en la literatura afectaron a los primeros dedos del pie y como en los restantes casos, la avulsión ungueal total fue el tratamiento habitualmente empleado (1,5,7).…”

Section: Discussionunclassified

“…Pese a la implantación reciente de criterios ecografícos válidos para diagnóstico de la patología, la avulsión ungueal sigue siendo en la actualidad un gesto habitual para tratar eficazmente el problema y la par obtener un diagnóstico de confirmación 7 .…”

Section: Introductionunclassified

Nueva técnica quirúrgica para el tratamiento de la retroniquia: avulsión parcial proximal

Córdoba–Fernández

Lobo-Martín

2020

Eur J Pod

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La retroniquia u onicocriptosis proximal es una patología que se presenta con relativa frecuencia en las consultas de podología. La avulsión ungueal completa ha sido el tratamiento de elección descrito en la literatura para el abordaje de la patología. A pesar de ser efectiva, no está exenta de inconvenientes asociados a la pérdida de la función mecánica que la lámina ungueal tiene encomendada en el primer dedo de los pies. Para evitar o aminorar la aparición de estos inconvenientes, proponemos una alternativa sencilla consistente en la avulsión parcial proximal no incisional de la lámina ungueal dejando intacta la porción distal adherida al lecho hasta que la nueva lámina ungueal termine por desplazarla.

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“…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). A side-by-side comparative study is essential to facilitate the diagnosis.…”

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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Ultrasonographic Criteria for Diagnosing Unilateral and Bilateral Retronychia

Abstract: Ultrasonography can support the diagnosis of retronychia in unilateral and bilateral cases.

Cited by 28 publications

References 22 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

Nueva técnica quirúrgica para el tratamiento de la retroniquia: avulsión parcial proximal

Ultrasound in Sports and Occupational Dermatology

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