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Hand (New York, N.Y.) Sep 2017Paronychia is defined as infection afflicting the eponychial nail folds of the hand or foot. Such infections are rarely reported in the perinatal age group, and not...
BACKGROUND
Paronychia is defined as infection afflicting the eponychial nail folds of the hand or foot. Such infections are rarely reported in the perinatal age group, and not previously described in a neonate younger than 2 weeks. Trauma resulting in inoculation of the nail fold is the most common predisposing factor to paronychia. Oral trauma in the pediatric population from finger sucking predisposes this population to a different set of bacterial pathogens than adults. Contamination can progress to infection and abscess formation within the nail fold with the most prevalent vector in adult infections being Staphylococcus aureus. Comparatively, mixed anaerobic and aerobic infections tend to afflict children with oral soothing habits.
METHODS
This is a case report will present the rare occurrence of a paronychia in a neonate caused by methicillin-resistant Staphylococcus aureus.
RESULTS
The management and treatment strategies for paronychia in this atypical neonatal patient consisted of incision and drainage and antibiotic therapy.
CONCLUSION
Neonates with oral self-soothing behaviors may be more at risk for developing paronychia of mixed anaerobic and aerobic infections. Initial therapy with broad-spectrum antibiotics amoxicillin/clavulanate or clindamycin is suggested. Incision and drainage in the perinatal setting coupled with antibiotics is curative.
Topics: Anti-Bacterial Agents; Drainage; Female; Fingersucking; Humans; Infant, Newborn; Linezolid; Methicillin-Resistant Staphylococcus aureus; Paronychia; Staphylococcal Infections
PubMed: 28720045
DOI: 10.1177/1558944717692092 -
Foot and Ankle Surgery : Official... Apr 2024Paronychia is a prevalent clinical disease affecting the soft tissue surrounding the nails. Most cases of toenail paronychia are commonly associated with ingrown... (Review)
Review
BACKGROUND
Paronychia is a prevalent clinical disease affecting the soft tissue surrounding the nails. Most cases of toenail paronychia are commonly associated with ingrown toenails. While conservative treatment is effective for mild cases of ingrown toenails, surgical intervention becomes necessary for moderate to severe cases, particularly when granulomas form.
OBJECTIVE
To provide a systematic understanding of these classic and modified procedures for surgeons to select the appropriate surgical interventions for patients suffering from moderate to severe ingrown toenails and discuss this technology's advantages and limitations for dermatologic surgery.
METHODS
A literature search was performed using PubMed/MEDLINE and Google Scholar databases. Studies discussing surgical intervention for ingrown toenails were included. Moreover, the surgical steps were meticulously depicted by detailed schematic diagrams.
RESULTS
These surgical techniques can be divided into three categories: matrix resection, debulking of periungual soft tissues, and the rotational flap technique. Each approach possesses distinct advantages and limitations.
CONCLUSION
For moderate to severe cases, surgical interventions may exhibit superior outcomes, faster recovery times, and lower recurrence rates. The surgeon must possess a comprehensive understanding and proficient skillset in various surgical techniques for ingrown toenails.
Topics: Humans; Nails; Paronychia; Nails, Ingrown; Surgical Flaps; Conservative Treatment
PubMed: 38177051
DOI: 10.1016/j.fas.2023.12.003 -
Dermatologic Clinics Apr 2021Bacterial and viral infections of the nail unit are very common as primary infections, especially bacterial paronychia and warts, but they can also be superinfections... (Review)
Review
Bacterial and viral infections of the nail unit are very common as primary infections, especially bacterial paronychia and warts, but they can also be superinfections complicating other nail disorders. In many nail unit infections, the clinical presentation is nonspecific: in these cases, diagnostic tests are mandatory before treatment, to avoid spread of the infection and drug resistance. The most common forms of bacterial and viral infections that may affect the nail unit are herein described in detail, with diagnostic and treatment options provided.
Topics: Humans; Nail Diseases; Paronychia; Warts
PubMed: 33745637
DOI: 10.1016/j.det.2020.12.001 -
Japanese Journal of Clinical Oncology Apr 2016Epidermal growth factor receptor inhibition is a good target for the treatment of lung, colon, pancreatic and head and neck cancers. Epidermal growth factor... (Review)
Review
Epidermal growth factor receptor inhibition is a good target for the treatment of lung, colon, pancreatic and head and neck cancers. Epidermal growth factor receptor-tyrosine kinase inhibitor was first approved for the treatment of advanced lung cancer in 2002. Epidermal growth factor receptor-tyrosine kinase inhibitor plays an essential role in the treatment of cancer, especially for patients harbouring epidermal growth factor receptor activating mutation. Hence, skin toxicity is the most concerning issue for the epidermal growth factor receptor-tyrosine kinase inhibitor treatment. Skin toxicity is bothersome and sometimes affects the quality of life and treatment compliance. Thus, it is important for physicians to understand the background and how to manage epidermal growth factor receptor-tyrosine kinase inhibitor-associated skin toxicity. Here, the author reviewed the mechanism and upfront preventive and reactive treatments for epidermal growth factor receptor inhibitor-associated skin toxicities.
Topics: Administration, Cutaneous; Administration, Oral; Adrenal Cortex Hormones; Anti-Bacterial Agents; Antineoplastic Agents; Aspirin; Dermatologic Agents; ErbB Receptors; Exanthema; Humans; Paronychia; Patient Education as Topic; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Quality of Life; Randomized Controlled Trials as Topic; Retinoids; Severity of Illness Index; Skin; Skin Diseases; Sunscreening Agents; Vitamin K
PubMed: 26826719
DOI: 10.1093/jjco/hyv207 -
Journal of Cutaneous and Aesthetic... 2022Retronychia is an uncommon type of ingrown nail characterized by ingrowing of the proximal nail plate into the proximal nail fold (PNF), inciting cycles of inflammation....
Retronychia is an uncommon type of ingrown nail characterized by ingrowing of the proximal nail plate into the proximal nail fold (PNF), inciting cycles of inflammation. The condition can be symptomatic due to swelling and inflammation of the PNF, but most often it is noticed because of a proximal thickening of the nail plate and the failure of nail to grow distally. It usually affects the great toenails of young females, commonly due to recurrent trauma and footwear-related issues. This condition is difficult to recognize in the initial stages and often requires surgical management when the nail plate becomes significantly impacted. We present a case of retronychia in a 24-year-old lady, who was treated surgically. The report serves to highlight the diagnostic and therapeutic approach in such cases.
PubMed: 36561419
DOI: 10.4103/JCAS.JCAS_248_20 -
Skin Appendage Disorders Nov 2019Pemphigus is an autoimmune bullous disease affecting the skin and mucous membranes. Associated nail involvement is underestimated and is characterized by a variety of...
BACKGROUND
Pemphigus is an autoimmune bullous disease affecting the skin and mucous membranes. Associated nail involvement is underestimated and is characterized by a variety of clinical manifestations. Our aim was to describe the clinical aspects of nail involvement during pemphigus.
PATIENTS AND METHODS
A retrospective study was conducted of patients with pemphigus over a period of 12 years. The diagnosis of pemphigus was based on clinical and immunopathological data. Clinical data were collected from patient records prior to initiation of treatment.
RESULTS
Overall,141 cases of pemphigus were collected. Of these, 60 patients had nail involvement. After eliminating fungal origin, we selected 37 patients in our study. The main clinical forms were paronychia and dystrophy. Two cases of destruction of the nail apparatus were found in patients with pemphigus vegetans. The disease was bilateral in 11 cases (29.7%). The presence of ungual involvement was correlated with severity of pemphigus, particularly severe oral disease ( = 0.002).
CONCLUSION
Nail lesions were polymorphic in our patients. These signs show accumulated inflammation of the nail after a long evolution of the disease. Nail involvement may precede, be concomitant, or follow the mucocutaneous lesions of pemphigus and be a sign of severity or relapse of the disease.
PubMed: 31799264
DOI: 10.1159/000501228 -
Drugs Feb 2021ARCHER 1050, an ongoing, randomized, open-label, phase III trial of dacomitinib versus gefitinib in newly diagnosed patients with advanced non-small-cell lung cancer... (Comparative Study)
Comparative Study Randomized Controlled Trial
Updated Overall Survival in a Randomized Study Comparing Dacomitinib with Gefitinib as First-Line Treatment in Patients with Advanced Non-Small-Cell Lung Cancer and EGFR-Activating Mutations.
BACKGROUND
ARCHER 1050, an ongoing, randomized, open-label, phase III trial of dacomitinib versus gefitinib in newly diagnosed patients with advanced non-small-cell lung cancer (NSCLC) and an EGFR-activating mutation, reported significant improvement in overall survival (OS) with dacomitinib.
OBJECTIVE
This paper reports an updated OS analysis of ARCHER 1050 after an extended follow-up.
PATIENTS AND METHODS
In this multinational, multicenter trial, adults (aged ≥ 18 years or ≥ 20 years in Japan and Korea) with newly diagnosed NSCLC and EGFR mutation (exon 19 deletion or exon 21 L858R substitution), and no history of central nervous system metastases, were randomized 1:1 to receive dacomitinib 45 mg/day (n = 227) or gefitinib 250 mg/day (n = 225). Randomization was stratified by race and EGFR mutation type. An ad hoc updated analysis of OS was conducted at the protocol-defined cut-off of 48 months from first dosing of the last enrolled patient (13 May 2019).
RESULTS
After a median follow-up of 47.9 months, 133 (58.6%) patients had died in the dacomitinib arm and 152 (67.6%) in the gefitinib arm. The hazard ratio (HR) for OS was 0.748 (95% CI 0.591-0.947; two-sided P = 0.0155); median OS was 34.1 months with dacomitinib versus 27.0 months with gefitinib. The HR for OS in patients with dose reduction(s) in the dacomitinib arm (n = 154) compared with all patients in the gefitinib arm was 0.554 (95% CI 0.420-0.730); median OS was 42.5 months for patients with dose reduction(s) in the dacomitinib arm. The most common adverse events were diarrhea (87.7%), paronychia (61.7%), dermatitis acneiform (49.3%), and stomatitis (43.6%) with dacomitinib, and diarrhea (55.8%) and alanine aminotransferase increased (40.2%) with gefitinib.
CONCLUSIONS
The OS benefit from first-line treatment with dacomitinib versus gefitinib was maintained after extended follow-up in patients with advanced NSCLC with EGFR-activating mutations. CLINICALTRIALS.GOV: NCT01774721 (registered 24 January 2013).
Topics: Aged; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Dose-Response Relationship, Drug; ErbB Receptors; Female; Gefitinib; Humans; Lung Neoplasms; Male; Mutation; Protein Kinase Inhibitors; Quinazolinones; Survival Analysis
PubMed: 33331989
DOI: 10.1007/s40265-020-01441-6 -
Nederlands Tijdschrift Voor Geneeskunde Sep 2022Familiarity with common nail disorders enables the clinician to diagnose and treat nail disorders and to recognize red-flag conditions. Knowledge of the anatomy of the...
Familiarity with common nail disorders enables the clinician to diagnose and treat nail disorders and to recognize red-flag conditions. Knowledge of the anatomy of the nail unit is essential to understand the origin of nail disorders. This article focuses on neoplasms, abnormalities of nail color and shape, infections, and inflammatory conditions of the nail unit. There are various neoplasms of and around the nail unit, like squamous cell carcinoma (in situ), melanoma, and benign neoplasms such as mucous cyst, subungual exostosis, glomus tumor, onychopapilloma and fibro(kerato)ma. The most common deviating colors of the nail are red, white and brown-black. Abnormalities of nail color and shape may indicate an underlying systemic disease. Infections of the nail unit include onychomycosis, acute paronychia, pseudomonas nail infection and verruca vulgaris. The inflammatory conditions we discuss in this article are chronic paronychia, psoriasis, alopecia areata and lichen planus.
Topics: Humans; Paronychia; Glomus Tumor; Nail Diseases; Exostoses; Melanoma
PubMed: 36300431
DOI: No ID Found -
Skin Appendage Disorders Sep 2020Retronychia is an increasingly known cause of paronychia. It was classically regarded as an indication for total nail plate avulsion, but recent case series have... (Review)
Review
Retronychia is an increasingly known cause of paronychia. It was classically regarded as an indication for total nail plate avulsion, but recent case series have questioned the real need for this approach. In order to establish a proper recommendation for patients presenting with retronychia, we retrospectively reviewed all articles with retronychia case reports. Total nail plate avulsion is still the most efficient treatment option. Topical steroids and other noninvasive approaches can be useful in some early, mild cases, but further prospective studies are needed in order to access their efficacy.
PubMed: 33088810
DOI: 10.1159/000509370 -
Primary Care Dec 2015A variety of nail deformities commonly presents in the primary care office. An understanding of nail anatomy coupled with inspection of the nails at routine office... (Review)
Review
A variety of nail deformities commonly presents in the primary care office. An understanding of nail anatomy coupled with inspection of the nails at routine office visits can reveal undetected disorders. Some problems are benign, and treatment should be attempted by the primary care provider, such as onychomycosis, paronychia, or ingrown toenails. For conditions such as benign melanonychia, longitudinal ridges, isolated Beau lines, and onycholysis, clinicians may offer reassurance to patients who are concerned about the change in their nails. For deformities such as early pterygium or clubbing, a thorough evaluation and referral to an appropriate specialist may be warranted.
Topics: Humans; Nail Diseases; Nails; Nails, Ingrown; Primary Health Care
PubMed: 26612379
DOI: 10.1016/j.pop.2015.08.005