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Ingrowing toenail (onychocryptosis) (Pathophysiology (Nail grows into…
Ingrowing toenail
(onychocryptosis)
Definition
Toenails growing laterally
into adjacent fleshy bed,
causing pain and swelling
Epidemiology
Common
Pathophysiology
Nail grows into nail bed, causing inflammation
Nailbed becomes hardened, with heaped up
infection (proudflesh)
Incorrect cutting and shoe pressure
predisposes lateral nail growth
Clinical
presentation
Pain and swelling
of big toe
Diagnosis
History
PMH
Current conditions
DH
Current meds, allergies
PC/HPC
Painful/swollen toe,
previous ingrown, nail care, shoes
SH
Occupation, sports/recreation
Examination
Ankle/foot
Usually single toe, lateral nail
growth with red, swollen adjacent skin
Management
Surgical
Whole nail avulsion
Indication: severe ingrown, conservative
measures not helped
MOA: removal of lateral nail wedges plus
phenol treatment to prevent regrowth
Conservative
Information and advice
Cotton wool soaked in surgical spirit to proudflesh,
await outgrowth of nail then cut correctly