En Bloc Excision of Proximal Nail Fold for Treatment of Chronic Paronychia

Grover, Chander; Bansal, Shikha; Nanda, Soni; Reddy, B. Naresh Kumar; Kumar, Vijay

doi:10.1111/j.1524-4725.2006.32079.x

Cited by 26 publications

(20 citation statements)

References 8 publications

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“…It can be shave biopsy, elliptical excision, punch, or en bloc excision (for PNF). [15] Prior to any excision over the nail folds, it is wise to insert a nail spatula underneath the concerned fold to prevent any inadvertent damage to the underlying nail bed or matrix. 4.…”

Section: Techniques/typesmentioning

confidence: 99%

Role of nail biopsy as a diagnostic tool

Grover

Chaturvedi

Reddy

2012

Indian J Dermatol Venereol Leprol

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Nail biopsy (NB) is an investigation that is not routinely resorted to by most of the dermatologists. The commonly cited reasons are the complexity of the procedure, risk of scarring and the reluctance of the patient. However, in cases with isolated nail psoriasis, isolated nail lichen planus, onychomycosis not confirmed on direct microscopy and culture, or longitudinal melanonychia, the treating dermatologist is left with no choice but to resort to this procedure. Nail as a unit, is capable of projecting only a limited number of clinical manifestations. This is responsible for the more or less similar clinical presentation of many different nail disorders. Hence, a practical knowledge of the indications, appropriate patient selection, procedural details and histopathological interpretation of a NB is a must-have for any practicing dermatologist. The risk of scarring is none to minimal if appropriate type of biopsy is performed, not to mention the wealth of histopathological data that can be retrieved from the nail unit. This article aims to explore the various practical do's and don'ts for the NB and tells us what to expect from of the procedure.

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Section: Techniques/typesmentioning

confidence: 99%

Role of nail biopsy as a diagnostic tool

Grover

Chaturvedi

Reddy

2012

Indian J Dermatol Venereol Leprol

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“…Medical treatment for this condition is unsatisfactory in a significant number of cases. [17] In these patients, no response is evident to irritant avoidance and topical therapy and surgical approach forms a vital part of management. An en bloc excision of the PNF combined with a total, or more commonly partial, restricted to the base of the nail plate, nail plate avulsion has been shown to be a useful method in chronic, recalcitrant paronychia, especially where the PNF is fibrosed or thickened.…”

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confidence: 99%

Nail avulsion: Indications and methods (surgical nail avulsion)

Pandhi¹,

Verma²

2012

Indian J Dermatol Venereol Leprol

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The nail is a subject of global importance for dermatologists, podiatrists and surgeons. Nail avulsion is a frequently undertaken, yet simple, intriguing procedure. It may either be surgical or chemical, using 40% urea. The former is most often undertaken using the distal approach. Nail avulsion may either be useful for diagnostic purposes like exploration of the nail bed, nail matrix and the nail folds and before contemplating a biopsy on the nail bed or for therapeutic purposes like onychocryptosis, warts, onychomycosis, chronic paronychia, nail tumors, matricectomy and retronychia. The procedure is carried out mostly under local anesthesia with or without epinephrine (1:2,00,000 dilution). Besides the above-mentioned indications, the contraindications and complications of nail avulsion are briefly outlined.

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“…The wound is left open and allowed to drain. Recently, Grover et al 31 reported good results in their series of patients who have undergone en bloc excision of the proximal nail fold. They reported no cases of eponychial scarring or nail dystrophy and showed improved results when combined with concurrent nailplate removal ( Figure 5).…”

Section: Operative Managementmentioning

confidence: 97%

Felons and paronychias

Desai¹,

Yao²

2010

Current Orthopaedic Practice

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Felons and paronychias are common fingertip infections of the hand that can lead to significant disability if left untreated. Although treatment principles have remained relatively unchanged over the years, new chemotherapeutic agents and multi-drug resistant bacteria may give rise to an increased number of complicated and aggressive cases seen by the treating physician. This up-to-date review focuses on the current accepted practice guidelines for the diagnosis and treatment of felons and paronychias. Specifically, a special emphasis is placed on more recently published studies.

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En Bloc Excision of Proximal Nail Fold for Treatment of Chronic Paronychia

Abstract: En bloc excision of the PNF is a useful method in recalcitrant chronic paronychia. Simultaneous avulsion of the nail plate improves the surgical outcome. Strict avoidance of irritant exposure is necessary to ensure complete treatment and prevent recurrence.

Cited by 26 publications

References 8 publications

Role of nail biopsy as a diagnostic tool

Role of nail biopsy as a diagnostic tool

Nail avulsion: Indications and methods (surgical nail avulsion)

Felons and paronychias

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