“Retronychia – clinical and pathophysiological aspects”

Abstract

Retronychia represents proximal ingrowth of the nail that occurs when the nail embeds backwards into the proximal nail fold. It is suspected when there is a persistent paronychia, particularly in the setting of trauma. Important clinical criteria for diagnosis are inflammation of the proximal nail fold, granulation tissue emerging from under the nail fold, thickening of the proximal portion of the nail plate and interruption of nail growth. The condition is rarely diagnosed and often misinterpreted, and is therefore unnecessarily treated with systemic antibiotics and antifungals. Avulsion of the nail confirms the diagnosis and it is the curative treatment. Conservative treatment with an adhesive technique is a valid option in early cases. We report 20 cases of retronychia diagnosed in our department between 2010 and 2013.

Occupational Retronychia: A Report of a Case in a UPS Employee

“…Most commonly precipitated by trauma, the nail plate loses fixation to the matrix and allows new nail growth under the old nail plate. This results in multiple generations of nail plates misaligned on top of one another that embed beneath the nail fold [2]. …”

“…Both anatomical and environmental factors are thought to contribute to retronychia, such as repeated micro-trauma (e.g., running), inadvertent trauma (e.g., tight-fitting shoes), abnormally curved nails, and ischemic damage [1]. The great toe is most commonly affected, and most cases have been reported in young adults and women [2, 3]. We report a case of occupational retronychia related to a workplace injury in package handler.…”

Retronychia: clinical diagnosis and surgical treatment

“…It frequently affects women (∼82%), and the great toes are the most common location 2. The most frequent trigger is (micro) trauma 3.…”

Ultrasonographic Criteria for Diagnosing Unilateral and Bilateral Retronychia

“…Retronychia is a nail disorder characterized by embedding of the proximal nail plate into the proximal nail fold, which clinically appears as an apparent halt to nail growth with a chronic proximal paronychia . It may be an underestimated condition that can appear after or concomitant to a severe illness, can be related to stress‐relevant situations, can be secondary to trauma, including sports injuries, or can appear as an idiopathic episode . Additionally, it has been reported that retronychia may have a similar etiology as Beau lines and onychomadesis.…”

“…So far, the diagnosis has been essentially clinical, which may represent a challenge because retronychia can easily mimic other nail disorders such as infections, psoriasis, tumors, and other common causes of nail dystrophy . Thus, because of its simulative nature, retronychia can generate several consultations to a wide range of specialists, which include dermatologists and orthopedic surgeons, and can demand consultations in emergency departments .…”