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Anti-Phospholipid Antibodies: Clinical Complications Reported in Medical Literature
Published in E. Nigel Harris, Thomas Exner, Graham R. V. Hughes, Ronald A. Asherson, Phospholipid-Binding Antibodies, 2020
Arterial occlusions in association with aPL antibodies are second only to venous involvement and are more completely discussed in Chapter 20. They are most commonly consequent on vasculitis, but cryoglobulinemia, associated TTP14 or DIC15 may be evident in some patients. These conditions should, if possible, be excluded in any lupus patient presenting with gangrene. Gangrene may rarely occur in association with severe Raynaud’s phenomenon. It has been reported by many authors,7,16-18 and may develop after minor surgery19 or after inadequate footcare or treatment for “ingrown toenails”, even by qualified chiropodists.20 Amputation of digits or part of digits may be required in some patients.
Ingrowing Nail
Published in Nilton Di Chiacchio, Antonella Tosti, Therapies for Nail Disorders, 2020
Azzam Alkhalifah, Florence Dehavay, Bertrand Richert
Aksoy et al. developed a procedure that they named “lateral foldplasty.” This complex technique combines, after curettage of the granulation tissue, two flaps: first a rectangular skin flap on the lateral fold and a second triangular flap on the adjacent lateral part of the tip of the toe. After trimming, the two flaps are sutured, which results in the lowering of the distal part of the lateral nail fold. This flap can be associated with a small lateral surgical matrix excision if necessary. They retrospectively analyzed the procedure in 32 patients with 52 ingrown toenails. They reported 4% of recurrence, 1 partial flap necrosis, and good cosmetic outcomes.96 Level of evidence C.
Lumps and bumps
Published in Michael Gaunt, Tjun Tang, Stewart Walsh, General Surgery Outpatient Decisions, 2018
Ingrowing toenail is a common condition, mainly in young people. It usually affects the lateral edge of the great toenail. A sharp edge of the nail traumatises the nail bed causing pain, ulceration, infection and a granulation tissue response, which exacerbates the condition.
Experiences of foot health in patients with rheumatoid arthritis: a qualitative study
Published in Disability and Rehabilitation, 2022
Anne-Marie Laitinen, Carina Boström, Sasu Hyytiä, Minna Stolt
The physical factors included the progression of the patient’s RA, the inability to cut toenails independently, and body stress (particularly in the lower extremities) resulting from daily activities. The participants stated that as their RA progressed, it affected their ability to look after their feet. They had lived with RA for many decades and knew that at some point they could be less able to care for themselves. In the case of foot self-care, stiffness in the joints and not being able to bend down were major restrictions. Moreover, existing foot problems (such as minor toe deformities or overlapping toes) also hampered foot self-care. Thickening and ingrowing toenails were difficult to cut due to limited manual dexterity and hand muscle strength. Spouses, children or grandchildren tried to help, but their skill in managing thickened toenails was limited. Ingrown toenails were painful, and lack of hand and finger coordination made self-care impossible. The stress caused by performing daily activities affected the whole body, particularly lower extremities, leading to exhaustion. Long walk and standing long time made their feet hurt, thus limiting functional ability.
Efficacy and safety of topical acetylcysteine combined with the use of an overcurvature-correcting device in patients with pincer nail deformity: a randomized, vehicle-controlled, investigator-blinded study
Published in Journal of Dermatological Treatment, 2023
Masataka Saito, Akihiko Ikoma, Akira Fujikawa, Kazuaki Tanaka
The main study limitation was the small study size and exploratory nature of the endpoints. In addition, the exclusion criteria meant that patients with an ingrown toenail were not eligible for evaluation due to differing treatment recommendations, and those with brittle pincer nails and pincer nails less than 1 mm thickness were not eligible as a result of difficulty in attaching the device. Further studies in a wider patient base will be needed to confirm these findings across the full clinical population. Finally, in this study, the follow-up period after removing the nail correction devices was set to 7 days. Studies with a longer duration of follow-up are warranted in order to confirm the maintenance of the pincer nail correction effect over time.
Remote synchronous toenail procedure training using a sausage model
Published in Journal of Community Hospital Internal Medicine Perspectives, 2021
Stephen K. Stacey, Edward J. Malone
Utilizing inexpensive supplies for creating the model and ubiquitous communication devices (e.g., cell phones), we developed a remote training curriculum to educate residents in the treatment of ingrown toenails. The objective in this exercise was to develop a novel approach to teach common procedures for treatment of ingrown toenails while respecting social distancing in a financially-constrained environment. This study was exempt from review by the institutional research review board.