Journal of Clinical & Experimental Dermatology Research
Open Access

A Painful Nail Disorder

Sara Mai^*, Hind Palamino, Siham Belmourida, Ilham Meknassi and Karima Senouchi ^*Correspondence: Sara Mai, Department of Dermatology, University Hospital Ibn Siba, Rabat, Morocco, Tel: +212625104836, Email:

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Clinical Image

An 18 year-old female patient presented to our department for a 6 month history of pain and dystrophy affecting the two great toenails. Previous treatments with antibiotics and foot baths had not improved the condition [1,2] . Physical examination revealed a painful paronychia with an inflammation of the proximal nail and a xanthonychia with a thickening of the proximal nail plate that had a deep transversal split (Figures 1 and 2).

Figure 1. Paronychia with an inflammation of the proximal nail.

Figure 2. Xanthonychia with a thickening of the proximal nail plate.

The diagnosis of retronychia was highly suspected and a complete nail avulsion was performed under regional anesthesia, allowing a confirmation of the diagnosis as multiple generations of nail plates were found under the proximal nail fold [3]. The evolution was favorable with a complete resolution of the symptoms within a few days and a regrowth of a normal nail plate after two mouths.

Retronychia is an ingrowth of the nail plate under the proximal nail fold forming multiples stacking nail generations underneath. In case of proximal paronychia, xanthonychia, and disruption of linear nail plate growth the diagnosis of retronychia should be suspected allowing appropriate and early treatment [4].

Source of Support

Nil.

Conflict of Interest

None.

References

1. Wortsman X, Calderon P, Baran R. Finger retronychias detected early by 3D ultrasound examination. J Eur Acad Dermatol Venereol. 2012;26:254-256.
2. Richert B. Surgery of the nail plate. In: Richert B, Di Chiacchio N, Haneke E (eds) Nail surgery. London: Healthcare. 2010;pp: 32-32.
3. Ventura F, Correia O, Duarte AF, Barros AM, Haneke E. Retronychia: Clinical and pathophysiological aspects. J Eur Acad Dermatol Venereol. 2016;30:16-19.
4. Baumgartner M, Haneke E. Retronychia: Diagnosis and treatment. Dermatol Surg. 2010;36:1610-1614.