COMPLICATED ONYCHOMYCOSIS AND INGROWN NAIL: COMPLEX TREATMENT (CASE SERIES)

Abstract

The aim of research is optimal sequence of surgical treatment, local and system therapy after moving away of the staggered nails at destructive onychomycosis, complicated by the secondary ingrown nail for some patients with the complicated mycotic defeat of nails. Materials and methods. Over a fi ve-year period 325 cases of incarnated onychomycosis, 182 cases late relapses of onychocryptosis (after previous surgeries at other clinics) were performed. Patients with such combined pathology got fi ve-day system «pulses» of 400 mg/day itraconazole therapy at a simultaneous use of hepatoprotectors and correction of comorbid pathology. Results. Three variants of dermatophytoma are differentiated: front center – with up to 25% eroded nail – 65 cases, subtotal – from 25 to 70% (without capturing the growth plate) – 138 cases, total – from 70 to 90% (with affected growth plate of the nail) – other cases. Surgical treatment provided in addition to standard decompression stage (complete removal of the nail plate), cutting pathologic eponychial tissues, hypergranulations and dermatophytoma, contained antirecurrent component (partial marginal matrixectomy in the ingrowth area) to prevent from repeated ingrowth. Conclusions. In all cases of mycotic onychocryptosis (secondary ingrown toenail) underwent a comprehensive treatment of comorbid pathology, system therapy of itraconazole to operative treatment (basic onychial defeats sanation) and in a postoperative period, sanation of other nails for prevention of mycotic reinfection was carried out by ciclopirox & amorolfi ne nail lacquer.

Keywords

• destructive incarnated onychomycosis, ingrown nail, antimycotic therapy, surgical removal