Hong Kong medical journal = Xianggang yi xue za zhi · 2011
Clinical characteristics and treatment outcomes of patients undergoing nail avulsion surgery for dystrophic nails.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Lai W Y, Tang William Y M, Loo Steven K F, Chan Y
Аннотация
OBJECTIVE: To evaluate the clinical characteristics and treatment outcomes of patients undergoing surgical nail avulsion.
DESIGN: Retrospective study.
SETTING: Two dermatology centres in Hong Kong.
PATIENTS: A total of 32 patients with nail diseases who underwent 33 nail avulsion procedures were reviewed from case records.
MAIN OUTCOME MEASURES: Age, gender, co-morbidities, disease duration, clinical features, histopathology and fungal culture of nail plate, nail bed specimen for fungal culture in appropriate cases, and postoperative outcome.
RESULTS: The mean age of the patients at the time of nail avulsion was 54 (range, 27-86) years. The most frequent preoperative findings were thickened nails (23 specimens, 70%) and discolouration (20 specimens, 61%). Onychomycosis was the most common pre-consultative diagnosis (20 specimens, 61%). Prior to nail avulsion, topical or systemic treatment had been tried in more than half of the cases. Histopathology of the avulsed nails confirmed onychomycosis in 24 (73%) of specimens. The clinical cure rate was 88% and the mycologic cure rate was 100%. The procedure was well tolerated without significant complications. Relapse was only noted in three (9%) of the patients having nail avulsions. The time for full re-growth ranged from 5 to 10 months.
CONCLUSIONS: Total nail avulsion is an effective management option for patients whose diagnosis of onychomycosis was doubtful, and constitutes a treatment armamentarium especially for patients with single or oligo-onychomycosis.
DESIGN: Retrospective study.
SETTING: Two dermatology centres in Hong Kong.
PATIENTS: A total of 32 patients with nail diseases who underwent 33 nail avulsion procedures were reviewed from case records.
MAIN OUTCOME MEASURES: Age, gender, co-morbidities, disease duration, clinical features, histopathology and fungal culture of nail plate, nail bed specimen for fungal culture in appropriate cases, and postoperative outcome.
RESULTS: The mean age of the patients at the time of nail avulsion was 54 (range, 27-86) years. The most frequent preoperative findings were thickened nails (23 specimens, 70%) and discolouration (20 specimens, 61%). Onychomycosis was the most common pre-consultative diagnosis (20 specimens, 61%). Prior to nail avulsion, topical or systemic treatment had been tried in more than half of the cases. Histopathology of the avulsed nails confirmed onychomycosis in 24 (73%) of specimens. The clinical cure rate was 88% and the mycologic cure rate was 100%. The procedure was well tolerated without significant complications. Relapse was only noted in three (9%) of the patients having nail avulsions. The time for full re-growth ranged from 5 to 10 months.
CONCLUSIONS: Total nail avulsion is an effective management option for patients whose diagnosis of onychomycosis was doubtful, and constitutes a treatment armamentarium especially for patients with single or oligo-onychomycosis.