En bloc excision of proximal nail fold for treatment of chronic paronychia.
BACKGROUND
Chronic paronychia is a very recalcitrant dermatosis, which is particularly prevalent in housewives. Medical treatment for this condition is unsatisfactory in a significant number of cases. Surgical approach forms an important part of management, however, this area has received little attention. Various surgical approaches have been tried in the past but a comparative analysis has not been attempted.


OBJECTIVE
The present study aims at assessing the efficacy of en bloc excision of proximal nail fold (PNF). Moreover, a comparative analysis has been undertaken to assess whether or not simultaneous nail plate avulsion improves the treatment outcome.


METHODS
Thirty patients of chronic paronychia with nail plate irregularities were randomly divided into two treatment groups (15 patients each). After a detailed evaluation, en bloc excision of PNF with or without nail plate removal was performed. Postoperative measures were advised and the patients were kept under regular follow-up thereafter. Assessment of postoperative complications was also performed.


RESULTS
Twelve patients in group I and 13 patients in group II completed the treatment protocol. Of these, 70% of patients were cured in group II (en bloc excision with nail avulsion) whereas only 41% were cured in group I (en bloc excision without nail avulsion).


CONCLUSIONS
En bloc excision of the PNF is a useful method in recalcitrant chronic paronychia. Simultaneous avulsion of the nail plate improves the surgical outcome. Strict avoidance of irritant exposure is necessary to ensure complete treatment and prevent recurrence.
Grover
Chander
C
Department of Dermatology, Venereology and Leprology, Maulana Azad, Medical College, New Delhi, India. chandergroverkubba@rediffmail.com
Bansal
Shikha
S
Nanda
Soni
S
Reddy
B S N
BS
Kumar
Vijay
V
D000293:Adolescent; D000328:Adult; D002648:Child; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009262:Nails / Q000601:surgery*; D009264:Nails, Malformed / Q000382:microbiology / Q000473:pathology / Q000601:surgery*; D010304:Paronychia / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome