title: Chronic paronychia treatment: Square flap technique.
abstract: BACKGROUND
  Chronic paronychia is an inflammatory process of the periungual folds that lasts longer than 6 weeks. It manifests as hypertrophy of the proximal and lateral nailfolds, absence of cuticle, progressive retraction of the proximal nailfold, and onychodystrophy. Surgical treatment is recommended if there has been insufficient response to 6 months of appropriate medical therapies.
  
  
  OBJECTIVE
  We describe a new surgical technique that removes the fibrotic tissue without complete excision of the proximal and lateral nailfold, minimizing nailfold retraction and recovery time.
  
  
  METHODS
  We present a case series of 34 fingers (9 patients) treated with this new technique.
  
  
  RESULTS
  All nailfolds healed well without complications. At the end of the follow-up, all fingers, apart from 2, were relieved of the preoperative symptoms. The length of the ungual plate was maintained in all patients, with no retraction of the nailfolds.
  
  
  CONCLUSIONS
  Follow-up period of 6 months and small sample size are limitations of this study.
  
  
  CONCLUSIONS
  This surgical technique can provide an alternative treatment for chronic paronychia, with good prognosis during follow up-period and optimal cosmetic results.
authors.affiliation: Dermatology Institute Prof. Rubem David Azulay, Nail Studies Center, Rio de Janeiro, Brazil. Electronic address: luizadalmeida@gmail.com.
authors.forename: Luiza
authors.initials: L
authors.lastname: Ferreira Vieira d'Almeida
authors.affiliation: Dermatology Institute Prof. Rubem David Azulay, Nail Studies Center, Rio de Janeiro, Brazil.
authors.forename: Francine
authors.initials: F
authors.lastname: Papaiordanou
authors.affiliation: Dermatology Institute Prof. Rubem David Azulay, Nail Studies Center, Rio de Janeiro, Brazil.
authors.forename: Erika
authors.initials: E
authors.lastname: Araújo Machado
authors.affiliation: Dermatology Institute Prof. Rubem David Azulay, Nail Studies Center, Rio de Janeiro, Brazil.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Loda
authors.affiliation: Université de Franche-Compté, Nail Disease Center, Cannes, France.
authors.forename: Robert
authors.initials: R
authors.lastname: Baran
authors.affiliation: Dermatology Institute Prof. Rubem David Azulay, Nail Studies Center, Rio de Janeiro, Brazil.
authors.forename: Robertha
authors.initials: R
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005355:Fibrosis / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D010304:Paronychia / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D013524:Surgical Flaps
keywords: inflammation; nail; nail surgery; nailfold; paronychia; surgery