Histopathological analysis of chronic paronychia.
Journal
International journal of dermatology
ISSN: 1365-4632
Titre abrégé: Int J Dermatol
Pays: England
ID NLM: 0243704
Informations de publication
Date de publication:
Apr 2023
Apr 2023
Historique:
revised:
06
11
2022
received:
12
10
2022
accepted:
04
12
2022
pubmed:
12
1
2023
medline:
17
3
2023
entrez:
11
1
2023
Statut:
ppublish
Résumé
Chronic paronychia is an inflammatory process of the nail folds lasting more than 6 weeks. Clinically, there is hypertrophy and retraction of the folds and absence of the cuticle. Treatment involves clinical measures and, when there is no response or the hypertrophy of the folds is very pronounced, surgical treatment is indicated. Post-surgical histopathology is little studied in the literature. In this sense, we believe that the histopathological study is important not only for the individualized understanding of the patient's chronic disease, avoiding relapses, but also for the understanding of its pathophysiology and treatment possibilities. To describe the histopathological changes found in biopsies of the proximal nail fold of patients with chronic paronychia undergoing surgical treatment. A histopathological study of 16 nail folds from 6 patients after surgery was performed at 2 study centers. The most prevalent epidermal findings were orthokeratosis, hypergranulosis, acanthosis and spongiosis and the dermal findings were fibrosis and mononuclear inflammatory infiltrate. The histopathological study allowed us to conclude that chronic paronychia is primarily an inflammatory process, but it is not possible to conclude whether microorganisms such as Candida and bacterial cocci are part of the etiology or just secondary and opportunistic agents.
Sections du résumé
BACKGROUND
BACKGROUND
Chronic paronychia is an inflammatory process of the nail folds lasting more than 6 weeks. Clinically, there is hypertrophy and retraction of the folds and absence of the cuticle. Treatment involves clinical measures and, when there is no response or the hypertrophy of the folds is very pronounced, surgical treatment is indicated. Post-surgical histopathology is little studied in the literature. In this sense, we believe that the histopathological study is important not only for the individualized understanding of the patient's chronic disease, avoiding relapses, but also for the understanding of its pathophysiology and treatment possibilities.
OBJECTIVE
OBJECTIVE
To describe the histopathological changes found in biopsies of the proximal nail fold of patients with chronic paronychia undergoing surgical treatment.
MATERIALS AND METHODS
METHODS
A histopathological study of 16 nail folds from 6 patients after surgery was performed at 2 study centers.
RESULTS
RESULTS
The most prevalent epidermal findings were orthokeratosis, hypergranulosis, acanthosis and spongiosis and the dermal findings were fibrosis and mononuclear inflammatory infiltrate.
CONCLUSION
CONCLUSIONS
The histopathological study allowed us to conclude that chronic paronychia is primarily an inflammatory process, but it is not possible to conclude whether microorganisms such as Candida and bacterial cocci are part of the etiology or just secondary and opportunistic agents.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
514-517Informations de copyright
© 2023 the International Society of Dermatology.
Références
Rigopoulos D, Larios G, Gregoriou S, Alevizos A. Acute and chronic paronychia. Am Fam Physician. 2008;77(3):339-46.
Stone OJ, Mullins JF. Incidence of chronic paronychia. JAMA J Am Med Assoc. 1963;186(1):71-3.
Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014;22(3):165-74.
Lomax A, Thornton J, Singh D. Toenail paronychia. Foot Ankle Surg. 2016;22(4):219-23.
Barlow AJE, Chattaway FW, HolgateE MC, Aldersley T. Chronic Paronychia. Br J Dermatol. 1970;82(5):448-53.
Tosti A, Piraccini BM, Ghetti E, Colombo MD. Topical steroids versus systemic antifungals in the treatment of chronic paronychia: an open, randomized double-blind and double dummy study. J Am Acad Dermatol. 2002;47(1):73-6.
de Lavor Queiroz NP, Padoveze EH, Saliba AF, de Araújo Sampaio GÂ, Debs EA, Di Chiacchio N. Long-term follow-up of patients who underwent surgery for chronic paronychia. Surg Cosmet Dermatol. 2012;4(3):219-21.
Bahunuthula RK, Thappa DM, Kumari R, Singh R, Munisamy M, Parija SC. Evaluation of role of Candida in patients with chronic paronychia. Indian J Dermatol Venereol Leprol. 2015;81(5):485-90.
Grover C, Bansal S, Nanda S, Reddy BSN, Kumar V. En bloc excision of proximal nail fold for treatment of chronic paronychia. Dermatol Surg. 2006;32(3):393-9.
Relhan V, Goel K, Bansal S, Garg K. Management of chronic paronychia. Indian J Dermatol. 2015;59(1):15-20.
Baran R, Bureau H. Surgical gem. Surgical treatment of recalcitrant chronic paronychias of the fingers. J Dermatol Surg Oncol. 1981;7(2):106-7.
Rockwell PG. Acute and chronic paronychia. Am Fam Physician. 2001;63(6):1113-6.
Nakamura R, Baran R. Doenças da Unha. 2nd ed. Rio de Janeiro: Elsevier; 2018. p. 389.
Ferreira Vieira d'Almeida L, Papaiordanou F, Araújo Machado E, Loda G, Baran R, Nakamura R. Chronic paronychia treatment: Square flap technique. J Am Acad Dermatol. 2016;75(2):398-403.
Haneke E. Histopathology of the Nail: Onychopathology. 1st ed. Boca Raton, FL: CRC Press, Taylor & Francis Group; 2017. p. 307.