Annals of dermatology

Korean Dermatological Association (대한피부과학회)
권호 표지
DOI QR코드

DOI QR Code

A Clinical Study of 35 Cases of Pincer Nails

  • Lee, Jae-In (Department of Dermatology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Lee, Young-Bok (Department of Dermatology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Oh, Shin-Tack (Department of Dermatology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Hyun-Jeong (Department of Dermatology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea) ;
  • Cho, Baik-Kee (Department of Dermatology, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea)
  • Published : 2011.11.30
⟨ Previous Next ⟩

Abstract

Background: Pincer nail is a nail deformity characterized by transverse overcurvature of the nail plate. Pincer nail can affect a patient's quality of life due to its chronic, recurrent course; however, there have been no clinical studies on the pincer nail condition in Korean patients. Objective: The purpose of this study was to characterize the clinical findings and treatment of pincer nail. In addition, possible etiological factors were considered, and treatment efficacy was evaluated. Methods: The medical records and clinical photographs of 35 patients (12 males, 23 females) who were diagnosed with pincer nail between August 1, 2005 and July 31, 2009 were studied. Results: Patient age ranged from 10 to 77 (52.09${\pm}$17.26) years, and there was a predominance of female (23 out of 35 patients, F : M=2 : 1). The mean duration of the disorder was 7.45 years (range 0.25~40); 85% had pincer nail for at least 1 year. In addition, 40% had a history of previous treatment and recurrence. There were 82.8% patients with the common type of pincer nails. The most commonly involved nails were both great toenails. Among 35 patients, nail grinding was started in 30 patients, and 25 patients showed clinical improvement with nail grinding. The width index increased and the height index decreased after treatment. The mean follow up period was 8.42 months (range 1~27), and 7 patients showed recurrence after 8.8 months (range 2~20). Among 35 patients, 5 patients were treated with nail extraction with matricectomy, and the symptoms resolved immediately. The mean follow up period was 7.6 months (range 0~19), and recurrence was not observed. Onychomycosis was also present in 37.1% of patients, and itraconazole pulse therapy for 3 months was added. Conclusion: The results of this study demonstrate the clinical features of pincer nail in Korean patients. The findings show that the common type of pincer nail was most common, and nail grinding as a conservative treatment greatly improved pincer nails despite a risk of recurrence. When onychomycosis was also present, oral antifungal therapy added to nail grinding resulted in a more rapid change in nail thickness and clinical improvement.

Keywords

References

  1. Frost L. Root resection for incurvated nail. J Natl Assoc Chiropodists 1950;40:1928.
  2. Cornelius CE 3rd, Shelley WB. Pincer nail syndrome. Arch Surg 1968;96:321-322. https://doi.org/10.1001/archsurg.1968.01330200159034
  3. Kosaka M, Kusuhara H, Mochizuki Y, Mori H, Isogai N. Morphologic study of normal, ingrown, and pincer nails. Dermatol Surg 2010;36:31-38. https://doi.org/10.1111/j.1524-4725.2009.01361.x
  4. Baran R, Dawber RPR. Diseases of the nail and their management. Boston, MA: 3rd ed. Blackwell Science, 2001: 496-499.
  5. Baran R, Haneke E, Richert B. Pincer nails: definition and surgical treatment. Dermatol Surg 2001;27:261-266.
  6. Baran R, Broutart JC. Epidermoid cyst of the thumb presenting as pincer nail. J Am Acad Dermatol 1988;19: 143-144. https://doi.org/10.1016/S0190-9622(88)80236-6
  7. Higashi N. Pincer nail due to tinea unguium. Hifu 1990; 32:40-44.
  8. Hwang SM, Lee SH, Ahn SK. Pincer nail deformity and pseudo-Kaposi's sarcoma: complications of an artificial arteriovenous fistula for haemodialysis. Br J Dermatol 1999; 141:1129-1132. https://doi.org/10.1046/j.1365-2133.1999.03219.x
  9. Greiner D, Schofer H, Milbradt R. Reversible transverse overcurvature of the nails (pincer nails) after treatment with a beta-blocker. J Am Acad Dermatol 1998;39:486-487. https://doi.org/10.1016/S0190-9622(98)70329-9
  10. Liao YC, Lee JY. Psoriasis in a 3-month-old infant with Kawasaki disease. Dermatol Online J 2009;15:10.
  11. Kirkland CR, Sheth P. Acquired pincer nail deformity associated with end stage renal disease secondary to diabetes. Dermatol Online J 2009;15:17.
  12. Kosaka M, Kamiishi H. New strategy for the treatment and assessment of pincer nail. Plast Reconstr Surg 2003;111: 2014-2019. https://doi.org/10.1097/01.PRS.0000056835.65112.A8
  13. Chapman RS. Letter: overcurvature of the nails--an inherited disorder. Br J Dermatol 1973;89:317-318.
  14. Mimouni D, Ben-Amitai D. Hereditary pincer nail. Cutis 2002;69:51-53.
  15. Kim KD, Sim WY. Surgical pearl: nail plate separation and splint fixation--a new noninvasive treatment for pincer nails. J Am Acad Dermatol 2003;48:791-782. https://doi.org/10.1067/mjd.2003.196
  16. Maeda N, Mizuno N, Ichikawa K. Nail abrasion: a new treatment for ingrown toe-nails. J Dermatol 1990;17:746- 749. https://doi.org/10.1111/j.1346-8138.1990.tb03023.x
  17. Roh DK, Lee DW, Cho BK. A case of heredetary pincer nail treated with nail grinding method. Korean J Dermatol 1997;35:971-974.
  18. Arai H, Arai T, Nakajima H, Haneke E. Formable acrylic treatment for ingrowing nail with gutter splint and sculptured nail. Int J Dermatol 2004;43:759-765. https://doi.org/10.1111/j.1365-4632.2004.02342.x
  19. ane JE, Peterson CM, Ratz JL. Avulsion and partial matricectomy with the carbon dioxide laser for pincer nail deformity. Dermatol Surg 2004;30:456-458.
  20. Ozawa T, Yabe T, Ohashi N, Harada T, Muraoka M, Ishii M. A splint for pincer nail surgery: a convenient splinting device made of an aspiration tube. Dermatol Surg 2005;31:94-98. https://doi.org/10.1097/00042728-200501000-00016
  21. Mutaf M, Sunay M, Isk D. A new surgical technique for the correction of pincer nail deformity. Ann Plast Surg 2007;58:496-500. https://doi.org/10.1097/01.sap.0000245128.96037.09

Cited by

  1. Quick and Easy Correction of a Symptomatic Pincer Nail Using a Shape Memory Alloy Device vol.39, pp.10, 2011, https://doi.org/10.1111/dsu.12312
  2. Curvature Index of Pincer Nail vol.1, pp.7, 2011, https://doi.org/10.1097/gox.0b013e3182a9647a
  3. Physics of nail conditions: why do ingrown nails always happen in the big toes? vol.11, pp.6, 2011, https://doi.org/10.1088/1478-3975/11/6/066004
  4. Anatomical Characteristics and Surgical Treatments of Pincer Nail Deformity vol.42, pp.2, 2011, https://doi.org/10.5999/aps.2015.42.2.207
  5. Pincer nail deformity as the main manifestation of Clouston syndrome vol.173, pp.2, 2011, https://doi.org/10.1111/bjd.13703
  6. Nail Plate and Bed Reconstruction for Pincer Nail Deformity vol.10, pp.3, 2011, https://doi.org/10.4055/cios.2018.10.3.385
  7. To Study the Outcome of Three-Flap Technique in the Management of Pincer Nail vol.12, pp.1, 2011, https://doi.org/10.4103/jcas.jcas_140_18
  8. Significance of Surgery to Correct Anatomical Alterations in Pincer Nails vol.31, pp.1, 2011, https://doi.org/10.5021/ad.2019.31.1.59
  9. Prevalence of Onychomycosis among Patients with Transverse Overcurvature of the Nail: Results of a Cross-Sectional Study vol.6, pp.6, 2011, https://doi.org/10.1159/000509985
  10. Polyethylene Nail Brace for Ingrown Toenails Treatment: A Randomized Clinical Trial vol.17, pp.21, 2011, https://doi.org/10.3390/ijerph17217741