Grover Chander, Bansal Shikha, Nanda Soni, Reddy B S N, Kumar Vijay
Department of Dermatology, Venereology and Leprology, Maulana Azad, Medical College, New Delhi, India.
Dermatol Surg. 2006 Mar;32(3):393-8; discussion 398-9. doi: 10.1111/j.1524-4725.2006.32079.x.
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.
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.
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.
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).
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.
慢性甲沟炎是一种非常难治的皮肤病，在家庭主妇中尤为常见。在很多病例中，针对这种疾病的药物治疗效果并不理想。手术治疗是治疗的重要组成部分，然而，这方面受到的关注较少。过去尝试过各种手术方法，但尚未进行比较分析。
本研究旨在评估近端甲皱襞（PNF）整块切除的疗效。此外，还进行了比较分析，以评估同时拔除指甲是否能改善治疗效果。
30例伴有指甲板异常的慢性甲沟炎患者被随机分为两个治疗组（每组15例）。经过详细评估后，对PNF进行整块切除，切除时有的病例同时拔除指甲，有的病例不拔除。术后给出了相应措施建议，此后对患者进行定期随访。还对术后并发症进行了评估。
第一组12例患者和第二组13例患者完成了治疗方案。其中，第二组（整块切除并拔除指甲）70%的患者治愈，而第一组（整块切除但不拔除指甲）只有41%的患者治愈。
PNF整块切除是治疗难治性慢性甲沟炎的一种有效方法。同时拔除指甲可提高手术效果。必须严格避免接触刺激物，以确保彻底治疗并防止复发。
