Manor Lakes Medical Centre, Cnr Ballan Road & Manor Lakes Blvd, Wyndham Vale, VIC 3024, Australia.
Hong Kong Med J. 2011 Apr;17(2):127-31.
To evaluate the clinical characteristics and treatment outcomes of patients undergoing surgical nail avulsion.
Retrospective study.
Two dermatology centres in Hong Kong.
A total of 32 patients with nail diseases who underwent 33 nail avulsion procedures were reviewed from case records.
Age, gender, co-morbidities, disease duration, clinical features, histopathology and fungal culture of nail plate, nail bed specimen for fungal culture in appropriate cases, and postoperative outcome.
The mean age of the patients at the time of nail avulsion was 54 (range, 27-86) years. The most frequent preoperative findings were thickened nails (23 specimens, 70%) and discolouration (20 specimens, 61%). Onychomycosis was the most common pre-consultative diagnosis (20 specimens, 61%). Prior to nail avulsion, topical or systemic treatment had been tried in more than half of the cases. Histopathology of the avulsed nails confirmed onychomycosis in 24 (73%) of specimens. The clinical cure rate was 88% and the mycologic cure rate was 100%. The procedure was well tolerated without significant complications. Relapse was only noted in three (9%) of the patients having nail avulsions. The time for full re-growth ranged from 5 to 10 months.
Total nail avulsion is an effective management option for patients whose diagnosis of onychomycosis was doubtful, and constitutes a treatment armamentarium especially for patients with single or oligo-onychomycosis.
评估行外科拔甲术患者的临床特征和治疗结局。
回顾性研究。
香港的两家皮肤科中心。
从病历中回顾了 32 例患有指甲疾病并接受 33 次指甲拔脱术的患者。
年龄、性别、合并症、疾病持续时间、临床特征、指甲板和甲床标本的组织病理学和真菌培养（在适当的情况下进行真菌培养），以及术后结局。
行指甲拔脱术时患者的平均年龄为 54 岁（范围 27-86 岁）。最常见的术前发现是指甲增厚（23 例，70%）和变色（20 例，61%）。最常见的术前诊断为甲真菌病（20 例，61%）。在指甲拔脱之前，超过一半的病例尝试了局部或系统治疗。24 例（73%）拔脱指甲的组织病理学证实为甲真菌病。临床治愈率为 88%，真菌学治愈率为 100%。该操作耐受良好，无明显并发症。仅在 3 例（9%）行指甲拔脱术的患者中观察到复发。完全再生的时间范围为 5 至 10 个月。
对于甲真菌病诊断可疑的患者，全甲拔脱是一种有效的治疗选择，尤其是对于单发或寡发甲真菌病患者。
