Wahlen Bianca Maria, El-Menyar Ayman, Elkholy Ayman
Department of Anesthesia, Hamad Medical Corporation, Doha, Qatar.
Department of Surgery, Clinical Research of Trauma and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar.
Eur J Case Rep Intern Med. 2024 Feb 12;11(3):004326. doi: 10.12890/2024_004326. eCollection 2024.
In rare dermatology cases the differential diagnosis is challenging, e.g. when one nail is growing below another, the provisional diagnosis could be confusing. It may present as chronic paronychia, candidiasis, bacterial infections, rheumatoid arthritis, psoriasis, subungual tumours, or cysts.
We present a case of iatrogenic rupture of the nails of both big toes following a commonly known recommendation from physiotherapists in the initial stages of hallux valgus or chronic arthritis by using kinesio tape to prevent the big toe from fixation in the valgus position. The initial provisional diagnosis of retronychia was revised, and a final diagnosis of onychomadesis was made. The patient's complaint was solved after around one year without any specific therapy.
The differential diagnosis for onychomadesis needs a careful and detailed history that may prevent a patient from a frightening diagnosis and painful, long-lasting treatments.
The differential diagnosis of retronychia, onychomycosis and onychomadesis is challenging.Both onychomadesis and retronychia share a common pathophysiologic mechanism.A careful and detailed history prevents a patient from a frightening diagnosis and painful, long-lasting treatment of nail disorders.
在罕见的皮肤科病例中，鉴别诊断具有挑战性，例如当一个指甲生长在另一个指甲下方时，初步诊断可能会令人困惑。它可能表现为慢性甲沟炎、念珠菌病、细菌感染、类风湿性关节炎、银屑病、甲下肿瘤或囊肿。
我们报告一例医源性双侧大脚趾指甲破裂的病例，这是在拇外翻或慢性关节炎初期，按照物理治疗师的一项常见建议，使用肌内效贴布防止大脚趾固定在外翻位置后发生的。最初的逆行甲初步诊断被修正，最终诊断为甲脱。患者的症状在未进行任何特殊治疗的情况下大约一年后得到解决。
甲脱的鉴别诊断需要仔细且详细的病史，这可能会使患者避免令人恐惧的诊断以及痛苦且持久的治疗。
逆行甲、甲癣和甲脱的鉴别诊断具有挑战性。甲脱和逆行甲具有共同的病理生理机制。仔细且详细的病史可使患者避免令人恐惧的诊断以及对指甲疾病进行痛苦且持久的治疗。
