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      Correction of Pincer Nail Deformity Using Dermal Grafting

      case-report

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          Abstract

          Pincer nail deformity is characterized by excessive curvature and distortion of the nail in the transverse dimension, and particularly at the distal part of the nail plate. This deformity leads to pinching off and loss of soft tissue in the affected digit, causing severe pain. Many treatment methods have been proposed; however, an effective long-term method preserving the nail matrix has not yet been established. We present here a case of pincer nail in the left thumb in a 49-year-old woman who was treated successfully with dermal grafting under the nail bed. We describe the surgical method and the treatment results. To the best of our knowledge, this is the first report in the Korean medical literature on the use of dermal grafting for the treatment of pincer nail deformity.

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          Most cited references18

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          Pincer nails: definition and surgical treatment.

          There are four main types of ingrown nail. These are distal nail embedding, juvenile (subcutaneous) ingrown nail, hypertrophy of the lateral nail fold (lip), and pincer nail. The etiology of pincer nail may be hereditary or acquired. The mechanism of the most common form, an enlarged base of the distal bony phalanx, is discussed. Use of roentgenogram and magnetic resonance imaging highlights exophytes of the base and dorsal hyperostosis of the distal phalanx. Global assessment may lead in mild cases to medical therapy. Usually, however, the lateral matrix horn must be surgically removed or cauterized by phenol. Dermal grafting under the nail matrix provides excellent long-term results.
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            Pincer nail syndrome.

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              [Pincer nail. Conservative correction by attachment of a plastic brace].

              In three women, pincer nail deformity of the big toes was successfully treated by means of commercially available plastic braces. The nail plate was first flattened with an electrically driven dermatological grinder, and pliant braces were then stuck transversely on the nail plate to counteract the overcurvature. Within 3-6 months the nail growth was normalized in two cases and almost completely normalized in the third.
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                Author and article information

                Journal
                Ann Dermatol
                AD
                Annals of Dermatology
                Korean Dermatological Association; The Korean Society for Investigative Dermatology
                1013-9087
                2005-3894
                December 2011
                27 December 2011
                : 23
                : Suppl 3
                : S299-S302
                Affiliations
                [1 ]Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea.
                [2 ]Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Korea.
                [3 ]Division of Beauty Design, Wonkwang University, Iksan, Korea.
                Author notes
                Corresponding author: Kun Park, M.D., Ph.D., Department of Dermatology, Wonkwang University School of Medicine, Wonkwang University Hospital, 344-2 Sinyong-dong, Iksan 570-711, Korea. Tel: 82-63-859-1602, Fax: 82-63-842-1895, derma@ 123456chol.com
                Article
                10.5021/ad.2011.23.S3.S299
                3276781
                22346262
                840907f3-a64d-42c9-8f1f-76bea84dfe37
                Copyright © 2011 Korean Dermatological Association; The Korean Society for Investigative Dermatology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 13 July 2010
                : 15 December 2010
                : 15 December 2010
                Categories
                Case Report

                Dermatology
                dermal grafting,pincer nail deformity
                Dermatology
                dermal grafting, pincer nail deformity

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