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Ingrown ToenailAka: Onychocryptosis

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  1. Epidemiology
    1. Unilateral in 80% of cases
    2. Usually affects hallux (great toe)
  2. Risk Factors
    1. Improper nail cutting (nail incurves into nail fold)
    2. Poorly fitting shoes (callus forms in nail fold)
    3. Obesity
    4. Hyperhidrosis
    5. Foot trauma
    6. Altered gait
    7. Congenital disorders
      1. Pachyonychia congenita
      2. Trisomy 13
      3. Unna-Thost Syndrome
    8. Comorbid conditions
      1. Pityriasis
      2. Hyperthyroidism
      3. Diabetes Mellitus (dystrophic nails)
      4. Acromegaly
  3. Stages of Ingrown Toenail
    1. Stage 1 ingrown nail
      1. Erythema, trace edema and pain at lateral nail fold
    2. Stage 2 ingrown nail
      1. Increased pain and discharge from nail edge
      2. Signs of bacterial Paronychia
    3. Stage 3 ingrown nail
      1. Most significant symptoms of ingrown nail
      2. Lateral nail fold hypertrophy and granulation tissue
  4. Complications
    1. Bacterial Paronychia
  5. Management Non-surgical
    1. Warm water soaks
    2. Insert cotton-wick at lateral Nail Groove edge
    3. Silver nitrate to lateral nail granulation tissue
    4. Treat Paronychia with antibiotics if present
  6. Management: Surgical nail avulsion
    1. See Toenail Removal
  7. Prevention
    1. Trim nail flat and not too short
  8. References
    1. Mandracchia (July, 1998) Hospital Medicine, p. 36-43
    2. Peggs in Pfenninger (1994) Procedures, Mosby, p. 28-43
    3. Zuber (2002) Am Fam Physician 65(2):2547

Nails, Ingrown (C0027343)

Definition (MSH)Excessive lateral nail growth into the nail fold. Because the lateral margin of the nail acts as a foreign body, inflammation and granulation may result. It is caused by improperly fitting shoes and by improper trimming of the nail.
ConceptsAcquired Abnormality (T020)
ICD9703.0
EnglishEmbedded toenail, INGROWING NAIL, Ingrowing toenail, INGROWN NAIL, Ingrown Nails, Ingrown toenail, Onychocryptosis, Onyxis, Unguis aduncus, Unguis incarnatus
Spanishonicocriptosis, onixis, uña de dedo del pie encarnada, uña encarnada, uña encarnada de dedo de pie, una de dedo del pie encarnada, una encarnada, una encarnada de dedo de pie, unguis aduncus, unguis incarnatus
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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