Keloid formation on the great toe after chronic paronychia secondary to ingrown nail

Keloid is a clinically intractable fibro‐proliferative disease that spreads beyond the original scar or lesion. Although several theories have attempted to explain the mechanism of keloid formation, the phenomenon still remains obscure. Our present study examines a rare case of keloid formation that occurred on the great toe after a repeated paronychia secondary to an ingrown nail. The 22‐year‐old female patient had a large keloid with chronic paronychia and a history of ingrown nails on her left great toe on both the lateral nail folds. We excised the keloids and made new lateral nail grooves without extracting the nail. The open wounds were conservatively managed with the help of moisturized dressings until the wounds were completely epithelialised. Adjuvant therapies with oral medication, intermittent intralesional injection and toe care were performed during the follow‐up period. Histopathological analysis of the specimen revealed the presence of irregular, thick, glassy and dense collagen of keloid and inflammation of paronychia. During the 14‐month follow‐up period, adjuvant combination therapies successfully inhibited recurrence of keloid as well as paronychia and the normal appearance of the great toe was maintained. This study addresses a case of keloid formation on the great toe due to repeated recurrence of ingrown nails and consequent chronic paronychia. It is implied that if an ingrown nail is not controlled, it will result in the production of chronic inflammation and tension stress, which might trigger the formation of a secondary keloid.     

Acute paronychia heralding the exacerbation of pemphigus vulgaris

Acute paronychia, the suppurative inflammation involving the paronychium of the nails, is usually caused by bacterial or fungal infection and has been rarely reported as a presentation of pemphigus vulgaris (PV). We report a woman with PV who presented with suppurative paronychia of multiple fingernails and toenails, which preceded the exacerbation of other mucocutaneous lesions. A biopsy specimen of the paronychium revealed suprabasal vesicles due to acantholysis. Systemic corticosteroids and adjuvant immunosuppressants were effective in treating mucocutaneous lesions as well as nail disease. We conclude that in patients with PV, acute paronychia could be a manifestation of the disease per se, rather than an infectious process. Only the precise diagnosis with adequate immunosuppressive treatment can lead to good control of disease activity.     

A Comparison of Sodium Fusidate Ointment (‘Fucidin’)Alone Versus Oral Antibiotic Therapy in Soft-Tissue Infections

Summary

A Study Was Carried Out In 90 Patients With Superficial, Soft-Tissue Infections To Compare The Effectiveness Of Topical Treatment With 2 % Sodium Fusidate Ointment Used Alone, And Oral Antibiotic Therapy (Clindamycin, Erythromycin, Or Flucloxacillin) Plus A Placebo Ointment. The Results Showed That The Number Of Days For Healing To Take Place Was Significantly Shorter With Sodium Fusidate Ointment, And There Was Also A Highly Significant Preference For It Over Oral Antibiotic Therapy In The Subjective Assessment Of Clinical Response. Bacteriological Investigations Of Swabs From 58 Of The Patients Showed Staphylococcus Aureus To Be The Most Frequently Isolated Pathogen: 72% Of The Strains Were Penicillin-Resistant But All Were Sensitive To Sodium Fusidate. It Is Suggested That Oral Antibiotic Therapy Should Be Reserved For Those Cases Where There Is Evidence Of Systemic Spread Of The Infection And That Sodium Fusidate Ointment, With Or Without Surgical Drainage, Should Be The Standard Initial Treatment In The Out-Patient Andgeneral Practice Situation.     

116例甲沟炎部分拔甲加清创治疗及护理

目的：探讨针对甲沟炎行部分拔甲术加清除甲床坏死组织的治疗及护理效果。方法：对116例甲沟炎患者做好术前准备及解释工作,手术过程严格无菌操作,术后做好心理护理及健康指导。结果：116例甲沟炎患者术后均未发生伤口感染,术后复发率低。结论：部分拔甲术加清除甲床坏死组织治疗能有效减轻患者疼痛、促进伤口愈合、减少甲沟炎复发。     

Studies on the in vivo hypoglycemic activities of two medicinal plants used in the treatment of diabetes in Jordanian traditional medicine following intranasal administration

The claimed hypoglycemic activities of Paronychia argentea Lam. (Caryophyllaceae) and Teucrium polium L. (Labiatae), two traditionally widely used medicinal plants in Jordan were evaluated using normoglycemic and alloxan induced hyperglycemic rabbits by intranasal administration of the plant crude extracts (10%) in a vehicle containing 5% (w/w) Pluronic F127. No significant difference was observed between the extract treated and non-treated control animals receiving only water.     

甲床甲沟部分切除加残留甲床部分剥离甲沟重建术的临床研究

目的观察甲床甲沟部分切除加残留甲床部分剥离甲沟重建术治疗第一足趾嵌甲的临床效果。方法选取临床常见嵌趾甲患者共60例,男37例,女23例,随机分为A组（单纯拔甲组）、B组（甲床甲沟部分切除组）、C组（甲床甲沟部分切除加残留甲床部分剥离甲沟重建术组）,并行功能评价、对比临床治疗效果。结果经过对所有患者的术后随访,观察其治疗效果,并依据提前设计对功能评价标准进行个体化评分,所得数据行SPSS13.0软件分析,t检验,P〈0.05,手术效果有显著差别。结论甲床甲沟部分切除加残留甲床部分剥离甲沟重建术的治疗效果明显优于甲床甲沟部分切除术和单纯拔甲。     

Pharmacological and toxicological effects of Paronychia argentea in experimental calcium oxalate nephrolithiasis in rats

Aim of the study

Renal protection and antiurolithiasic effects of two extracts of Paronychia argentea (PA), a traditional Algerian plant commonly known as Algerian tea, were evaluated. This study was carried out to determine whether the aqueous extract (APA) or the butanolic extract (BPA) of aerial parts could prevent or reduce calculi aggregation in experimental calcium oxalate (Ox) nephrolithiasis in Wistar rats.

Materials and methods

The two extracts (APA and BPA) were administrated orally and daily, during 28 days to nephrolithiasic treated rats at the dose of 250, 500 mg/kg b.w. and 10, 20 mg/kg b.w. respectively.Body weight, renal index, liver index, serum level of creatinine, uric acid, urea, K⁺, Ca²⁺, Mg²⁺, Na⁺ and transaminase (alanine aminotransferase, ALT; aspartate aminotransferase, AST), phosphatase alkaline activity (PAL) were evaluated following the 28 days treatment in rats. In addition histopathological changes in kidney and liver were stained in hematoxylin eosin (HE).

Results

The effect of the extracts could be advantageous in preventing urinary stone retention by reducing renal necrosis and thus inhibit crystal retention. In contradiction with APA, the two doses of BPA attenuated elevation in the serum creatinine (p < 0.01) and blood urea levels (p < 0.01) (nephroprotective effect). However, the increase in ALT (27%) and PAL (31–51%) serum levels and in the relative liver weights (p < 0.01) in the groups treated with doses of APA may indicate that this extract has not a hepatoprotective effect against oxalate toxicity.

Conclusions

The presented data indicate that administration of the butanolic extract of aerial parts to rats with NaOx induced lithiasis, and reduced and prevented the growth of urinary stones in experimental calcium oxalate nephrolithiasis in Wistar rats.     

磺胺嘧啶银霜联合烫疮油用于趾甲沟炎拔甲创面处理的效果

目的探讨磺胺嘧啶银（Sulfadiazine Silver,SD-Ag）霜和烫疮油联合使用对甲沟炎拔甲创面的疼痛、单次创面处理时间、创面处理次数及愈合时间的影响。方法 45例甲沟炎拔甲患者随机分为A、B、C3组,每组15例。3组拔甲创面分别覆盖凡士林纱（A组）、SD-Ag霜＋凡士林纱（B组）、烫疮油＋SD-Ag霜＋凡士林纱（C组）,隔天创面处理,直至创面上皮化。采用视觉模拟评分法（VAS法）进行疼痛评分,比较第1、2次创面处理的疼痛分值;3组单次创面处理时间、创面处理次数和愈合时间比较,数据用均数±标准差（x±s）表示,采用单因素方差（One-Way ANOVA）进行统计学分析。结果 C组第1、第2次创面处理的疼痛分值[（2.01±1.03）,（1.03±0.74）]低于A组[（3.98±1.65）,（2.52±0.73）]和B组[（5.84±1.28）,（3.73±1.25）];C组单次创面处理时间（3.25±0.73）min少于A组（3.98±1.65）min和B组（5.63±0.79）min;C组创面处理次数（5.65±0.63）少于A组（8.33±0.85）和B组（6.92±0.81）;C组愈合时间（14.02±0.86）d少于A组（20.83±1.53）d和B组（17.82±1.04）d,C组与A、B组间两两比较,差异有统计学意义（P〈0.05）。结论 SD-Ag霜和烫疮油联合使用,可有效减轻甲沟炎拔甲患者创面疼痛,缩短单次创面处理时间和愈合时间,减少创面处理次数,促进创面愈合,对于临床创面修复有重要意义。