A 56-year-old presents with pain in the toenail of the left foot secondary to wearing tight-fitting shoes. Repeated trauma to the toenails has its consequences!
A 56-year-old, otherwise healthy woman presented with complaints of localised pain in the lateral fold of the big toe of the left foot. The pain has been progressive over the past 4 months. The patient had no other medical condition/comorbidities. Upon further interrogation, she revealed a history of repetitive strain injuries due to tight-fitting footwear. Moreover, the affected nail had not grown for more than 8 months.
On local examination, the left big toe had a painful proximal perionyxis, with oozing through the suprungual fold.
The doctor performed surgical avulsion of the toenail confirming the diagnosis. Thereafter, the nail completely healed.
Retronychia is a disease of adulthood that describes a combination of proximal nail plate ingrowth associated with multiple misaligned nail plates beneath the proximal nail. It is predominating seen in females and is associated with frequent trauma to the toes and hence the toenails. The diagnosis is clinical. Avulsion of the nail remains the treatment of choice. The procedure allows for rapid healing and pain relief. Moreover, it is imperative to educate the patient regarding the tight-fitting footwear to prevent repeated trauma to the toenails, thereby reducing the risk of retronychia.
Source: Khalidi M, Kerrouch H, Amraoui ME, Hjira N, Boui M (2021) Retronychia: About Two New Cases. Clin Med Img Lib 7:168. doi.org/10.23937/2474-3682/1510168