A consequence of Tight-Fitting Footwear

tight-fitting footwear
Nail dystrophy and greenish brown coloring of the nail with no nail growth

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

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Dr. Arsia Hanif has been a meritorious Healthcare professional with a proven track record throughout her academic life securing first position in her MCAT examination and then, in 2017, she successfully completed her Bachelors of Medicine and Surgery from Dow University of Health Sciences. She has had the opportunity to apply her theoretical knowledge to the real-life scenarios, as a House Officer (HO) serving at Civil Hospital. Whilst working at the Civil Hospital, she discovered that nothing satisfies her more than helping other humans in need and since then has made a commitment to implement her expertise in the field of medicine to cure the sick and regain the state of health and well-being. Being a Doctor is exactly what you’d think it’s like. She is the colleague at work that everyone wants to know but nobody wants to be. If you want to get something done, you approach her – everyone knows that! She is currently studying with Medical Council of Canada and aspires to be a leading Neurologist someday. Alongside, she has taken up medical writing to exercise her skills of delivering comprehensible version of the otherwise difficult medical literature. Her breaks comprise either of swimming, volunteering services at a Medical Camp or spending time with family.


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