ONYCHOMYCOSIS WITH NAIL INCARNATION: COMPLEX SURGICAL TREATMENT (CLINICAL ANALYSIS)

Clinical parallels of in-patient and out-patient surgical treatment for nail ingrowth (complicated and combined mycotic-associated processes and relapses) were clarified; morphologic changes were studied; causes of unsatisfactory outcomes of chronic pathology complex treatment were analyzed for prospective approaches to preventing relapses. Over a five-year period 436 unguis incarnates diagnosis (325 cases of incarnated mycotical-assotiated nail pathology) were performed. If the infection is limited to less than one-half of the eponychium, a single incision placed to drain the paronychium and to elevate the eponychial fold for excision of the proximal one-third of the nail is satisfactory. Extension to the opposite side of the fingernail, which is uncommon, is called a run-around abscess. In these cases, the paronychia is compressed along the nail edge, trapping the abscess. All procedures that successfully treat paronychia separate it from the hard nail. Analysis of subonychial scraping allowed stating the prevalence of red trichophytia, where in 74% cases it was associated with mold, in 26% cases it was associated with yeast fungi; and in 31% cases – with the bacterial flora; applied 4-5 five-day system "pulses" of 400 mg/day itraconazole therapy. In patients embedded and applied the low-impact methods of excision of the nail and partial marginal matricectomy mechanical carving and coagulation with the further dermatophytoms scraping off by the Folkman's spoon. Sanation of other nails for prevention of mycotic reinfection was carried out by ciclopirox & amorolfine nail lacquer. Frequent variants of nail lesions are onychocryptosis (incarnation of the nail) and destructive onychomycosis, which account for more than half of all calls for medical care for onychial pathology. With onychocryptosis clinically and morphologically manifesting there are changes in the eponychium.