INCARNATION OF NAIL PLATES IN PATIENTS WITH DESTRUCTIVE ONYCHOMYCOSIS ON THE BACKGROUND OF COMORBIDAL PATHOLOGY: SOME FEATURES OF THE CLINICAL COURSE (MANIFESTATIONS), AUTHOR'S VIEWS

The aim of the scientific work was to analyze the features of the clinical course and improve the results of complex treatment of nail plate incarnations in patients with destructive onychomycosis on the background of comorbid pathology. In the article, based on the analysis of clinical and pathomorphological material – complicated nail dystrophies and nail destructions (onychia) in 1838 patients aged 5-92 years: 1007 men and 831 women, clinical manifestations, pathomorphological changes and principles of individualized complex treatment were studied. Clinical ENMK classification of nail plate ingrowths and new methods of mobilization and removal of incarnated nail plates was proposed (through onycholyzed structures) in the presence of onychomycosis and other comorbid pathology. It has been stated that the clinical ENMK classification of nail plate ingrowths provides an opportunity for an individual choice of complex treatment. A method of access to the ingrown edge of the nail plate has been introduced – block-like eponychectomy, the effectiveness of which is determined by the total elimination of the altered eponychium from the ingrowth side, the creation of an opportunity for adequate resection, clear visualization of the growth zone and the matrix for performing the marginal nail matrix removal, the possibility of expanding access for revision of the subungual structures, including the distal phalanx. Treatment can be carried out an outpatient clinic, with minimal trauma to the patient. We recommend using effective three-component methods of surgical treatment of nail incarnation: marginal nail resection or removal of the nail plate, supplemented by excision of pathologically altered eponycheal tissues and marginal removal of the altered nail matrix in the ingrowth area.