Seher Bostanci

Chemical matricectomy with phenol for the treatment of ingrowing toenail : A review of the literature and follow-up of 172 treated patients

There are many options for the treatment of ingrowing toenail, ranging from simple conservative approaches to extensive surgical procedures. Although conservative treatment modalities are helpful in patients with stage 1 disease, stage 2 and 3 ingrowing toenails are best treated surgically. The aim of this study was to evaluate the efficacy of chemical matricectomy with phenol for the treatment of ingrowing toenail. A total of 350 phenol ablations were performed on 172 patients with stage 2 and 3 disease. Each patient was reviewed weekly until full wound healing was achieved and afterwards, to assess the long-term efficacy of the treatment, they were followed up for a mean period of 25 months. The healing period after the operation ranged from 2 to 4 weeks and no postoperative complications were seen. Only two recurrences (0.57%) were observed, after 9 and 17 months, respectively, and nail spikes had developed in only two toes (0.57%). The success rate was found to be 98.8%. We conclude that phenol cauterization is an excellent surgical method for the treatment of ingrowing toenail because of its simplicity, low morbidity and high success rate.

Sodium Hydroxide Chemical Matricectomy for the Treatment of Ingrown Toenails: Comparison of Three Different Application Periods

Objective Sodium hydroxide matricectomy is a successful method for the treatment of ingrown toenails. This study was designed to evaluate the optimal sodium hydroxide application period providing high success rates with minimal postoperative morbidity. Materials and Methods Sixty-six patients with 225 ingrown nail edges were treated in three groups receiving 30-second, 1-minute, and 2-minute applications of sodium hydroxide. Each patient was reviewed postoperatively for pain, drainage, and tissue damage. The median long-term follow-up period was 14 months. Results The success rate of the therapy was 70.9% in the first group, 92.7% in the second group, and 94.4% in the third group. In all groups, about half of the patients experienced minimal pain within 48 hours following the operation, but only in the third group, 20% of the patients had minimal pain, which continued about 1 week. Drainage and tissue damage were minimal or mild in all groups and disappeared within 3 weeks in the first and second groups but were prolonged to 6 weeks in the third group. conclusion The success rate of 30-second application is significantly lower than 1-minute and 2-minute applications. Although the success rates of the latter two procedures are similar, the prolonged healing time is the disadvantage of the 2-minute application. We conclude that 1-minute application of 10% sodium hydroxide is simple, safe, and highly effective for the treatment of ingrown nails.

Chemical Matricectomy with 10% Sodium Hydroxide for the Treatment of Ingrown Toenails in People with Diabetes

BACKGROUND Treatment of ingrown toenails using chemical matricectomy in patients with diabetes has been difficult, because delayed wound healing, wound infections, and digital ischemia can interfere with the procedure. Chemical matricectomy with 10% sodium hydroxide is an effective treatment for ingrown toenails in a normal population. OBJECTIVES Investigation of the effectiveness and safety of chemical matricectomy with 10% sodium hydroxide solution for ingrown toenails in patients with diabetes. MATERIAL AND METHODS Thirty patients with diabetes with 40 ingrown toenails and 30 patients without diabetes with 41 ingrown toenails were enrolled in the study. After partial avulsion of the affected edge, germinal matrix was treated for 1 minute with 10% sodium hydroxide. Patients were observed on alternate days until complete healing was achieved and followed for up to 24 months for recurrence. RESULTS Assessment of the treatment in both groups for complete healing, postoperative pain, tissue damage, drainage, infections, and rate of recurrences revealed no statistically significant difference. CONCLUSIONS The partial avulsion of the affected edge and the treatment of the germinal matrix for 1 minute with 10% sodium hydroxide preceded by matrix curettage is an effective and safe treatment modality for ingrown toenails in people with diabetes. The authors have indicated no significant interest with commercial supporters.

Treatment of Basal Cell Carcinoma Located in the Head and Neck Region with Intralesional Interferon α-2a

AbstractObjective: Intralesional injections of interferon have been reported to provide successful results in the treatment of basal cell carcinoma. However, there are only a few reports describing the long-term efficacy of this therapy. The aim of our study was to evaluate the efficacy and long-term results of interferon α-2a (IFNα-2a) in the treatment of basal cell carcinoma. Methods: Twenty dermatopathologically proven basal cell carcinoma lesions were treated with intralesional IFNα-2a injections three times weekly for 3 weeks. The dose per injection was 1.5 sX 106 IU if the lesion was <2cm in diameter and 3.0 sX 106 IU if it was >2cm. Eight weeks after the last injection, the lesion sites were rebiopsied and all cases were reevaluated both clinically and dermatopathologically. Patients with complete cure were followed up for 7 years to determine the long-term results. Results: Eleven lesions (55%) showed complete clinical and dermatopathological remission, six lesions (30%) showed partial remission, and two lesions (10%) showed no response. One lesion (5%) increased in size during the treatment. No serious adverse effects were observed. During the follow-up period there was only one recurrence, at the fifth year. Conclusion: Treatment with intralesional IFNα-2a was shown to be an effective therapeutic option for basal cell carcinoma, with low recurrence rates in long-term follow-up.

A case of pemphigus vulgaris possibly triggered by quinolones

Pemphigus vulgaris is an autoimmune blistering disorder in which both genetic and environmental factors, mainly drugs, are thought to play a part in its aetiopathogenesis. Although some drugs that contain thiol groups, such as d‐penicillamine and captopril, and non‐thiol drugs, such as cephalosporin, have been reported to trigger or induce pemphigus, there are no previous reports regarding the influence of quinolones in triggering this disease. Here we present a case of pemphigus possibly triggered by quinolones.

Long-term results of rituximab–intravenous immunoglobulin combination therapy in patients with epidermolysis bullosa acquisita resistant to conventional therapy

Abstract Background: Epidermolysis bullosa acquisita (EBA) is a rare subepidermal bullous disease. Long-term remission in this disease is difficult using current treatments, unlike that in patients with other autoimmune bullous diseases. Objective: We retrospectively evaluated the effectiveness and side effects of rituximab–intravenous immunoglobulin (IVIg) combination treatment in five patients with EBA resistant to conventional treatment. Patients and methods: Rituximab (375 mg/m2) was administered for four consecutive weeks to four patients, and their treatment continued with IVIg at a dose of 2 g/kg/month. One patient received two cycles of rituximab for three consecutive weeks, IVIg in the fourth week, followed by monthly IVIg administrations as in the other patients. Results: The total number of IVIg therapy cycles ranged from 10 to 26 (mean 19.4). Mean skin involvement, mucosal involvement, and disease severity scores decreased after a mean follow-up of 22.6 months (range, 10–28 months). In an analysis performed during months 24–28, the number of CD19-positive B cells was found to be below the normal reference range in four patients. Limitations: This was a retrospective study with a limited number of patients. Conclusion: Rituximab–IVIg combination treatment seems to be effective and safe for treating patients with EBA resistant to conventional treatments.

Acquired ichthyosis associated with type 1 diabetes mellitus

Acquired ichthyosis is an uncommon disease which is characterized by symmetric scaling of the skin. Acquired ichthyosis has been described in association with a variety of underlying causes, including malignancies, drugs, infections, endocrine, metabolic and autoimmune diseases. Acquired ichthyosis associated with diabetes mellitus has been reported only in one case. We report the case of a new-onset diabetes mellitus with a one-month history of generalized acquired ichthyosis and palmoplantar keratoderma corroborated with skin biopsy, which completely disappeared after regulation of blood glucose levels with insulin therapy.

Epithelioid sarcoma metastatic to the tongue: a rare entity

Epithelioid sarcoma (ES) typically arises as a firm nodule on the extremities of young men. The tumor is remarkable for diagnostic difficulties both clinically and histopathologically resulting in a high frequency of initial misdiagnosis. ES is also known to have a high rate of recurrence and high rate of metastasis predominantly to the lymph nodes, lungs, and scalp. Herein, the second case of ES with metastasis to the tongue is reported.

Congenital malalignment of the great toenails in a pair of monozygotic twins.

Congenital malalignment of the great toenails is the lateral deviation of the long axis of nail growth relative to the distal phalanx. The nails grow slowly, with thickening, curving, and transverse ridging. We describe a pair of 3-year-old monozygotic female twins with congenital malalignment of the great toenails complicated by ingrowing and paronychia. Although there are a few cases without any family history, congenital malalignment is believed to be inherited through an autosomal-dominant gene of variable expression. This report provides further evidence of the heritability of the disease.

Chemical matricectomy with sodium hydroxide: long-term follow-up results.

BACKGROUND Chemical matricectomy with sodium hydroxide is a method being used successfully in the treatment of ingrown toenail. OBJECTIVE In this study, it was aimed to evaluate long-term recurrence rates after chemical matricectomy using sodium hydroxide application of different durations. MATERIALS AND METHODS Two hundred two patients with ingrown nail edges were treated with either 1-minute (Group 1) or 2-minute (Group 2) applications of sodium hydroxide matricectomy. All patients were followed for at least 2 years. RESULTS Chemical matricectomy with sodium hydroxide was applied to a total of 585 nail edges of 202 cases. The overall recurrence rates in Group 1 and Group 2 were 6.4% and 7.1%, respectively, during the average 7.5-year follow-up period. No statistically significant differences were detected in terms of recurrence between the 2 groups (p = .73). CONCLUSION Chemical matricectomy with sodium hydroxide is an easy method in the treatment of ingrown nails, with low morbidity and high success rates. There was no difference between 1-minute and 2-minute applications in terms of recurrence during the long-term follow-up. Chemical matricectomy with 1-minute application of sodium hydroxide showed high success in terms of long-term follow-up results.