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Retronychia is commonly underdiagnosed and exhibits classic features of proximal nail fold elevation and nail plate layering. Herein we summarize the literature and discuss cause, diagnosis, and treatment of this condition.

BACKGROUND: Amivantamab is an epidermal growth factor receptor (EGFR) and MET bispecific antibody approved for certain patients with advanced non-small cell lung cancer with EGFR variant. Cutaneous toxicities are known on-target effects of EGFR inhibition. OBJECTIVES: This article describes the occurrence and management of cutaneous toxicities in patients whose disease progressed on platinum chemotherapy treated with amivantamab. METHODS: Post hoc analysis evaluated incidence, severity, and time to first onset of rash and paronychia. Five nurses and advanced practice providers were interviewed. FINDINGS: Of 380 patients, 296 (78%) experienced treatment-related rash and/or paronychia. Paronychia (43%), rash (36%), and dermatitis acneiform (35%) were most frequent, with scalp rash reported by 17%. Treatment modifications because of rash and paronychia were infrequent. Nurses and advanced practice providers collaborate with physicians to manage cutaneous toxicities by administering comedications, modifying amivantamab dose, and educating patients. [ABSTRACT FROM AUTHOR]

Paronychia, felon and herpetic whitlow are common superficial hand infections. Although having similarities there are many differences between clinical presentation and treatment. Paronychia can present as acute and chronic condition. Treatment options varies from medical to surgical therapy. Formed abscesses may require drainage and possible antibiotic course. Herpetic whitlow is rare manifestation of hand infection with unique treatment options. Chronic infections differs in etiology and clinical presentation and need specialized treatment. Role of noninfectious causes should always be considered, including malignancy if no adequate treatment response is gained. Making correct diagnosis, followed by adequate treatment will prevent huge range of complications. Article reviews common hand infections, presentation, diagnosis and treatment strategies.

Objective To explore the clinical efficacy of silver-containing polyamide mesh in the treatment of ingrown toenail. Methods A retrospective analysis was conducted based on the clinical data of 147 patients with ingrown toenail paronychia in the Department of Plastic Surgery of Changhai Hospital from October 2021 to October 2022. According to the different materials (gauze fiber balls or silver-containing polyamide mesh), Patients were divided into gauze fiber ball group (68 patients) and silver polyamide mesh group (79 patients). We analyzed the pain scores on the first and seventh days after treatment, the cases which the inserted material had been removed by patients' self or the doctor because of pain, the cases which the dressing self-fell off before removal, and the treatment efficacy at the third month after removal of the dressing. Results Silver-containing polyamide mesh group: patients had mild postoperative pain, and no patient pull the padding out by self or requested the doctor to do that, two mesh fell out, and the cure rate at the third month after removal of the dressing was 93.7%. Gauze fiber ball group: obvious postoperative pain, nine patients pulled the padding out by self or requested the doctor to do that because of unbearable pain, eight balls fell out, and the cure rate at the third month after removal of the padding was 73.5%. Conclusion The silver-containing polyamide mesh is a suitable padding material for ingrown toenail. The advantages include easy to handle, less painful, and has a higher cure rate, which has clinical value for promotion and application. [ABSTRACT FROM AUTHOR]

Abstract We report a 4‐year‐old girl developing therapy refractory paronychia induced by selumetinib, an oral selective inhibitor of mitogen‐activated protein kinase 1/2 prescribed for a large submandibular plexiform neurofibroma. Although this cutaneous reaction is well‐known and more prevalent in children than in adults, no histopathological characterisations of nail unit toxicity in children on selumetinib have been reported so far. We show histopathological studies on patient‐derived periungual inflamed skin to investigate the cutaneous impact of selumetinib therapy. Our findings are consistent with those of epidermal growth factor receptor inhibitors and support the role of a non‐specific immune activation rather than opportunistic infection in the underlying mechanism of the disease. Partial bilateral matricectomies with electrocautery were resolutive, and the child restarted selumetinib with no recurrence of paronychia during a follow‐up period of 3 months after nail surgery.

Paronychia is a prevalent clinical disease affecting the soft tissue surrounding the nails. Most cases of toenail paronychia are commonly associated with ingrown toenails. While conservative treatment is effective for mild cases of ingrown toenails, surgical intervention becomes necessary for moderate to severe cases, particularly when granulomas form. To provide a systematic understanding of these classic and modified procedures for surgeons to select the appropriate surgical interventions for patients suffering from moderate to severe ingrown toenails and discuss this technology's advantages and limitations for dermatologic surgery. A literature search was performed using PubMed/MEDLINE and Google Scholar databases. Studies discussing surgical intervention for ingrown toenails were included. Moreover, the surgical steps were meticulously depicted by detailed schematic diagrams. These surgical techniques can be divided into three categories: matrix resection, debulking of periungual soft tissues, and the rotational flap technique. Each approach possesses distinct advantages and limitations. For moderate to severe cases, surgical interventions may exhibit superior outcomes, faster recovery times, and lower recurrence rates. The surgeon must possess a comprehensive understanding and proficient skillset in various surgical techniques for ingrown toenails. [ABSTRACT FROM AUTHOR]

Objectives: Hand infections are important factors affecting human health. The issue of work accidents has become very important with the increase in work ethics and culture. Work accidents also affect healthcare professionals. The aim of the present study is a detailed analysis of healthcare workers who develop acute paronychia in the workplace. Methods: The study included twenty healthcare workers who developed acute paronychia as a result of workplace trauma between 2017 and 2021. Paronychia occurred in all patients following needle or scalpel sticking at work. Results: The patients recovered on the 5th day after treatment. One patient underwent surgical drainage. There was no recurrence in long-term follow-up. Acute paronychia was statistically significantly more common in the female patient group (n=16) and mostly occurred due to needle sticking (n=17). Conclusion: In this study, it has been put forward for the first time in the literature that acute paronychia may occur due to trauma occurring in the workplace among healthcare workers. [ABSTRACT FROM AUTHOR]

Skin toxicities caused by epidermal growth factor receptor tyrosine kinase inhibitors can affect patient quality of life and lead to treatment adjustments, including dose reduction or discontinuation. This retrospective study aimed to profile skin toxicities and their impact on treatment adjustments. A total of 288 non-small cell lung cancer patients treated with first-, second-, or third-generation epidermal growth factor receptor tyrosine kinase inhibitors were included. Skin toxicities, including papulopustular rash, xerosis, paronychia, and pruritus, were assessed based on medical records, and their severity was evaluated based on the required dermatological intervention. Papulopustular rash was the most common toxicity (74.3%), followed by pruritus (61.1%), xerosis (52.4%), and paronychia (39.6%). Papulopustular rash was more common in males and more severe in younger patients. Papulopustular rash was more prevalent in patients treated with first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors, while paronychia was notably frequent for the second-generation epidermal growth factor receptor tyrosine kinase inhibitors. Second-generation epidermal growth factor receptor tyrosine kinase inhibitors frequently caused multiple skin toxicities. Importantly, skin toxicities led to epidermal growth factor receptor tyrosine kinase inhibitor treatment adjustments in 26.7% of cases, with second-generation epidermal growth factor receptor tyrosine kinase inhibitors demonstrating higher adjustment rates. Papulopustular rash and paronychia were the main causes of treatment adjustments, with even mild paronychia being linked to treatment adjustments. Effective management of skin toxicities is essential for optimizing treatment outcomes in patients receiving epidermal growth factor receptor tyrosine kinase inhibitors.

The ingrown toenails paronychia is a common nail problem occurring when the nail plate grows laterally into the periungual skin. It may cause hypertrophy of the nail folds tissues and purulent granuloma. At present, the clinical treatment of ingrown toenails paronychia mainly includes conservative treatment and surgical treatment. Appropriate treatment methods should be selected according to the demands of patients and the clinical manifestations of nail inlay. In addition, enhancement of prevention, removing potential causes and treating according to the nail inlay are helpful to reduce the recurrence rate and achieve relatively sound clinical efficacy. This review summarizes the clinical treatment and nursing progress of ingrown toenails paronychia, in order to provide reference for improving treatment efficacy and nursing quality. (嵌甲型甲沟炎是由于足趾两侧皮肤与皮下组织挤向趾甲或趾甲边缘压入甲沟软组织所致, 可引起甲缘外侧组织增生肥大和化脓性肉芽肿。目前, 临床上治疗嵌甲型甲沟炎主要包括保守治疗和手术治疗。临床上应根据患者的诉求以及嵌甲的临床表现选择合适的治疗手段, 同时重视预防, 去除诱因, 根据甲类型分别施治, 从而有效降低复发风险, 得到相对满意的临床疗效。本文综述嵌甲型甲沟炎的临床治疗及护理进展, 旨在为提高临床疗效及护理质量提供参考。)

Introduction: Despite the common occurrence of cetuximab (Cmab)-induced skin toxicity, management strategies are not well established. The traditional mainstay method consists of topical steroids, which, if used excessively, may give rise to other concerns. Alternatively, adapalene can activate epidermal growth factor receptor pathways to potentially alleviate these toxicities. Methods: We prospectively studied 31 patients with recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) who were eligible to use adapalene gel as a reactive treatment for topical steroid-refractory skin toxicity. For comparison, we retrospectively reviewed 99 patients with R/M SCCHN (historical control cohort) whose skin toxicity was mainly treated with topical steroids. We compared the frequency and severity of Cmab-induced skin toxicity, Cmab therapy status (e.g., dose modification), side effects caused by topical steroids and adapalene gel itself, and other medical interventions. Results: Adapalene gel was used by eight patients (25.8%) in the prospective cohort. Patients in the historical control cohort more frequently required escalation of topical steroid potency (34.3% vs. 12.9%, p = 0.022). Although there was no statistically significant difference in the frequency of grade ≥3 facial skin rash and paronychia between the two cohorts, the prospective cohort showed a significantly shorter time to complete recovery from grade 2/3 paronychia (16 vs. 47 days, p = 0.017). Further, while no skin infections were observed in the prospective cohort, 13 patients in the historical control cohort developed skin infections, especially periungual infection (0% vs. 13.1%, p = 0.024). In addition, no patients in the prospective cohort received a dose reduction of Cmab due to skin toxicities, compared to 20 patients in the historical control cohort (0% vs. 20.2%, p = 0.003). No apparent adapalene gel-related side effects were observed. Conclusions: Adapalene gel may be an effective management option for topical steroid-refractory Cmab-induced skin toxicities and could improve compliance with Cmab therapy. [ABSTRACT FROM AUTHOR]

Simple Summary: Although the LUX-Lung 8 trial has demonstrated the clinical benefit of afatinib as a second-line treatment for squamous cell carcinoma of the lung (LSCC), data on its use as a later-line treatment and sequential treatment following immunotherapy remain underexplored. This study on the real-world evidence of afatinib in LSCC patients who progressed both after chemotherapy and immunotherapy showed encouraging clinical outcomes with 2.1 months of time to treatment failure (TTF) and a 59.5% disease control rate in those patients without new safety signals. In addition, the erythroblastic oncogene B 2 (ERBB2) mutation was significantly associated with a longer TTF than the wild type. To the best of our knowledge, this is the first real-world study to demonstrate treatment outcomes, safety, and molecular biomarkers of afatinib in LSCC regardless of prior treatment lines. The present data may provide valuable insights for better management of patients with LSCC in routine clinical practice. This study aimed to evaluate treatment outcomes and safety of afatinib in patients with squamous cell carcinoma of the lung (LSCC) who progressed after chemotherapy and immunotherapy. We recruited patients both retrospectively and prospectively and collected the outcomes and safety data. Additionally, we performed next-generation sequencing using tumor tissue and/or plasma to explore potential molecular biomarkers. Altogether, 42 patients were included in the final analysis. The median number of prior treatments was three (range 1–8), and the median TTF was 2.1 months. Objective response rate and disease control rate were 16.2% and 59.5%, respectively, and median duration of response was 4.0 months among response evaluable patients (n = 37). Treatment-related adverse events (TRAEs, including diarrhea, stomatitis, and paronychia) occurred in 22 (52.3%) patients; however, most were grade 2 or lower, and only 5 cases were grade 3. TRAEs led to dose modification in 17 (40.5%) and discontinuation in 4 (9.5%) patients. The TTF in patients with ERBB2 mutations was significantly longer than that in patients without (6.8 vs. 2.1 months, p = 0.045). Our results highlight that afatinib is a reasonable treatment option in terms of effectiveness and safety, and ERBB2 mutation can be used as a predictive biomarker in clinical settings. [ABSTRACT FROM AUTHOR]

Infections of the hand and wrist are thankfully rare, but they present esoterically dependent on the specific structures involved. When underappreciated, they lead to delayed or incomplete management and destruction of highly specialized functional anatomy in the hand which results in significant disability. The general signs, symptoms and investigations for infections in the hand mirror infections elsewhere, but the variety of potential spaces in the hand mean there is no single sensitive indicator clinically, biochemically or radiologically. A high index of suspicion and understanding of the anatomy which affects the presentation, progression, treatment and complications of hand infections is required. This review describes the specific anatomy to be aware of to diagnose and manage hand infections completely, and highlights the near universal requirement for surgery to adequately clear infections in the hand. [ABSTRACT FROM AUTHOR]

Fusarium species (spp.) is frequently found in soil and plant residues and on plant bodies in all climatic zones worldwide. Although there have been few reports of onychomycosis caused by Fusarium spp., it is characterized by drug sensitivity and other characteristics. Here, we report what may be the first case of onychomycosis caused by Fusarium lactis. We analyzed the mycology and characterized previously reported cases of onychomycosis caused by Fusarium spp. A 73‐year‐old otherwise healthy woman presented with discoloration and thickening of her right thumbnail with paronychia. Direct microscopy revealed unevenly swollen hyphae, and a Grocott‐stained nail specimen showed septate hyphae. Based on the morphological features and gene analysis of fungus isolated from the nail, we diagnosed onychomycosis caused by F. lactis belonging to Fusarium fujikuroi species complex. Partial nail removal and topical application of 1% luliconazole solution resolved the condition in 6 months. Minimum inhibitory concentrations for isolated F. lactis showed high sensitivity to luliconazole but not itraconazole or terbinafine. The isolated F. lactis was temperature‐sensitive. A search of the literature revealed 57 cases of onychomycosis caused by Fusarium spp. with delineated clinical characteristics. Since those cases were investigated using morphological and/or molecular methods, we analyzed them by species complex as well as species. Onychomycosis caused by Fusarium spp. is predominantly found on the big toe, with Fusarium solani species complex and Fusarium oxysporum species complex accounting for over 70% of cases. Infection of only one digit with paronychia is a characteristic clinical manifestation of onychomycosis caused by Fusarium spp. Since there has been an increase in instances of molecular determination of Fusarium spp., it is deemed necessary to clarify its clinical and fungal nature. Due to its characteristic drug sensitivity and temperature‐sensitive nature, new treatments are expected to be developed. [ABSTRACT FROM AUTHOR]

To study the clinical effects of Ω toenail correction in the treatment of paronychia. One hundred thirty-six cases of 130 patients during the period from August 2018 to August 2021 were treated with Ω toenail correction according to clinical stages, the clinical therapeutic effects of which were evaluated in terms of the operation time, the time to resume movement, treatment cycle, 1-y recurrence rate, and visual analogue scale (VAS) scores before and after treatment. The clinical efficacy was analyzed and compared of Ω toenail correction in treating paronychia of different clinical stages. It has been demonstrated that there was no significant difference in operation time, time to resume movement, treatment cycle and recurrence rate among different stages of paronychia, while there existed the significant difference (p <.05) in VAS score of resting-state pain before and after correction which stood at 6.43 ± 0.29 points with the after-treatment VAS scores at 1.10 ± 0.22. There is a statistical difference (p <.05) in VAS score of movement-evoked pain between before and after treatment. The VAS scores of movement-evoked pain stood at 7.55 ± 0.42, which is in contrast with the after-treatment VAS at 1.74 ± 0.93. It has been concluded that Ω toenail correction characterized by easy operation can relieve the pain immediately, which can achieve satisfactory clinical efficacy for treating paronychia of different stages. [ABSTRACT FROM AUTHOR]

Simple Summary: Lung cancers with EGFR gene mutations treated with targeted therapy often develop another genetic change (T790M) that allows them to be treated with a further targeted therapy, Osimertinib, with good outcomes. The gold standard for the detection of these changes is to perform a tissue biopsy, but this is not always feasible. This study aimed to evaluate the outcomes of treatment with Osimertinib in patients who have a T790M mutation detected by non-invasive blood testing rather than tissue testing, and to explore the further genetic changes and DNA levels that can be detected in the blood during Osimertinib treatment. We demonstrated good tumour shrinkage and survival outcomes in this population, comparable to studies of patients identified through tissue testing. Levels of DNA markers in the blood before and during treatment with Osimertinib predicted outcomes. Based on this, blood testing for T790M can be used as a surrogate marker to guide Osimertinib use. Epidermal growth factor receptor (EGFR) T790M mutations drive resistance in 50% of patients with advanced non-small cell lung cancer (NSCLC) who progress on first/second generation (1G/2G) EGFR tyrosine kinase inhibitors (TKIs) and are sensitive to Osimertinib. Tissue sampling is the gold-standard modality of T790M testing, but it is invasive. We evaluated the efficacy of Osimertinib in patients with EGFR mutant NSCLC and T790M in circulating tumour DNA (ctDNA). PLASMA is a prospective, open-label, multicentre single-arm Phase II study. Patients with advanced NSCLC harbouring sensitizing EGFR and T790M mutations in plasma at progression from ≥one 1G/2G TKI were treated with 80 mg of Osimertinib daily until progression. The primary endpoint was the objective response rate (ORR); the secondary endpoints included progression-free survival (PFS), overall survival (OS), disease control rate (DCR) and toxicities. Plasma next-generation sequencing was performed to determine Osimertinib resistance mechanisms and assess serial ctDNA. A total of 110 patients from eight centres in five countries were enrolled from 2017 to 2019. The median follow-up duration was 2.64 (IQR 2.44–3.12) years. The ORR was 50.9% (95% CI 41.2–60.6) and the DCR was 84.5% (95% CI 76.4–90.7). Median PFS was 7.4 (95% CI 6.0–9.3) months; median OS was 1.63 (95% CI 1.35–2.16) years. Of all of the patients, 76% had treatment-related adverse events (TRAEs), most commonly paronychia (22.7%); 11% experienced ≥ Grade 3 TRAEs. The ctDNA baseline load and dynamics were prognostic. Osimertinib is active in NSCLC harbouring sensitizing EGFR and T790M mutations in ctDNA testing post 1G/2G TKIs. [ABSTRACT FROM AUTHOR]

Objective To observe the curative effect of thread-hanging combined with cotton plug on stage III paronychia. Methods Sixty-one patients with stage III paronychia were selected and randomly divided into a treatment group and a control group. The treatment group (n=31) was treated with thread-hanging and tampon under local infiltration anesthesia, and changed dressing and tampon every day after operation. After the wound healed, the patient soaked his feet in warm water every day and changed the tampon himself until the symptoms subsided, and the knot did not receive special treatment, and the nail plate would naturally shed as it outgrew the paronychia. The control group (n=30) was treated with thread-hanging and nail groove reconstruction under nerve block anesthesia, and the dressing was changed every day after operation. After thread removal, the patients soaked their feet in warm water every day until the symptoms subsided, and the knot was not specially treated, and it naturally fell off with the growth of the deck beyond the nail groove. The postoperative Visual Analog Scale (VAS) pain score, pain duration, wound healing time, cure rate, effective rate and recurrence rate of paronychia, and patients' satisfaction with the operation were compared between the two groups. Results Compared with the control group, the treatment group had lower VAS pain scores on the first and third postoperative days (2.1±0.3) and (0.2±0.1) vs. (6.3±0.1) and (3.2±0.2), respectively, shorter duration of pain and wound healing time (3.3±0.3) days and (10.1±0.5) days vs. (5.2±0.3) days and (15.2±0.3) days, respectively, higher cure rate (87.1% vs. 66.7%), lower failure rate (12.9% vs. 33.3%), lower recurrence rate (7.4% vs. 20.0%), and higher patient satisfaction (97.0% vs. 75.3%). The treatment group showed significant superiority over the control group in all outcomes. Conclusion For patients with stage III paronychia, threadhanging combined with cotton tampon without nail groove reconstruction is advantageous as it avoids additional skin trauma, and does not affect the nail appearance and normal periungual barrier after healing,, reduces patient discomfort, and shortens the time off work, resulting in a higher cure rate. This treatment approach is therefore worth promoting in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Painful paronychia and pseudopyogenic granuloma (PG) are common adverse drug reactions (ADRs) associated with the use of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) to treat non-small cell lung cancer (NSCLC). Multiple local management approaches have been tested with unsatisfactory results. We have introduced an occlusion therapy technique through which available topical drugs for longer than 2 years. Methods: Based on the cancer registry and case management system of our hospital, from July 2019 to July 2020, we retrospectively enrolled patients with NSCLC who were treated with EGFR-TKIs and received applications of 0.5% timolol ophthalmic solution (TIMOPTOL XE 0.5%®) combined with a neomycin/tyrothricin ointment (Biomycin ®) using the occlusion method to treat paronychia or PG. Results: A total of 22 patients were enrolled, with a mean age of 66.5 years, most of whom were women (72.7%). Periungual lesion-related pain was reported by all patients, and periungual bleeding and PG were reported in 14% (3/22) and 64% (14/22) of patients, respectively. After the occlusion therapy application of timolol ophthalmic solution combined with neomycin/tyrothricin ointment twice daily, the overall response rate was 83.3%, including complete response in 18% (4/22) of cases and partial response in 68% (15/22) of cases. Conclusion: We presented an occlusion method using available topical beta-blockers and antibiotic ointment for EGFR-TKI-induced paronychia and PG in Taiwan. The result is favorable. Further randomized control trial is urgent to validate our findings [ABSTRACT FROM AUTHOR]

The article focuses on the diagnosis and management of abscesses, including recurrent abscesses, the role of ultrasound and antibiotics, and the pathogenesis and clinical manifestations of skin and soft tissue abscesses. It includes a case study of an 18-month-old girl with a buttock abscess and discusses various types of abscesses, risk factors, and treatment options.

The cutaneous toxicity of MEK inhibitors may limit treatment adherence. The authors present a retrospective study of 41 paediatric patients with NF‐1 undergoing therapy with selumetinib and propose a treatment algorithm. [ABSTRACT FROM AUTHOR]

Nail conditions are not only aesthetic concerns, and nail changes may be a clue to an underlying systemic diseases or infection. Without timely treatment, nail diseases can continue to worsen and significantly impair performance of daily activities and reduce quality of life. Examination of the nails is essential at every medical visit, and may uncover important findings. Brittle nail syndrome, onychomycosis, paronychia, nail psoriasis, longitudinal melanonychia, Beau’s lines, onychomadesis and retronychia are common nail disorders seen in clinical practice. These conditions stem from infectious, inflammatory, neoplastic and traumatic aetiologies. Though each nail condition presents with its own distinct characteristics, the clinical findings may overlap between different conditions, resulting in misdiagnosis and treatment delays. Patients can present with nail plate changes (e.g. hyperkeratosis, onycholysis, pitting), discolouration, pain and inflammation. The diagnostic work-up of nail disease should include a detailed history and clinical examination of all 20 nail units. Dermoscopy, diagnostic imaging and histopathologic and mycological analyses may be necessary for diagnosis. Nail findings concerning for malignancy should be promptly referred to a dermatologist for evaluation and biopsy. Nail disease management requires a targeted treatment approach. Treatments include topical and/or systemic medications, discontinuation of offending drugs or surgical intervention, depending on the condition. Patient education on proper nail care and techniques to minimize further damage to the affected nails is also important. This article serves to enhance familiarity of the most common nail disorders seen in clinical practice. It will highlight the key clinical manifestations, systematic approaches to diagnosis and treatment options for each nail condition to improve diagnosis and management of nail diseases, as well as patient outcomes.Key messagesNail disease is not only a cosmetic issue, as nail changes can indicate the presence of a serious underlying systemic disease, infection or malignancy.Nail pain and changes associated with NP are physically and emotionally distressing and may contribute to functional impairment and diminished quality of life.LM is a hallmark sign of subungual melanoma and this finding warrants further investigation to rule out malignancy.

Raoultella ornithinolytica is a rare encapsulated Gram-negative aerobic and facultative anaerobic rod belonging to the Enterobacteriaceae family. It tends to inhabit water and soil environments and can be found on insects, fish, ticks, and termites, but can also found in the hospital environment.1, 2 R ornithinolytica has been documented in respiratory, urinary, gastrointestinal, and biliary tract infections as well as bacteraemia and systemic infections but has rarely been documented in soft tissue infections.2 This case study describes a recurrent paronychia infection secondary to R ornithinolytica in a young woman not responding to antibiotics and successfully treated with surgical management.

Retronychia is the embedding of the nail plate into the proximal nail fold, where there are two or more generations of superimposed nail plates under such fold. It is mainly related to local micro-traumas. The diagnosis is clinical and the use of ultrasound is useful for confirmation and/or ruling out other pathologies in difficult cases. The definitive treatment is surgical avulsion of the nail plate. It is frequently underdiagnosed since its most common form of presentation is chronic paronychia that does not respond to conventional treatments; however, when it does not manifest itself in this manner, as in our case, the clinical approach is difficult, which is why imaging aids can be used to allow a better approach to the pathology. [ABSTRACT FROM AUTHOR]

Epidermal growth factor receptor inhibitors (EGFR) have a high rate of class-specific dermatologic adverse events. Supportive treatment of dermatologic adverse events decreases their severity, minimizes the need for dose de-escalation / discontinuation of targeted therapy, improves commitment to anticancer treatment and patient’s quality of life. Close interdisciplinary cooperation between oncologists and dermatologists is a key to the successful management of patients treated with EGFR. This article highlights current approaches to classification, concepts of pathogenesis and clinical course of EGFR-associated dermatologic adverse events, current and promising prophylactic and therapeutic strategies to manage these adverse events.

Staphylococcus lugdunensis is a part of the normal skin flora. However, this organism can be a pathogen in certain situations such as advanced age or immunosuppression. Further study regarding situations in which this bacterium becomes a pathogen is warranted.

Cutaneous diphtheria, paronychia, nasal diphtheria, vestibulitis Keywords: cutaneous diphtheria; nasal diphtheria; paronychia; vestibulitis EN cutaneous diphtheria nasal diphtheria paronychia vestibulitis 949 951 3 10/03/23 20230901 NES 230901 CASE PRESENTATION A 7-month-old boy presented with a 3-week history of an eruption of the anterior nares and nasal vestibule and inflammation around the big toes bilaterally. The two common forms of diphtheria infections are respiratory and cutaneous diphtheria. [Extracted from the article]

Nail conditions are not only aesthetic concerns, and nail changes may be a clue to an underlying systemic diseases or infection. Without timely treatment, nail diseases can continue to worsen and significantly impair performance of daily activities and reduce quality of life. Examination of the nails is essential at every medical visit, and may uncover important findings. Brittle nail syndrome, onychomycosis, paronychia, nail psoriasis, longitudinal melanonychia, Beau's lines, onychomadesis and retronychia are common nail disorders seen in clinical practice. These conditions stem from infectious, inflammatory, neoplastic and traumatic aetiologies. Though each nail condition presents with its own distinct characteristics, the clinical findings may overlap between different conditions, resulting in misdiagnosis and treatment delays. Patients can present with nail plate changes (e.g. hyperkeratosis, onycholysis, pitting), discolouration, pain and inflammation. The diagnostic work-up of nail disease should include a detailed history and clinical examination of all 20 nail units. Dermoscopy, diagnostic imaging and histopathologic and mycological analyses may be necessary for diagnosis. Nail findings concerning for malignancy should be promptly referred to a dermatologist for evaluation and biopsy. Nail disease management requires a targeted treatment approach. Treatments include topical and/or systemic medications, discontinuation of offending drugs or surgical intervention, depending on the condition. Patient education on proper nail care and techniques to minimize further damage to the affected nails is also important. This article serves to enhance familiarity of the most common nail disorders seen in clinical practice. It will highlight the key clinical manifestations, systematic approaches to diagnosis and treatment options for each nail condition to improve diagnosis and management of nail diseases, as well as patient outcomes. Nail disease is not only a cosmetic issue, as nail changes can indicate the presence of a serious underlying systemic disease, infection or malignancy. Nail pain and changes associated with NP are physically and emotionally distressing and may contribute to functional impairment and diminished quality of life. LM is a hallmark sign of subungual melanoma and this finding warrants further investigation to rule out malignancy. [ABSTRACT FROM AUTHOR]

Purpose: Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are frequently associated with dermatologic adverse events (dAEs), having great impacts on patients' health-related quality of life (HRQoL) and treatment adherence. We aimed to examine the association between various dAEs and HRQoL in patients treated with EGFR-TKI therapy. Methods: This was a cross-sectional study including 132 non-small-cell lung cancer (NSCLC) patients treated with gefitinib, erlotinib, afatinib, or osimertinib in Taiwan. The severity level of dAEs was graded by NCI-CTCAE v4.03 and PRO-CTCAE ITEMS v1.0. All participants answered the Functional Assessment of Cancer Therapy-Epidermal Growth Factor Receptor Inhibitors (FACT-EGFRI-18) HRQoL questionnaire. Results: The clinician-reported severity of pruritus, photosensitivity, alopecia, and Karnofsky performance status was associated with HRQoL (β = − 6.773, p = 0.046; β = − 5.250, p = 0.032; β = − 8.121, p = 0.001; β = 0.327, p = 0.002; respectively). The clinician-reported severity of all dAEs except paronychia had negative correlations with HRQoL. The symptom gradings of CTCAE and PRO-CTCAE had positive correlation. Conclusions: The severity of pruritus, photosensitivity, and alopecia was associated with HRQoL of patients receiving EGFR-TKI therapy. Using patient-reported outcome measurements helps clinicians to capture the actual impact of symptoms on physical, social-emotional, and functional well-being. [ABSTRACT FROM AUTHOR]

Introduction: Retronychia is defined as a condition where the proximal nail plate grows into the proximal nail fold with the formation of multiple layers of nail plates. It relates to frequent microtrauma that affects the toenails, especially the big toe and it is less common on the fingernails., Case Presentation: Case 1: A 14-year-old female presented with nail growth stopped and painful swelling in her left hallux that did not respond to antibiotics. The patient had been traumatized at the same toenail. Retronychia was diagnosed, and nail avulsion was performed. Case 2: An 18-year-old man came with painful swelling and stopped growth in his right great toenail that did not improve with antibiotics. The patient had previously trauma the same toenail. Retronychia was diagnosed clinically, and nail avulsion was performed. Case 3: A 30-years-old woman presented with Inflammation and pain in her right toenail. She mentioned a previous trauma to her foot. Retronychia was diagnosed clinically and she underwent onychectomy., Discussion: Retronychia is a chronic nail abnormity based on unresolved chronic proximal paronychia caused by disintegrated nail growth and several generations of nail plate localization underneath the damaged nail. The most common reason for retronychia is trauma which also happens after repetitive micro-trauma. Clinical diagnosis is the basis of retronychia. Retronychia treatment varies between surgical treatment and conservative treatment., Conclusion: This paper highlights the importance of considering retronychia as a potential differential diagnosis in cases of chronic paronychia, and stresses the significance of early detection to prevent complications., Competing Interests: Conflict of interest statement There is no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)