Ingrown toenail

Background

Nailtip Anatomy

A. Nail plate; B. lunula; C. root; D. sinus; E. matrix; F. nail bed; G. hyponychium; H. free margin.
  • The perinychium includes the nail, the nailbed, and the surrounding tissue.
  • The paronychia is the lateral nail folds
  • The hyponychium is the palmar surface skin distal to the nail.
  • The lunula is that white semi-moon shaped proximal portion of the nail.
  • The sterile matrix is deep to the nail, adheres to it and is distal to the lunule.
  • The germinal portion is proximal to the matrix and is responsible for nail growth.
  • Lateral nail edge grows deep into nail wall → cycle of inflammation and hypertrophic granulation tissue can lead to abscess

Clinical Features

Typical ingrown toenail
  • Pain and swelling at distal nailbed, typically unilateral

Differential Diagnosis

Foot diagnoses

Acute

Subacute/Chronic

Evaluation

Workup

  • Typically does not require studies

Diagnosis

  • Typically a clinical diagnosis

Management

Disposition

  • Outpatient

See Also

External Links

References