Ingrown Toenail was found in 5-Minute Clinical Consult which helps you diagnose, treat, and follow up on over 900 medical conditions seen in everyday practice.
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- In ingrown toenail, the distal margin of the nail plate grows into the lateral nail fold, causing irritation, inflammation, and sometimes bacterial or fungal infection:
- Stage 1 (inflammation): Erythema, slight edema, tenderness of lateral nail fold
- Stage 2 (abscess): Increased pain, erythema, and edema, as well as drainage (purulent or serous)
- Stage 3 (granulation): Further increased erythema, edema, and pain, with granulation tissue growing over the nail plate
- Can be recurrent
- Synonym(s): Onychocryptosis
- Great toenail is almost exclusively affected.
- Lateral edge of nail is more commonly affected than the medial edge.
- Most common in males aged 16–25 years
- More common in elderly females than in elderly males
- More common in those with lower incomes
- 24.5/1,000 overall
- 50/1,000 ≥65 years
- Genetic factors:
- Increased nail fold width
- Decreased nail thickness
- Medial rotation of the toe
- Many others proposed; none proven, including:
- Distorted, thickened nail (onychogryphosis)
- Fungal infection (onychomycosis)
- Improper trimming of the lateral nail plate
- Poorly fitting shoes
- Trauma to nail or nail fold
- Properly fitting shoes
- Proper nail trimming
- Nail plate penetrates the nail fold.
- This causes a foreign body reaction (inflammation).
- Bacteria or fungi may enter through the opening in the nail fold, causing infection and abscess formation.
- The inflamed and infected tissue hypertrophies, further covering the nail plate.