What Is Retronychia?
Retronychia is a condition in which the nails grow into the skin of the fingers. The nails continue to grow and become embedded in the skin, causing pain and discomfort. It can be caused by various factors, including injury, infection, genetic disorders, repeated trauma to the nail bed, or it could be caused by an underlying condition like psoriasis (a skin condition that typically affects the knees, elbows, trunk, and scalp and results in a rash with itchy, scaly spots) or eczema (is a disorder that results in dry, irritated skin, and inflamed skin). Retronychia is usually not serious and can be treated with topical medications. In some cases, surgery may be recommended if there are complications or if other treatments fail to work.
What Are the Types of Retronychia?
There are three types of retronychia:
Acute Retronychia:
-
Acute retronychia is a rare, benign, and self-limiting condition that is characterized by erythema of the nail bed.
-
The nail bed may or may not be inflamed, and there may be mild tenderness at the site.
Chronic Retronychia:
-
It is an inherited condition, and it can affect any part of the nail. This condition is characterized by a longitudinal ridge on the nail plate. It can be seen on toenails as well as fingernails. The nails are usually thickened, and they often have ridges on them too.
-
Chronic retronychia can also cause pain and discomfort due to the pressure of the nail against other fingers or toes in tight shoes. The nails may become brittle or break off easily if left untreated.
-
Early diagnosis and treatment are important for this condition because it can lead to other complications, such as infection or amputation of digits if left untreated for long periods of time.
Proximal and Distal Retronychia:
-
If the injury is just a small area on the tip of the nail, then it is called distal retronychia. If it has spread all over the nail, then it is called proximal retronychia.
How Does Retronychia Develop?
Retronychia is thought to be developed from the nail plate's lack of continuity with the matrix. Here, the old nail is forced forward and backward by the growth of the new one. As a result, the old nail becomes embedded and is pushed upward rather than outward. The newly formed fragment is undergoing traction development brought on by inflammatory granulation tissue and is likely responsible for the backward motion of the entire nail unit.
What Are the Causes of Retronychia?
The triggering factors leading to retronychia include
-
Injury: Pressure created by repeated injury to the toenails is the most common factor leading to retronychia. Sports activities and wearing poorly fitting shoes can all contribute to trauma to the toenails.
-
Underlying Conditions: Certain medical conditions like arthritis (inflammation of the joints), eczema, and thrombophlebitis (inflammation of the veins due to underlying conditions) can also result in retronychia.
-
Activities: Repeated rubbing from tight clothing or shoes or repeatedly using the hands for tasks such as typing on a keyboard, texting, washing dishes, cooking, and gardening.
-
Environment: Working in an environment with excessive heat and humidity.
-
Genetics: Genetic factors contribute to the development of retronychia, especially for chronic states.
What Are the Signs and Symptoms of Retronychia?
-
The most common symptoms are pain and redness due to inflammation of the nail bed and the skin around it.
-
Some people with retronychia also experience tingling or numbness in their fingers because of nerve damage from pressure on nerves near the nail bed.
How Is Retronychia Diagnosed?
The diagnosis of retronychia is made by identifying the symptoms, which are the presence of a deep red or purple patch on the palm and fingers. In order to diagnose retronychia, the doctor will first identify the part of the nail which is affected. It can be diagnosed with a number of tests, including imaging tests and biopsy.
Imaging tests allow the identification or visualization of the nail components involved in the injury.
What Are the Differential Diagnosis of Retronychia?
Differential diagnosis includes:
-
Onychomycosis which can be identified by its yellowish discoloration and thickened nails with ridges or pits on them;
-
Abrasions and trauma to nails, which can be caused by accidents or dry skin;
-
The presence of an ingrown hair can cause redness and swell around that area;
-
Psoriasis, this condition causes scaling and redness on top of the nails as well as white scaly patches on both sides
How Is Retronychia Treated?
There are many treatment options available for retronychia, but they depend on the cause and severity of the retronychia. In most cases, it will be treated with antibiotics and steroids to help relieve pain and reduce swelling. If these treatments do not work, surgery may be required to remove part of the skin or some tissue from under the nails. The treatment options are elucidated below:
-
Topical Ointments and Lotions: The doctor may prescribe topical corticosteroids or pain relievers. These products are applied to the affected area two or three times a day for a period of five days to weeks, depending on severity.
-
Antibiotics: Antibiotics may be employed in cases where an infection is suspected from the site of injury.
-
Over-the-Counter: Taking over-the-counter pain medication like Acetaminophen if needed for pain relief.
-
Surgical Options: Severe cases are often treated with surgical intervention. Case reports indicate employing procedures avulsion of the nail for this condition. It has also been reported that the chances of recurrence of retronychia are minimal after avulsion.
What Are the Preventive Measures for Retronychia?
There are some prevention options available for retronychia, such as
-
Wearing gloves when doing household tasks or trimming the fingernails regularly.
-
Avoiding prolonged or repetitive hand use.
-
Wearing rightly fitting shoes to avoid exertion of pressure on the toes.
Conclusion
Retronychia is a rare disease that can affect one's palms in different ways depending on what causes it. Based on the severity and the cause of the condition, there are many treatment options available. A proper preventive measure can reduce the incidence of the disease considerably.
