Health

What is the best way to treat a client with scarring of the proximal nail fold region?

February 22, 2005 | Bookmark +

What is the best way to treat a client with scarring of the proximal nail fold region?

Answer

Scarring of the proximal nail fold region involving the matrix (nail growth center) is referred to as pterygium (not to be confused with the common cuticle overgrowth that is often incorrectly referred to as pterygium). This disorder is actually an overgrowth of the proximal nail fold onto the nail bed. By definition, pterygium forms if there is scar tissue in the nail matrix. Since the nail matrix at that particular site cannot manufacture nail plate, the proximal nail fold skin grows out with the skin of the nail bed, giving rise to the triangular formation known as pterygium. A number of skin and nail disorders may cause pterygium to form. There are two approaches to treat pterygium. The first is used if the pterygium is permanent due to scarring, but the primary disease is now inactive. Under some circumstances, these clients may be helped by surgical reconstruction with the removal of the pterygium and the scar tissue in the matrix, which results in a nail more cosmetically acceptable than it was before. In patients whose pterygium formation is still in an active stage, then the treatment would be directed at the primary disorder. Once the disorder is brought under control, further scarring will not occur and pterygium can be reduced or even prevented.

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What’s the cause of the pinkish-red oval area on the pad of my client’s toes?

I have a client who has a recurring problem with her fourth toes during the winter months. Both of her “ring finger” toes develop a pinkish-red oval area on the pad. Then a month later, when I see her again, the skin has become dry and hard like a callus, with the layers of skin peeling away to reveal a deeper, dark epicenter.  It’s extremely painful for her and, needless to say, we do not touch it. But it clears up in the summer when she’s wearing open-toed sandals, so I suspect it has to be due to the boots she wears in the winter. Plus she never puts lotion on her feet or uses a foot file in between visits. What do you think causes this?

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What are the big white spots on my natural-nail client’s nails?

I have a client who has been with me for about two years. She used to wear acrylic nails but has been a natural nail client for eight months or so. She has these white spots on her nails — big spots that are dry, but not flaky, right in the middle of the nail. I did try to buff them lightly but they do not come off or grow off. I had a new client come in last week who had the same on her toenails. She said it started after she had a pedicure done at another salon. Can you help?

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