Advance nail treatment

Nowadays in Patan at Shree Bhagwati skin care and cosmetic laser clinic provides numbers of treatments for nail pigmentation including skin disease like LP , nail fungus successfully treated with Q switch ND yag laser as well as Nail psoriasis treated with Excimer 308 nm along with modern medicine

Nail surgery

There are numbers of skin conditions in which we can perform nail surgery are as follows

Etiam sit amet orci eget eros faucibus tincidunt. Sed fringilla mauris sit amet nibh.Nullam quis ante etiam sit amet orci eget.eros faucibus tincidunt duis leo.

Diagnostic biopsies

Histopathology is the gold standard for the diagnosis of nail disorders,. Even nail clippings give valuable information for the diagnosis of onychomycosis and ungual psoriasis. A punch biopsy is good for nail bed and matrix diseases are commonly performed at Shree Bhagwati skin care and cosmetic laser clinic,Patan.

Nail Removal (avulsion)

Many different techniques have been described that are often seriously traumatizing to the entire nail organ. The use of a sturdy hemostat clamp that is run under the nail, closed, and then rotated to tear the nail from the matrix and nail bed is obsolete. Using a nail elevator is less traumatizing: It is gently inserted under the proximal nail,thus such types of specialised skill full surgeries done at Patan by Our Dermatologist

Paronychia

Acute paronychia is usually a painful bacterial infection resulting from a break in the skin, a prick of a thorn, or a splinter. When neglected, it may lead to severe finger deformity.Often, a superficial abscess can be identified. It can be drained with a #23 or #21 gauge needle by lifting the nail fold with the tip of the needle. Copious disinfection with chlorhexidine solution and/or methylated spirit is added. A short course of oral antibiotics may be given.

Trauma

Injury of the distal digit frequently presents with typically different patterns between fingers and toes. A common mechanism is the crush injury of the fingertip in a door This is not only exceedingly painful but may also cause a fracture of the distal phalanx, with more or less pronounced posttraumatic nail dystrophy. A general rule is that when the hematoma occupies more than 50% of the nail field, a fracture is likely. In case there is no dislocation of the bone fragments, we are taking expert orthopaedic opinion in such cases

Onychogryposis

The ram’s-horn–like thickening of the nail is called onychogryposis. It is mainly seen in debilitated and elderly individuals. The nail grows up instead of out and may even cause a pressure sore on the nail bed or perionychium. The patient can no longer cut his nail, which has become a nuisance. Nail avulsion is difficult from the distal aspect but very easy with the proximal approach.

Ingrowing nails

This is one of the most frequent ailments and often considerably decreases the quality of life. There are hundreds of different treatment approaches, some of which work, while others do not so we offered best treatment in Patan

Ingrowing toenail in infancy

There are three kinds of ingrowing toenails presenting in infancy before the age of 2 years.

1. Distal toenail embedding with normally directed nail. This is sometimes seen in neonates. Conservative management by gently massaging the distal nail wall in distal-plantar direction is the treatment of choice. In those rare cases where permanent improvement has not been obtained by 1 year of age, a circular soft-tissue resection may be performed in an identical manner as in adults.

2. Congenital Juvenile ingrown toenail There is virtually always an imbalance between the width of the nail plate and that of the distal portion of the nail bed.Overcurvature of the nail plate is an aggravating factor.Additional factors are medial rotation of the toe, thinner nails and thicker nail folds, sweating, convex cutting of the nail, and pointed-toe and high-heeled shoes. Clinically, three stages are differentiated:

1. Erythema, edema, and pain on pressure
2. Purulent drainage and infection
3. Purulent granulation tissue and

Pincer nails

Distally increasing transverse overcurvature of the nails are called pincer, tube nails, or ungues constringentes. In most cases, the big toenails are symmetrically involved, combined with a lateral deviation of the long axis of the nails. When the lesser toenails are involved, they are deviated medially. This is a congenital and in many cases undoubtedly hereditary condition. Systemic X-ray examinations have shown that, in addition to deviation, basal lateral and medial osteophytes exist that

Nail viral wart(Verrucae)

Common warts are benign infectious lesions due to human papillomavirus (HPV) strains of various types. They are very common in children but may occur at any age. In the beginning, they present as small round rough-surfaced hyperkeratotic nodules. With time, they may attain a size of up to 10 to 20 mm in diameter and become fissured. When located at the lateral nail folds, they are usually oval. Under the nail, they will elevate the nail plate. Under the proximal nail fold, this can also clear with our expertise surgery at Shree Bhagwati skin care and cosmetic laser clinic,Patan

Ungual fibrokeratomas

Fibrokeratomas of the nail region are relatively frequent and may arise from periungual skin, under the proximal nail fold, in the matrix, and in the nail bed. Each of them has a particular clinical appearance, although they are histologically identical. Acquired fibrokeratomas are solitary lesions, but they occur in large numbers in about one half of the patients with tuberous sclerosis complex, sometimes as the only clinical sign. Independent of their origin, their removal requires cutting

Digital myxoid pseudocyst

This is the most frequent pseudotumor of the nail region. It appears as a dome-shaped, skin-colored to transparent lesion in the proximal nail fold, measuring between 4 to 10 mm in diameter. Characteristically, it causes a longitudinal depression in the nail plate due to pressure on the matrix. Spontaneous rupture into the nail pocket is not uncommon and leads to irregularities in the canaliform nail depression. Two theories as to its pathogenesis exist:

Subungual exostoses

These commonly develop at the medio-dorsal tip of the terminal phalanx of the hallux elevating the nail plate. They can be palpated as a stone-hard tumor. A radiograph is taken to determine the extent of the lesion.The overlying skin is incised, the exostosis dissected, and generously clipped off at its base with a nail clipper or bone rongeur. If the lesion is located more proximally under the nail plate, this is partially avulsed to permit access to it. When the skin overlying the

Subungual glomus tumor

Glomus tumors are rare but very well known hamartomas of the hand, particularly of the nail apparatus. Intense pain is characteristically elicited by probing or by inadvertent shock. Subungual glomus tumors are seen as a 5 to 8 mm large round to oval violaceous spot causing a longitudinal erythematous band. They are extirpated via the lateral aspect of the phalanx when they are located in the lateral third of the nail bed or matrix. An L-shaped incision is performed and the nail bed dissected Bowen’s disease and squamous cell carcinoma For this conditions we do offer best referral services

Ungual melanoma

Melanoma of the nail apparatus is probably the most frequent malignant nail neoplasm. Two thirds to three quarters are pigmented, most of them causing a longitudinal melanonychia. Nail-bed melanomas are often amelanotic and do not cause a pigmented band. Brown streaks in the nail are treated according to their location in the nail: Laterally positioned streaks are treated by a lateral longitudinal nail biopsy; median ones by a punch or fusiform biopsy or horizontal excision.Experience and expert advice we offer if confirmed by biopsy.