Nail and Skin Pathologies Overview

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Questions and Answers

What is the recommended treatment for an ingrown toenail without infection?

Partial nail avulsion with matrixectomy (correct)

Total nail avulsion

Application of antifungal ointment

Use of corticosteroid injections

Which method is most effective for preventing the development of blisters during sports?

Only wearing athletic sandals

Regular application of talcum powder

Utilizing thick socks and forgiving surfaces (correct)

Wearing shoes that are the same size regardless of fit

What factor is commonly associated with the development of blisters in athletes?

High protein diet

Excessive hydration pre-competition

Frequent nail trimming

Shear forces acting between the epidermis and dermis (correct)

Which of the following is NOT a suggested method to prevent onycholysis in athletes?

Cutting nails very short to prevent trauma Signup and view all the answers

Which of the following statements about management of blisters is FALSE?

Leaving blisters intact is always recommended for faster healing Signup and view all the answers

What condition is characterized by the separation of the nail plate from the nail bed?

Onycholysis Signup and view all the answers

Which of the following is a predisposing cause for the formation of blisters?

Wearing shoes that are too tight Signup and view all the answers

What is a common cause of onychocryptosis in individuals?

Improperly fitting shoes Signup and view all the answers

What is the primary cause of corns?

Compressive pressure on the skin Signup and view all the answers

What is the most common agent responsible for Tinea Pedis?

Trichophyton rubrum Signup and view all the answers

What is an effective preventive measure against fungal infections like Tinea Pedis?

Using antifungal powder regularly Signup and view all the answers

Which of the following treatments is considered a last resort for the removal of warts?

Excision Signup and view all the answers

When treating a puncture wound in the foot, what is the most critical step?

Ensuring tetanus prophylaxis is up to date Signup and view all the answers

What is a recommended treatment option for calluses?

Moisturizing cream Signup and view all the answers

What type of pressure causes calluses to form?

Shear pressure Signup and view all the answers

To help alleviate increased pressure areas caused by deformities, which of the following is a common intervention?

Orthotic devices Signup and view all the answers

What is the primary prevention method for subungual hematoma in athletes?

Properly fitting shoes with a less constrictive toe box Signup and view all the answers

Which condition is characterized by dark red or black discoloration of the toenail due to bleeding beneath the nail bed?

Subungual hematoma Signup and view all the answers

What is the recommended treatment for a painful subungual hematoma?

Drilling holes through the top of the nail to relieve pressure Signup and view all the answers

Which nail pathology occurs primarily due to improper shoe fit and can lead to dorsal nail pain?

Onychocryptosis Signup and view all the answers

What is the long-term solution for recurrent fungal infections in athletes?

Consistent use of antifungal powder and maintaining foot hygiene Signup and view all the answers

Which of the following is NOT a typical treatment method for blisters in athletes?

Applying antifungal cream directly on the blister Signup and view all the answers

What is one of the main reasons that athletes develop corns and calluses?

Intense friction and pressure on the feet Signup and view all the answers

What is the treatment approach for an ingrown toenail causing significant pain?

Surgical avulsion of part of the nail Signup and view all the answers

Which of the following actions is NOT recommended for managing blisters on the feet?

Covering them securely with duct tape Signup and view all the answers

Which condition is most commonly associated with a hyperextension injury of the 1st MTP joint?

Turf Toe Signup and view all the answers

What imaging modality is primarily used to visualize soft tissue injuries related to nail pathologies?

MRI Signup and view all the answers

What is a common cause of onycholysis in athletes?

Nail bed trauma or infection Signup and view all the answers

Which of the following is an effective strategy to prevent fungal infections in athletes?

Keeping feet dry and using antifungal powder Signup and view all the answers

When is it appropriate to consider surgical intervention for an ingrown toenail?

After failed conservative treatments for significant pain and infection Signup and view all the answers

Study Notes

Nail Pathologies

Onycholysis

Separation of the nail plate from the nail bed
Common in athletes due to acute trauma or chronic microtrauma
Nutrient deficiencies (e.g., iron, riboflavin) can contribute
Prevention includes well-fitting shoes and nutrient supplementation
Treatment for loose and painful toenails: total nail avulsion

Onychocryptosis

Also known as an ingrown toenail
Caused by improperly fitting shoes and improper nail care (e.g., cutting nails too short)
Can present with or without infection
Prevention involves properly fitted shoes and good nail care
Treatment may require partial nail avulsion or matrixectomy

Skin Pathologies

Blisters

Develop from shear forces in sports requiring quick changes in direction
Caused by separation of the epidermis from the dermis filled with serous fluid
Predisposing factors: tight/narrow shoes, large shoes, synthetic surfaces, deformities causing friction
Prevention: well-fitting shoes, thick socks, forgiving surfaces, and moleskin
Treatment options include drainage, excision as a last resort, or laser treatment

Corns/Calluses

Hyperkeratotic lesions resulting from increased pressure
Corns arise from compressive pressure; calluses from shear pressure
Prevention strategies involve proper shoe fitting, orthosis, and moisturizing creams
Treatment includes debridement, strapping/padding, orthoses, and addressing deformities

Tinea Pedis

Fungal infection commonly known as athlete’s foot
Characterized by itching, burning, and often accompanied by cracks in the skin
Caused by fungi like Trichophyton species and can lead to bacterial superinfection
Prevention focuses on good hygiene, cotton socks, antifungal powders, and protective sandals
Treatment involves topical antifungals and oral medications for persistent cases

Foreign Body/Puncture Wound

Commonly occurs on the foot, especially if barefoot or through shoes
Treatment includes tetanus prophylaxis (especially for punctures), foreign body removal, and infection evaluation

Proprioception and Strength Training

Important for functional stability and preventing ankle sprains
Proprioception training can enhance body awareness before a potential sprain
Exercises include using wobble boards, BAPS boards, BOSU balls, and balance pads

Surgical Treatments

Anatomic repairs involve reapproximating ligaments, with Brostrom being most common
Non-anatomic repairs can include single or double ligament reconstructions

Turf Toe

Injury related to hyperextension of the 1st MTPJ causing disruption of the ligamentous complex
Commonly occurs on artificial turf surfaces, but similar injuries reported on natural grass
Caused by axial loads while the foot is positioned in equinus with the great toe extended
Symptoms include edema, ecchymosis, and pain specific to the dorsal or plantar areas
Imaging (AP, Lateral, MRI) can help diagnose soft tissue injuries and structural disruptions
Graded from I (attenuation) to III (complete disruption), with varying treatments and return-to-play timelines

Sports-related nail pathologies often stem from improperly fitted footwear
Common conditions include subungual hematoma, onycholysis, and onychocryptosis

Subungual Hematoma

Also referred to as "runner’s toe," characterized by dark discoloration due to bleeding beneath the nail
Pain arises from pressure buildup and can be caused by chronic or acute trauma
Prevention emphasizes proper shoe fit with sufficient toe box space
Treatment options: natural resolution, trephining for pain relief, nail avulsion for severe cases, and biopsy if melanoma is suspected

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Description

This quiz covers various nail and skin pathologies, including onycholysis, onychocryptosis, and blisters. It discusses their causes, prevention strategies, and treatment options. Ideal for students studying dermatology or related health fields.