Abstract
The present study evaluated the properties of nails, frequency of ingrown nails in
patients with type 2 diabetes mellitus (DM), risk factors for developing ingrown nails,
and effect of diabetic polyneuropathy and vasculopathy on the development and outcome
of ingrown nails. Our 6-month epidemiologic prospective study included 300 patients
with type 2 DM attending a DM outpatient clinic for routine examinations. The general
characteristics and foot changes of the study population were investigated. Diabetic
polyneuropathy and vasculopathy were evaluated using a biothesiometer, monofilament
tests, and arterial Doppler ultrasonography. The frequency of ingrown nails was 13.6%.
Multivariate analysis with logistic regression showed that body mass index (odds ratio
[OR] 1.077, 95% confidence interval [CI] 1.007 to 1.15; p = .03), previous trauma (OR 2.828, 95% CI 1.017 to 7,867, p = .042), a weak dorsalis pedis pulse (OR 2.72, 95% CI 1.17 to 6.30, p = .02), trimming type (OR 2.3, 95 CI 1.06 to 4.98), p = .35), onychogryphosis (OR 9.036, 95% CI 2.34 to 34.87, p = .001), and subungual hyperkeratosis (OR 4.3, 95% CI 1.99 to 9.3, p = .001) were predictive variables for ingrown nails in our population. The incidence
of onychomycosis was significantly greater in patients with ingrown nails (p = .032) than in patients without ingrown nails. The nail curvature ratio was greater
in the patients with ingrown nails than in the group with normal nails. Arterial Doppler
ultrasound examinations showed peripheral arterial disease in 19 patients (46.9%)
with ingrown nails. The prevalence of ingrown nails was greater in the patients with
DM than in the healthy population. Our results indicate that nail type, nail morphology,
and diabetic vasculopathy affect the formation and evolution of ingrown nails.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: January 10, 2018
Footnotes
Funding: None reported.
Conflict of Interest: None reported.
Identification
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© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
