Nail diseases

Nail anomalies are given a special place in our department and deserve a comprehensive approach. They are one of our partial specialisations. There are various nail disorders, ranging from innocent disorders (e.g. overgrown toenails, ingrown toenails) to serious disorder (e.g. tumours of the nail plate).

What is it?

Many people get nails that no longer look as good; they discolour, become crumbly or thicken.

Onychomycosis nail versus fungus nail?

• Onychomycosis nails are a thickening of nails with a yellow discolouration of the nail plate, without an underlying infection. They may be the result of prior trauma or of reduced blood supply to the nails (e.g. in the case of arteriosclerosis in the legs, smoking, etcetera). The treatment consists of flattening and keeping the nails soft, but complete healing is often not possible.
• Fungal nails can also thicken the nail plate, with a typical yellowish-brown discoloration and flaking under the nail plate. During the consultation with the physician or nurse, a large sample of it will be taken. Treatment is possible with prolonged ingestion (usually several months) of antifungal medication and mechanical removal (milling) of the remaining diseased fungal fragments.

Other infections (bacterial, yeast infections) can also infect the nail and the skin around it. Adequate and targeted cultivation is important to start the right treatment.

What categories can we distinguish?

We can categorise the nail disorders that we treat:

Surgical removal

• Tumours (benign, malignant, praecanceroses):
  mucoid cyst, periunal fibroids, fibrokeratomas, onychomatricoma, glomus tumour, exostoses, verrucae, botryomyncoma, praecanceroses such as Bowen’s disease, spinocellular epithelioma, melanoma
• Ingrowing nails:
  Classical ingrowing nails with/without hypergranulation tissue, pincer nail, retronychia
  .

Biopsies for diagnosis

Pigment changes, inflammatory diseases (psoriasis/lichen...)

Non-surgical treatment

An experienced, well-trained specialised nurse in nail and foot care works in the Dermatology Department:

• smoothing (milling) toenails that are too thick, collect nail fragments for examination
• placing wicks under ingrowing toenails
• hyperkeratoses: callous, exterogen

Nail surgery

You can contact Dr Veerle Dhondt for surgical interventions on nails:

• ingrowing toenails
• tumours of the nail plate
• nail bed and nail matrix biopsies
• decrease of deep cultures
• mucoid cysts

For ingrown nails you can also contact:

Practical information

• You will usually come to us upon referral from a GP or a specialist colleague.
• Interventions always take place at Maria Middelares General Hospital and last 30 minutes on average. We ask you to come ten minutes in advance and wear or bring an open shoe (slipper, wide sandal). Also make sure that someone can take you home.
• On the day of the operation and the day after, you will not be able to work or go to school. It is also best not to plan any major activities on the weekend following the operation. The Monday after the operation, a normal shoe can be worn again in most cases.
  
• Post-operative wound care depends on the procedure. Usually the bandage remains in place for 48 hours. The treated area may then be soaked in a lukewarm footbath. Afterwards, care with an antiseptic is recommended.
• It is recommended to keep the foot up for the first 48 hours after surgery.

Latest publication date: 04/01/2024