Practical podiatry : . ll of the nails may be affected; there may be asimple thickening or there may be a lateral overgrowth,which may result in paronychia. The inflammation maybe slight or it may be severe and purulent. The nail, as itcontinues to become thickened, may assume various shapesresembling claws, talons, horns, etc. The big toe nail is theone most usually affected and often only the one foot is in-volved. This is indicative of a traumatic etiology. Tuberculosis patients have a moderate onychauxis inmost cases, particularly on the nails of the fingers, whilehypertrophy is often seen
Practical podiatry : . ll of the nails may be affected; there may be asimple thickening or there may be a lateral overgrowth,which may result in paronychia. The inflammation maybe slight or it may be severe and purulent. The nail, as itcontinues to become thickened, may assume various shapesresembling claws, talons, horns, etc. The big toe nail is theone most usually affected and often only the one foot is in-volved. This is indicative of a traumatic etiology. Tuberculosis patients have a moderate onychauxis inmost cases, particularly on the nails of the fingers, whilehypertrophy is often seen in the inflammatory lesions suchas eczema, psoriasis, etc. DISEASES OF THE NAILS 243 Older persons are more liable to be affected with hyper-trophy of the nail than younger persons, as there is a nat-ural tendency to epithelial overgrowth in the aged. Treatment. To affect a cure in case of hypertrophyof the nails it is necessary to recognize the cause. Thus,in cases of onychauxis, in which the gener ah systemic condi-. ONYCHAUXIS tion is at fault, treatment must be directed by the familyphysician along constitutional lines and includes the takingof tonics, arsenic, mercury, etc. If a cutaneous lesion isthe etiologic factor, it becomes necessary to treat the caseboth generally and locally. If the cause be an external onealone, local treatment is sujEficient. For these latter condi-tions, the treatment is divided into palliative and radicalprocedures. The palliative treatment consists in keeping the nailproperly cut. For this purpose, the rotary file, or surgicaldrill, as it is called, is very efficient. Suitable burrs areused, and care is taken that the skin of the nail grooves isnot injured. Infections are easily caused through the care-less use of this instrument. After the nail has been thinnedand is as nearly like a normal nail as is possible, the part 244 PODIATRY should be cleansed with alcohol, and tincture of iodine (4%)should be applied. The grooves may be packed with
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