Onychocryptosis or ingrown nail is a common condition, seen mostly in adolescents and young adults. The etiology is multifactorial: repeated trauma, hyperhidrosis, a broad nail plate, cutting the corners of the nail at an angle. The condition can be classified into 3 or 4 progressive stages. In stage 1, the lateral nail border is painful and slightly swollen; the later stages are characterized by marked hypertrophy of the lateral nail folds and the development of granulation tissue.

Treatment depends on the clinical stage: while conservative measures are sufficient in stage 1, surgery is indicated in stages 2 to 4.

In onychocryptosis, the aim of surgery is to eliminate granulation tissue and hypertrophic tissue and to perform a matricectomy. Various clinical studies have shown matricectomy with 88% phenol to be a simple technique that gives excellent results with minimum complications. Several surgical techniques have been described for removing excess soft tissue. The method most often used is the Howard-Dubois technique, which is usually effective in mild to moderate cases.

In this issue of Actas Dermo-Sifiliográficas, Correa J et al.1 report on a series of 10 patients with onychocryptosis treated using the super U technique described by Dr. Péres Rosa. The evidence shows that this is a useful procedure in severe cases or when onychocryptosis recurs after treatment. Of note in this series are the good results obtained without complications, although the healing time was somewhat slow (6 weeks). Clinical studies comparing the different surgical procedures used to treat this very prevalent onychopathy are needed.