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Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management.

Publication ,  Journal Article
Ezekian, B; Englum, BR; Gilmore, BF; Kim, J; Leraas, HJ; Driscoll, TA; Tracy, ET; Rice, HE
Published in: J Pediatr Hematol Oncol
October 2017

PURPOSE: At our institution, a high proportion of children with onychocryptosis (ingrown toenail) requiring surgical intervention were noted to have a history of hematopoietic stem cell transplantation (HSCT). We analyzed the characteristics of patients who underwent surgical intervention for onychocryptosis and examined our institutional HSCT database to determine if an association exists between onychocryptosis and HSCT. MATERIALS AND METHODS: Surgical cases for onychocryptosis performed from 2000 to 2012 were identified. Nine demographic, clinical, and perioperative variables for both patients with and without prior HSCT were assessed. In a separate analysis, the institutional HSCT database was then queried to identify the prevalence and clinical characteristics associated with onychocryptosis after HSCT. RESULTS: We identified 17 children who had undergone surgical management of onychocryptosis, of which 8 (47.1%) had previous HSCT. Children who had undergone HSCT had an aggressive form of onychocryptosis with 50.0% having bilateral great toe and nail edge involvement and 37.5% having a recurrence. In HSCT cohort analysis of 1069 children, 91 (8.5%) had onychocryptosis. Male sex, non-black race, acute graft versus host disease, and increasing age at transplantation were independently associated with onychocryptosis. CONCLUSIONS: HSCT is strongly associated with onychocryptosis requiring surgical intervention. Children with a history of HSCT may also have more aggressive toenail disease, with higher rates of surgical intervention, bilateral ingrown toenails, recurrence, and need for return to the operating room. Clinicians should perform careful screening and early treatment in these patients.

Duke Scholars

Published In

J Pediatr Hematol Oncol

DOI

EISSN

1536-3678

Publication Date

October 2017

Volume

39

Issue

7

Start / End Page

e353 / e356

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Racial Groups
  • Oncology & Carcinogenesis
  • Nails, Ingrown
  • Male
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Graft vs Host Disease
  • Female
 

Citation

APA
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MLA
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Ezekian, B., Englum, B. R., Gilmore, B. F., Kim, J., Leraas, H. J., Driscoll, T. A., … Rice, H. E. (2017). Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management. J Pediatr Hematol Oncol, 39(7), e353–e356. https://doi.org/10.1097/MPH.0000000000000912
Ezekian, Brian, Brian R. Englum, Brian F. Gilmore, Jina Kim, Harold J. Leraas, Timothy A. Driscoll, Elisabeth T. Tracy, and Henry E. Rice. “Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management.J Pediatr Hematol Oncol 39, no. 7 (October 2017): e353–56. https://doi.org/10.1097/MPH.0000000000000912.
Ezekian B, Englum BR, Gilmore BF, Kim J, Leraas HJ, Driscoll TA, et al. Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management. J Pediatr Hematol Oncol. 2017 Oct;39(7):e353–6.
Ezekian, Brian, et al. “Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management.J Pediatr Hematol Oncol, vol. 39, no. 7, Oct. 2017, pp. e353–56. Pubmed, doi:10.1097/MPH.0000000000000912.
Ezekian B, Englum BR, Gilmore BF, Kim J, Leraas HJ, Driscoll TA, Tracy ET, Rice HE. Children Receiving Hematopoietic Stem Cell Transplantation are at Increased Risk of Onychocryptosis Requiring Surgical Management. J Pediatr Hematol Oncol. 2017 Oct;39(7):e353–e356.

Published In

J Pediatr Hematol Oncol

DOI

EISSN

1536-3678

Publication Date

October 2017

Volume

39

Issue

7

Start / End Page

e353 / e356

Location

United States

Related Subject Headings

  • Sex Factors
  • Risk Factors
  • Racial Groups
  • Oncology & Carcinogenesis
  • Nails, Ingrown
  • Male
  • Humans
  • Hematopoietic Stem Cell Transplantation
  • Graft vs Host Disease
  • Female