Evaluation of predisposing factors in patients with ingrown toenails: a prospective, case-control study

Abstract

Ingrown toenails (IGTN) are a prevalent, debilitating nail disorder that occurs when the edge of the nail plate grows abnormally to penetrate the periungual dermis. Multiple risk factors have been identified in the etiology. In this study, we aimed to investigate the risk factors that predispose patients to IGTN. This prospective, case-control study consisted of 130 patients with IGTN and 130 age- and sex-matched controls. The sociodemographic data, clinical features, and predisposing factors were questioned. Multivariate logistic regression (Enter and Forward: LR) analysis was applied to determine the risk factors related to IGTN. The IGTN group comprised 63 (48.5%) females and 67 (51.5%) males with a median age of 31 (IQR = 28.25) years. The most common type of IGTN in the study group was distal-lateral ingrowing in 115 (88.5%) patients. The median duration of IGTN was 5.5 (IQR = 10) months. In the multivariate regression analyses, the presence of improper nail trimming (OR: 7.063; 95% CI: 3.604–13.843), presence of hyperhidrosis (OR: 2.648; 95% CI: 1.198–5.853), poor foot hygiene (OR: 4.873; 95% CI: 2.271–10.456), presence of foot/toe deformity (OR: 5.413; 95% CI: 1.508–19.427), presence of increased curvature of the nails (OR: 2.588; 95% CI: 1.024–6.543), presence of onychomycosis (OR: 3.506; 95% CI: 1.267–9.705), increase in BMI (OR: 1.126; 95% CI: 1.038–1.221) were found to be the predisposing factors that increased the risk of IGTN. Improper nail trimming, hyperhidrosis, poor foot hygiene, onychomycosis, increased curvature of the nails, foot/toe deformity and increase in BMI were found to contribute significantly to the etiopathogenesis of the disease. Considering that most of these risk factors were modifiable, informing the public about risk factors will reduce the frequency of IGTN, and modifying risk factors in patients will enable rapid control of the disease and reduce recurrences.