We are considering a PNA with phenolisation.
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The challenge? The pt has RhA, and takes 2x10g Methotrexate once a week.
Common practice appears to be......avoid nail surgery for these pts...healing difficulties, immunosuppressed.... .
However, in terms of risk management.. the recurrent cryptosis is also undesirable.
2 previous wedge ressections with no matrixectomy healed in 3 months.
Nail regrowth, hypertrophied sulcus ("chubby toe") ,active lifestyle and failing conservative measures are inspiring us to pursue alternatives...
[Circulation & Sensation within normal limits - non-diabetic - 55yo male- orchardist]
Thoughts from the realm appreciated.
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