Hockey players and professional figure skaters are particularly at risk for this type of nail disorder. In severe cases, these patients may develop pincer nail deformity, a transverse overcurvature of the nail plate, leading to impingement on the nail bed and, possibly, excruciating pain. Nontraumatic Conditions Ingrown nails. Ingrown toenails usually involve the hallux and are caused by improper cutting of the lateral edge of the nail and the pressure of tight-fitting shoes. Inflammation of the lateral nail fold may be the result of a reaction to a foreign body or of an infection.
Treatment depends on the severity of the ingrown toenail.
Occasionally the portion of the nail plate that is growing into the underlying tissue requires surgical removal. It may follow a minor trauma or may be the result of an infected ingrown toenail. Active patients are also at risk for subacute and chronic paronychia because of the moist environment created by athletic footwear. The initial insult is maceration, followed by infection with Candida species. Chronic paronychia is characteristically less painful and erythematous and has a more indolent course than the acute bacterial type.