Molly Hinshaw, Professor of Dermatology at the University of Wisconsin, Madison, discussed the updates in managing nail disorders in the recent ODAC Dermatology, Aesthetic & Surgical Conference. She explained:

Retronychia is an ingrowth of the proximal nail plate into the proximal nail fold, miming chronic paronychia or nail inflammation. Elevation of the proximal nail plate is crucial for diagnosing, along with yellowing of the nail. Some cases also represent a second or even third nail growing under the nail plate. It can be managed sometimes with topical steroids, but secondary changes might require further treatment. 

Onycholysis: separating the nail from the nail bed is crucial when it is secondary to another issue. However, in primary onycholysis, retinoids should be used. Also, clipping back the nail and treating the nail bed every night with tretinoin 0.025% is advised. 

Pyogenic granuloma (PG) in the nail: adults with PG should undergo a histologic diagnosis because of potential misdiagnosis with amelanotic melanoma or squamous cell carcinoma, although in children, a biopsy may not be necessary. Treatment with topical beta-blockers can effectively treat PG and avoids the scarring related to surgical removal. 

Periungual or subungual warts: present alongside or under the nail may witness scarring of the nail bed with destructive approaches. Thus, treatments like lasers and liquid nitrogen are appropriate. Injecting antiviral cidofovir into the dermis right under the wart can be greatly effective, and one or two treatments are often enough.

Source: Collins TR. Treatment of several nail disorders reviewed. Dermatology News. 2023. Available from: https://www.mdedge.com/dermatology/article/261287/hair-nails/treatment-several-nail-disorders-reviewed