Management of ingrown toenails in patients with diabetes: a clinical case and expert approach of a podiatrist‑endocrinologist

Background. Ingrown toenail (onychocryptosis) in patients with diabetes mellitus is not only a local lesion but also a potential trigger for ulceration, infection, and non‑traumatic amputation. The purpose was to demonstrate how early diagnosis, the use of a patented podiatrist’s risk assessment chart (patent No. 137472), and gentle intervention make it possible to prevent complications in diabetic patients. Clinical case. Female, 82 years old, type 2 diabetes; fasting blood glucose — 11.1 mmol/L. After a self‑performed pedicure, edema and hyperemia of the great toe appeared. The use of the author’s risk chart revealed a pronounced neuropathy, diminished pulsation of the foot arteries, inflammation of the nail fold, hygiene errors, and lack of offloading (total score 4/15 — “red zone”). Gentle nail correction was performed, aseptic treatment with lincomycin solution, topical therapy (boosty gel Ag+ and gentaxan powder), offloading with a silicone spacer, systemic antibacterial and metabolic therapy. After 14 days, inflammation resolved, and the nail stabilized. Conclusions. The use of the podiatrist’s risk assessment chart (patent No. 137472) and early podiatric intervention, aligned with international IWGDF and ADA recommendations, reduces the likelihood of ulceration and amputation in patients with diabetes.