Paronychia - Overview, Causes, Symptoms, and Treatment

Published: 15th November 2009
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Paronychia is a common skin infection which develops around a fingernail or a toenail. The condition may be acute (i.e. start suddenly) or chronic (i.e. start gradually).

Acute Paronychia is associated with bacteria entering the skin folds following an injury to the impacted area through activities such as nail biting, aggressive manicuring, and finger sucking. It develops over a few hours and nail folds become red, painful, and swollen. Yellow pus may also develop under cuticles separating the nail from the skin. The most common bacteria involved is Staphylococcus aureus but others include Streptococcus species and Pseudomonas species.

Chronic Paronychia occurs gradually and is harder to treat. The skin around the nail is moist and swelling is less prominent than in Acute Paronychia. This variant of the disease is associated with prolonged exposure to water, detergents, and other chemicals. Activities such as dish washing, fishing, janitorial work, and bartending therefore increases the risk of contracting Chronic Paronychia. Individuals with diabetes are also more susceptible. Infection is caused by a mixture of yeasts and bacteria, particularly a fungus known as Candida. Infection may start in one nail fold but spread to others with each affected nail fold becoming swollen and lifted above the nails. Nails may take on a greenish discoloration.

Treatment

Acute Paronychia may be treated by soaking the fingers and toes in a mixture of 50% warm water and 50% liquid antibacterial soap for at least 15 minutes, 3-4 times a day. In more serious cases when symptoms do not improve, a physician may prescribe antibiotics such as dicloxacillin, erythromycin, cephalexin. In the case of pus build up near the nails, a doctor will need to numb the impacted area and drain the pus through an incision. A part of the nail may need to be removed. Chronic Paronychia is normally treated with anti-fungal medications like clotrimazole and ketoconazole applied to the skin. Other prevention measures include refraining from biting the fingernails, washing hands frequently, wearing rubber gloves, and controlling diabetes.

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