Paronychia

Paronychia is an infection of the skin around the nails, commonly affecting the cuticle or the area at the nail folds. It can be acute (develops quickly) or chronic (persists over time).

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Causes

Acute Paronychia

Bacterial Infection: Usually caused by Staphylococcus aureus or Streptococcus species.

Trauma to the Nail Area:

Nail-biting or picking.

Cutting the cuticle too aggressively.

Punctures or splinters near the nail.

Manicures with unsterilized tools.

Chronic Paronychia

Fungal Infection: Typically caused by Candida species.

Prolonged Exposure to Moisture:

Frequent hand washing or soaking hands.

Working in wet environments (e.g., dishwashers, healthcare workers).

Skin Conditions: Eczema or psoriasis can predispose individuals to paronychia.

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Signs and Symptoms

Acute Paronychia:

1. Pain: Sudden, throbbing pain around the nail.

2. Swelling and Redness: Visible inflammation around the affected area.

3. Pus Formation: Collection of pus under the skin near the nail.

4. Warmth: The area feels warm to the touch.

Chronic Paronychia:

1. Mild Swelling and Redness: Persistent inflammation around the nail.

2. Thickened or Discolored Nail: The nail may appear ridged or distorted.

3. Cuticle Loss: The cuticle may pull away from the nail.

4. Occasional Discharge: In some cases, pus or fluid may leak.

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Effects

1. Nail Deformity: Chronic cases can lead to thickened, ridged, or discolored nails.

2. Pain and Discomfort: Makes everyday tasks like writing or typing uncomfortable.

3. Spread of Infection: Untreated acute cases may spread to other fingers or deeper tissues (felon or cellulitis).

4. Loss of Nail: Severe or recurrent infections may cause the nail to detach.

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Solutions

Preventive Measures

Avoid nail-biting or picking at the skin around the nails.

Use proper nail hygiene (trim nails carefully and avoid cutting the cuticle).

Wear gloves for wet work or when exposed to chemicals.

Avoid harsh nail products or unsterilized manicure tools.

Treatment for Acute Paronychia

1. Warm Soaks: Soak the affected finger in warm water or saline 3-4 times daily to reduce swelling and promote drainage.

2. Antibiotics: For bacterial infections, topical (e.g., mupirocin) or oral antibiotics (e.g., amoxicillin-clavulanate) may be prescribed.

3. Incision and Drainage: If there is pus, a healthcare provider may drain the abscess.

Treatment for Chronic Paronychia

1. Antifungal Medications: Topical antifungal creams (e.g., clotrimazole, nystatin) for fungal infections.

2. Moisture Protection:

Use emollients to protect the skin.

Keep hands dry; use gloves for water exposure.

3. Corticosteroid Creams: For inflammation, a low-dose steroid may be combined with antifungal treatments.

Severe or Refractory Cases

Surgical Intervention: Removal of part of the nail or nail fold may be needed in chronic or severe cases.

Advanced Care: Dermatologist consultation for persistent cases or underlying conditions (e.g., psoriasis, eczema).

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Key Points

Acute paronychia responds quickly to treatment when caught early.

Chronic paronychia requires long-term management, especially for moisture control.

Maintaining good nail and hand hygiene is essential to prevent recurrence.

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