Paronychia Disease

DESCRIPTION

Infectious inflammation of the folds of skin surrounding the fingernail or toenail. May be acute or chronic.

System(s) affected: Skin/Exocrine
Genetics: No known genetic pattern
Incidence/Prevalence in USA:
Common
Predominant age: All ages
Predominant sex: Female > Male (3:1)

SIGNS AND SYMPTOMS

Separation of nail fold from nail plate
Red, painful swelling of skin around nail plate
Purulent
Secondary changes of nail plate
Green changes in nail (Pseudomonas)

CAUSES

Acute – Staphylococcus aureus. Less frequently by Streptococci and Pseudomonas
Chronic – Candida albicans. Less frequently by fungi – dermatophytes and occasionally by molds (Scytalidium, Fusarium)

RISK FACTORS

Acute – trauma to skin surrounding nail, ingrown nails
Chronic – frequent immersion of hands in water, diabetes mellitus

LABORATORY

Gram stain
Culture and sensitivity
KOH preparation plus fungal culture

Drugs that may alter lab results: Use of over-the-counter antimicrobials or antifungals
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

N/A

SPECIAL TESTS

None

IMAGING

N/A

DIAGNOSTIC PROCEDURES

N/A

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

Acute – warm compresses or vinegar soaks, elevation
Chronic – keep fingers dry

SURGICAL MEASURES

Incision and drainage (I&D) of abscess, if present. If there is a subungual abscess or ingrown nail present, will need partial or complete removal of nail.

ACTIVITY

Full activity

DIET

No special diet

PATIENT EDUCATION

Chronic - keep fingers dry

PREVENTION/AVOIDANCE

Chronic – avoid frequent wetting of hands, wear rubber gloves with cloth liner
Good diabetic control

POSSIBLE COMPLICATIONS

Acute – subungual abscess
Chronic – secondary ridging, thickening, and discoloration of nail, nail loss

EXPECTED COURSE AND PROGNOSIS

With adequate treatment and prevention, healing can be expected

ASSOCIATED CONDITIONS

Diabetes mellitus

AGE-RELATED FACTORS

Pediatric: Anaerobes may be involved in cases with thumb/finger sucking
Geriatric:N/A
Others: N/A

PREGNANCY

N/A

OTHER NOTES

May be considered work-related in bartenders, waitresses, nurses and others who often wet their hands

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

Holistic healing that treats the person, not just the disease. Experience gentle, lasting wellness with expert constitutional care.