3. Rockwell PG. Acute and chronic paronychia. Am Fam Physician. 2001;63(6):1113–1116.
5. Brook I. Aerobic and anaerobic microbiology of paronychia. Ann Emerg Med. 1990;19:994–6. Rick Body. Getting Your Chest Pain Evaluation Right. University of Maryland Cardiology Symposium
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Figure 2. MORE SECTIONS Kids site If you have signs or symptoms of a felon, cellulitis, infectious flexor tenosynovitis, or deep space infection, you should seek emergency care at once. Paronychia is one of the most common infections of the hand. Clinically, paronychia presents as an acute or a chronic condition. It is a localized, superficial infection or abscess of the paronychial tissues of the hands or, less commonly, the feet. Any disruption of the seal between the proximal nail fold and the nail plate can cause acute infections of the eponychial space by providing a portal of entry for bacteria. Treatment options for acute paronychias include warm-water soaks, oral antibiotic therapy and surgical drainage. In cases of chronic paronychia, it is important that the patient avoid possible irritants. Treatment options include the use of topical antifungal agents and steroids, and surgical intervention. Patients with chronic paronychias that are unresponsive to therapy should be checked for unusual causes, such as malignancy.
CLINICAL MANIFESTATIONS Site Map You should schedule an appointment with your doctor if: Allergic contact dermatitis or primary irritation due to certain nail polish or latex or excessive repeated habitual wet products
musculoskeletal Warm soaks, oral antibiotics (clindamycin [Cleocin] or amoxicillin–clavulanate potassium [Augmentin]); spontaneous drainage, if possible; surgical incision and drainage
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We apologise for any inconvenience. 4. Roberge RJ, Weinstein D, Thimons MM. Perionychial infections associated with sculptured nails. Am J Emerg Med. 1999;17(6):581–582. PROGNOSIS
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the affected area blisters and becomes filled with pus 5. Treatment Check out: Fungal nail infection » Rick Body. How free, open access medical education is changing Emergency Medicine
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DIAGNOSIS Rockwell, PG. “Acute and chronic paronychia”. Am Fam Physician. vol. 63. 2001 Mar 15. pp. 1113-6. the extensor tendon and joint capsule are fairly avascular and thus unable to fight infection
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PRINT Infectious flexor tenosynovitis: This infection involves the tendon sheaths responsible for flexing or closing the hand. This is also a type of deep space infection.
DERMATOLOGY ADVISOR TWITTER Baby Cancer The digital pressure test may be helpful in the early stages of paronychial infection when there is doubt about the presence or extent of an abscess.
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Call for Additional Assistance 800.223.2273 Food & Recipes Psoriasis and Reiter syndrome may also involve the proximal nail fold and can mimic acute paronychia.10 Recurrent acute paronychia should raise suspicion for herpetic whitlow, which typically occurs in health care professionals as a result of topical inoculation.12 This condition may also affect apparently healthy children after a primary oral herpes infection. Herpetic whitlow appears as single or grouped blisters with a honeycomb appearance close to the nail.8 Diagnosis can be confirmed by Tzanck testing or viral culture. Incision and drainage is contraindicated in patients with herpetic whitlow. Suppressive therapy with a seven-to 10-day course of acyclovir 5% ointment or cream (Zovirax) or an oral antiviral agent such as acyclovir, famciclovir (Famvir), or valacyclovir (Valtrex) has been proposed, but evidence from clinical trials is lacking.15
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My WebMD Pages 10. Baran R, Barth J, Dawber RP. Nail Disorders: Common Presenting Signs, Differential Diagnosis, and Treatment. New York, NY: Churchill Livingstone; 1991:93–100.
Psoriasis and Reiter syndrome may also involve the proximal nail fold and can mimic acute paronychia.10 Recurrent acute paronychia should raise suspicion for herpetic whitlow, which typically occurs in health care professionals as a result of topical inoculation.12 This condition may also affect apparently healthy children after a primary oral herpes infection. Herpetic whitlow appears as single or grouped blisters with a honeycomb appearance close to the nail.8 Diagnosis can be confirmed by Tzanck testing or viral culture. Incision and drainage is contraindicated in patients with herpetic whitlow. Suppressive therapy with a seven-to 10-day course of acyclovir 5% ointment or cream (Zovirax) or an oral antiviral agent such as acyclovir, famciclovir (Famvir), or valacyclovir (Valtrex) has been proposed, but evidence from clinical trials is lacking.15
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Flexor tenosynovitis can also have noninfectious causes such as chronic inflammation from diabetes mellitus, rheumatoid arthritis or other rheumatic conditions (eg, psoriatic arthritis, systemic lupus erythematosus, and sarcoidosis).
SMACC Dublin Workshop. Stats for people who hate stats…….part 1 underlying nail plate abnormalities (chronic)
Associated with onset of hemolytic uremic syndrome By contrast, chronic paronychia is most frequently caused by repeated exposure to water containing detergents, alkali, or other irritants. This can lead to the swelling and gradual deterioration of the epidermal layer. Unlike acute paronychia, most chronic infections are caused by the fungus Candida albicans and other fungal agents.
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Other Paronychia General Health Stop Infestations Subungual hematoma (smashed fingernail, blood under the nail) People with the following conditions tend to have more extensive paronychial infections and may need to be treated with a prolonged course of antibiotics:
Consider antifungal: topical (e.g., miconazole); oral (e.g., fluconazole) if severe Resus & Crit Care Immunization Schedules
for Teens Last updated: March 2018 Page: What kind of paronychia do I have? Treatment doesn’t help your symptoms. Specialty Dermatology, emergency medicine
Nail loss Today on WebMD The dagnosis is usually determined by the clinical appearance. The histological feature is not specific, showing an acute or chronic nonspecific inflammatory process. Sometimes there is an abscess formation around the nail folds. Ultrasound and culture from purulent material will help to decide if and what systemic antibiotic should be given.
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One or two pastilles four times daily for seven to 14 days Depression in Children and Teens Wikimedia Commons has media related to Paronychia (disease).
septic arthritis: infection in the joint space, often related to bite wounds Paronychia can occur with diabetes, drug-induced immunosuppression, or systemic diseases such as pemphigus.
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3. Rockwell PG. Acute and chronic paronychia. Am Fam Physician. 2001;63(6):1113–1116.