Educational Theories you must know. St.Emlyn’s Feb 1, 2008 Issue Pregnancy & Baby Minor Injuries Language Selector Phillips BZ. Nail Anatomy. In: Nail Anatomy. New York, NY: WebMD. http://emedicine.medscape.com/article/1948841-overview. Updated September 12, 2013. Accessed February 28, 2017. Components of the nail complex include the nail bed (matrix), the nail plate and the perionychium. The nail bed lies beneath the nail plate and contains the blood vessels and nerves. Within the nail bed is the germinal matrix, which is responsible for the production of most of the nail volume, and the sterile matrix. This matrix is the “root” of the nail, and its distal portion is visible on some nails as the half-moon–shaped structure called the lunula.1 The nail plate is hard and translucent, and is composed of dead keratin.2 The plate is surrounded by the perionychium, which consists of proximal and lateral nail folds, and the hyponychium, the area beneath the free edge of the nail1 (Figure 1). Health in Young Adults A bacterial agent that’s introduced to the area around your nail by some type of trauma typically causes an acute infection. This can be from biting or picking at your nails or hangnails, being punctured by manicurist tools, pushing down your cuticles too aggressively, and other similar types of injuries. Ravi Ubriani, MD, FAAD News Center Trusted medical advice from the Caitlin McAuliffe Eye Health Diagnosis: Gram stain of blister contents shows gram-positive cocci. Mental Health Sex & Relationships Nail Infection (Paronychia) Menu A felon is an abscess on the palmar surface of the fingertip. Bacteria are normally introduced via minimal penetrating trauma, such as a splinter. PAMELA G. ROCKWELL, D.O., is clinical assistant professor in the Department of Family Medicine at the University of Michigan Medical School, Ann Arbor. Dr. Rockwell also serves as the medical director of the Family Practice Clinic at East Ann Arbor Health Center in Ann Arbor, which is affiliated with the University of Michigan Medical School. She received a medical degree from Michigan State University College of Osteopathic Medicine in East Lansing and completed a family practice residency at Eastern Virginia Medical School in Norfolk, Va. Dosage adjustment may be necessary in patients with renal impairment; cross-sensitivity documented with cephalosporins; diarrhea may occur Put your email in the box below and we will send you lots of #FOAMed goodness TREATMENT OPTIONS and OUTCOMES WebMD does not provide medical advice, diagnosis or treatment. Differentials Sex & Relationships Media file 2: A herpetic whitlow. Image courtesy of Glen Vaughn, MD. Newsletters Sign Up to Receive Our Free Newsletters Clotrimazole cream (Lotrimin) TREATMENT Autoimmune disease, including psoriasis and lupus A to Z Guides RED FLAGS View More Books (test page) Kept Your Wisdom Teeth? Privacy Policy & Terms of Use Most of the time, paronychia is no big deal and can be treated at home. In rare cases, the infection can spread to the rest of the finger or toe. When that happens, it can lead to bigger problems that may need a doctor's help. Herpetic Whitlow Dermatology & Plastic Surgery Institute Jump up ^ Rigopoulos D, Larios G, Gregoriou S, Alevizos A (February 2008). "Acute and chronic paronychia". Am Fam Physician. 77 (3): 339–46. PMID 18297959. Septic tenosynovitis Rockwell, PG. "Acute and chronic paronychia". Am Fam Physician. vol. 63. 2001 Mar 15. pp. 1113-6. Three or four times daily until clinical resolution (one month maximum) Infectious flexor tenosynovitis: This bacterial infection is usually the result of penetrating trauma that introduces bacteria into the deep structures and tendon sheaths, which allows the spread along the tendon and associated sheath. "Opportunities do not come with their values stamped upon them." Waltbie Davenport Babcock If you suspect any kind of injury to your nail or to the skin around the nail, you should seek immediate treatment. A fungal nail infection, also known as onychomycosis or tinea unguium, happens when a fungus that's normally in your finger- or toenails overgrows. Caveats and cautions Insurance & Bills Educational theories you must know. Kurt Lewin change cycle. St.Emlyn’s Anatomy of the nail. In addition, immunosuppressed patients are more likely to have chronic paronychia, particularly diabetics and those on steroids. It is worth noting that indinavir (an antiretroviral drug) is associated with chronic paronychia, particularly of the big toe, which resolves when the drug is ceased. Psoriasis might also predispose to chronic paronychia as well as being a differential diagnosis in these patients. Figure 5. Acute Paronychia Itraconazole (Sporanox) Do I have paronychia? Languages MyChartNeed help? 33. Bednar MS, Lane LB. Eponychial marsupialization and nail removal for surgical treatment of chronic paronychia. J Hand Surg [Am]. 1991;16(2):314–317. Felon: Often, incision and drainage is required because the infection develops within the multiple compartments of the fingertip pad. Usually an incision will be made on one or both sides of the fingertip. The doctor will then insert an instrument into the wound and break up the compartments to aid in the drainage. Sometimes, a piece of rubber tubing or gauze will be placed into the wound to aid the initial drainage. The wound may also be flushed out with a sterile solution to remove as much debris as possible. These infections will require antibiotics. The wound will then require specific home care as prescribed by your doctor. detachment of your nail Show More Advertising Policy RESOURCES There is no evidence that treatment with oral antibiotics is any better or worse than incision and drainage for acute paronychia. Acute paronychiae are usually caused by Staphylococcus aureus and are treated with a first-generation cephalosporin or anti-staphylococcal penicillin. Broader coverage is indicated if other pathogens are suspected. Chronic paronychiae may be caused by Candida albicans or by exposure to irritants and allergens. Splinting the hand may enhance healing Table 2 How to Recognize and Treat an Infected Hangnail First Aid detachment of your nail I get ingrown toenails a lot. What can I do to prevent paronychia? Sports May progress to thick, discolored nail plates → separation of cuticles/nail folds from the nail plate athletes foot | paronychia treatment over the counter athletes foot | sore under fingernail athletes foot | toenail cuticle infection
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