Let’s start with some anatomy (hurrah!) Find Lowest Drug Prices Follow up High doses may cause bone marrow depression; discontinue therapy if significant hematologic changes occur; caution in folate or glucose-6-phosphate dehydrogenase deficiency A favourite among SAQ-writers, flexor tenosynovitis is an acute (bacterial) infection within the finger’s flexor sheath which may arise following penetrating trauma to the tendon sheath or as spread from an untreated felon. There are four cardinal signs as described by Kanavel: Read the Issue Adjust dosage in patients with severe hepatic dysfunction; associated with severe and possibly fatal colitis; inform patient to report severe diarrhea immediately Today on WebMD Diagnosis: Gram stain of blister contents shows gram-positive cocci. Acute Categories: Men, Seniors, Women Related Articles Turkman et al described the "digital pressure test for paronychia": A paronychia will appear as a blanched area when light pressure is applied to the volar aspect of the affected digit. Nail Abnormalities Clinical science Fungal Infections: What You Should Know Weight Loss and Diet Plans Acne 15. Bowling JC, Saha M, Bunker CB. Herpetic whitlow: a forgotten diagnosis. Clin Exp Dermatol. 2005;30(5):609–610. Herpetic whitlow is discussed in herpes simplex virus infections. Giving Appointments & AccessPay Your BillFinancial AssistanceAccepted InsuranceMake a DonationRefer a PatientPhone DirectoryEvents Calendar 32. Grover C, Bansal S, Nanda S, Reddy BS, Kumar V. En bloc excision of proximal nail fold for treatment of chronic paronychia. Dermatol Surg. 2006;32(3):393–398. Felon: The fingertip is swollen and painful. The swelling usually develops over several days and is located in the pad area of the fingertip. The area will have a throbbing pain and be painful to the touch. The area is usually red, and a visible collection of pus may be seen under the skin. The swollen area may have a portion that feels soft as if it contains fluid. As the swelling continues, the area may become tense or hard to the touch. Relax & Unwind Prevention and Wellness NEWS CASES CALCULATORS CHARTS CME DRUGS MEETINGS MULTIMEDIA RESOURCES Injury Rehabilitation Help WebMDRx Savings Card note: Recommendations are based on expert opinion rather than clinical evidence. 10. Baran R, Barth J, Dawber RP. Nail Disorders: Common Presenting Signs, Differential Diagnosis, and Treatment. New York, NY: Churchill Livingstone; 1991:93–100. Sex and Birth Control References:[5][6] Investigations to consider This site complies with the HONcode standard for trustworthy health information: verify here. You might be right. All of my childhood paronychia were managed by my (non-medical) Mum, using hot water and encouragement to stop biting my nails (more on that later). But these patients do come to the Emergency Department, or minor injuries unit, so we should probably have some idea what to do with them. 3. Billingsley EM. Paronychia. In: Paronychia. New York, NY: WebMD. http://emedicine.medscape.com/article/1106062-overview. Updated June 6, 2016. Accessed February 28, 2017. Phone: +44 (0) 207 111 1105 Migraine and Headache Treatments Privacy Policy Medical treatment Healthy Living Acute paronychia. Advertise with Us dawn laporte 2 0 0 1342 days ago 2. Habif TP. Clinical dermatology: a color guide to diagnosis and therapy. 3d ed. St. Louis: Mosby, 1996. flexor tenosynovitis:  purulent material resides within the flexor tendon sheath. Reference 10. Jules KT, Bonar PL. Nail infections. Clin Podiatr Med Surg. 1989;6:403–16. Definition: soft tissue infection around a fingernail Commonly Abused Drugs Each of the main finger infections has specific signs and symptoms that make identification unique and can sometimes cause confusion if not properly evaluated. Caveats and cautions Autoimmune diseases, such as psoriasis pemphigus vulgaris, scleroderma, lupus erythematosus, etc URL: https://www.youtube.com/watch%3Fv%3DASTC2NpPYk0 Abstract Chronic paronychia responds slowly to treatment. Resolution usually takes several weeks or months, but the slow improvement rate should not discourage physicians and patients. In mild to moderate cases, nine weeks of drug treatment usually is effective. In recalcitrant cases, en bloc excision of the proximal nail fold with nail avulsion may result in significant cure rates. Successful treatment outcomes also depend on preventive measures taken by the patient (e.g., having a water barrier in the nail fold). If the patient is not treated, sporadic, self-limiting, painful episodes of acute inflammation should be expected as the result of continuous penetration of various pathogens. Want to use this article elsewhere? Get Permissions The optimal treatment is different for acute verus chronic paronychia. For acute paronychia, optimal treatment is systemic/topical treatment or surgery. For chronic paronychia, optimal treatment is prevention and treatment of the chronic inflammation. 19. Baran R. Common-sense advice for the treatment of selected nail disorders. J Eur Acad Dermatol Venereol. 2001;15(2):97–102. Featured Topics Arthritis and Carpal Tunnel Syndrome Life in the Fast Lane Types - Never trim the cuticles !!!!! Removing the cuticles leads to the absence of protection beneath the lateral and proximal nail folds, causing paronychia. Blog, News & Mobile Apps Definition: bacterial infection of the distal periungual tissue Appointments & Locations Women changes in nail shape, color, or texture Visit The Symptom Checker About retronychia Chronic paronychia may cause the cuticle to break down. This type of paronychia may eventually cause the nail to separate from the skin. The nail may become thick, hard and deformed. Find a Doctor Acute paronychia is usually the result of a direct trauma to the skin, such as a cut, hangnail, or ingrown nail. Bacteria are most common cause of the infection, predominately Staphylococcus aureus but also certain strains of the Streptococcus and Pseudomonas bacteria. Try not to suck fingers. A to Z Guides Healthline and our partners may receive a portion of revenues if you make a purchase using a link above. Questions Acute Paronychia Public Health Where did it occur? Home? Work? In water? In dirt? From an animal or human bite? 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