RBCC External resources For Healthcare Professionals Translate » Clinical Charts Research Procedural videos The most common cause of acute paronychia is direct or indirect trauma to the cuticle or nail fold. Such trauma may be relatively minor, resulting from ordinary events, such as dishwashing, an injury from a splinter or thorn, onychophagia (nail biting), biting or picking at a hangnail, finger sucking, an ingrown nail, manicure procedures (trimming or pushing back the cuticles), artificial nail application, or other nail manipulation.3–5 Such trauma enables bacterial inoculation of the nail and subsequent infection. The most common causative pathogen is Staphylococcus aureus, although Streptococcus pyogenes, Pseudomonas pyocyanea, and Proteus vulgaris can also cause paronychia.3,6,7 In patients with exposure to oral flora, other anaerobic gram-negative bacteria may also be involved. Acute paronychia can also develop as a complication of chronic paronychia.8 Rarely, acute paronychia occurs as a manifestation of other disorders affecting the digits, such as pemphigus vulgaris.9 Information from references 3, 10 through 13, and 17 through 22. Joint infection Avoid finger sucking This material may not be published, broadcast, rewritten or redistributed in any form without prior authorization. This article is about the nail disease. For the genus of plants, see Paronychia (plant). — Administration 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). Get Started Virchester Journal Club 2013. St.Emlyn’s Twitter Acute and chronic paronychia Jump to section + What have you done to care for this before seeing your doctor? Copyright & Permissions What Paronychia Looks Like Privacy policy. St Emlyn’s for Educators Paronychia is more common in adult women and in people who have diabetes. People who have weak immune systems—such as people who must take medicine after having an organ transplant or people who are infected with HIV (human immunodeficiency virus)—are also at higher risk of getting paronychia. An acute paronychia, like the one above, is typically of relatively short onset and evolves over a few days. It can occur in fingers or toes, on the radial or ulnar (medial or lateral in toes) side of the nail. The usual infective organism is Staph. aureus in adults (mouth flora in children); the affected digit is red, warm, painful and swollen, sometimes with reported or visualised pus (you can sometimes see a little dried crusty yellow collection at the nail fold). The infection commonly follows minor nail trauma, such as a manicure or, more commonly, nail biting or sucking. Case of the week In patients with a chronic paronychia that is unresponsive to therapy, unusual and potentially serious causes of abnormal nail and skin appearance, such as malignancy, should be explored.3,10 (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.) Do People With Atopic Dermatitis Get More Skin Infections? PSORIASIS More Topics Visit our interactive symptom checker 5 References FRCEM QIP: The Quality Improvement Projects Anatomy of the nail. In other projects Is Daytime Drowsiness a Sign of Alzheimer's? Take a Look at These Skin Infection Pictures Associated with onset of hemolytic uremic syndrome Terms of Use Avoid contact with eyes; may irritate mucous membranes; resistance may result with prolonged use What Do Doctors Do? Once treated by stronger medications, the hangnail should clear up within 5 to 7 days. Other entities affecting the fingertip, such as squamous cell carcinoma of the nail29,30 (Figure 5), malignant melanoma, and metastases from malignant tumors,31 may mimic paronychia. Physicians should consider the possibility of carcinoma when a chronic inflammatory process is unresponsive to treatment.30 Any suspicion for the aforementioned entities should prompt biopsy. Several diseases affecting the digits, such as eczema, psoriasis, and Reiter syndrome, may involve the nail folds.10 Patient leaflets  ·  Printed by Atlassian Confluence , the Enterprise Wiki. Don't miss a single issue. Sign up for the free AFP email table of contents. Educational theories you must know. Miller’s pyramid. St.Emlyn’s Email Felon is an infection of the distal pulp space of the fingertip. While the cause is often unknown, minor trauma most commonly precedes infection. It is a clinical diagnosis based on the presence of local pain, swelling, induration, and erythema. Early stages of felon may be managed conservatively with analgesics and antibiotics. Later stages require incision and drainage. Complications include fingertip soft tissue necrosis and osteomyelitis. FeminEM network swelling Sitio para padres Don’t rip off the hangnail, as it can worsen the condition. If your symptoms worsen or don’t clear within a week, consult your doctor. You should also consult your doctor if you’re experiencing severe pain, major swelling of the finger, excessive pus, or other signs of infection. Jump up ^ Rigopoulos, Dimitris; Larios, George; Gregoriou, Stamatis; Alevizos, Alevizos (2008). "Acute and Chronic Paronychia" (PDF). American Family Physician. 77 (3): 339–346. PMID 18297959. Retrieved January 7, 2013. Copyright © 2017, 2012 Decision Support in Medicine, LLC. All rights reserved. About Cleveland Clinic Prosector's paronychia is a primary inoculation of tuberculosis of the skin and nails, named after its association with prosectors, who prepare specimens for dissection. Paronychia around the entire nail is sometimes referred to as runaround paronychia. View Article Sources Causes of paronychia Public Health If the infections are treated early and properly, the prognosis for full recovery is good. However, if treatment is delayed, or if the infection is severe, the prognosis is not as good. Figure: a punch to the tooth may inadvertently lacerate the skin over the MCP joint and introduce oral flora into the joint  seborrheic dermatitis | is paronychia contagious seborrheic dermatitis | paronychia pain relief seborrheic dermatitis | felon finger infection home treatment
Legal | Sitemap