(Alternative Names: Nail Infection)
Paronychia is an infection of the skin and soft tissue around one or several toenails or fingernails. A rapidly developing infection of less than six weeks duration is called an acute infection, while other cases are called chronic paronychia. Acute cases are generally due to bacterial infection whereas chronic cases have infection with mixed types of germs.
Most cases of paronychia can be controlled by early detection and appropriate simple measures. A basic knowledge of preventive and self help measures can help reduce patient burden.
· Paronychia is one of the commonest nail and skin infection in the world
· Paronychia can occur in any age group
· Acute cases have a sudden onset while chronic cases evolve slowly
· Acute paronychia results from breach of the natural barrier between the nail and its surrounding tissues whereas chronic paronychia follows repeated slow damage that damages natural resistance and facilitates growth of germs of mixed varieties
· Chronic paronychia is commoner in females, housekeepers, maids, gardeners, laundry workers, swimmers, dishwashers, and fishermen.
· Recurrent cases of paronychia may turn out to be having an underlying malignancy
· Individuals having low resistance due to diseases of the immune system and on resistance lowering drugs run greater risk of developing paronychia
Features, Self Help, & Preventive Measures
Acute paronychia most often, is a result of nail injury that follows nail biting, finger sucking, insect bites, thorn pricks, and damage by nail cosmetics, manicure, pedicure, and prolonged exposure to moisture or chemicals. It has a sudden onset with redness, swelling, and pain around the nail. These symptoms quickly give rise to accumulation of pus and throbbing type of pain.
Chronic paronychia begins as swelling, redness, and pain on the sides of the nail which occurs over a period of several weeks. It is likelier to occur more often in patients with diabetes, excessive perspiration, hormonal disorders, and low body resistance. It is usually accompanied by disfigured and discolored nails.
Diagnosis of paronychia can be established by history and features. Laboratory studies are generally not required but might be helpful to confirm presence of predisposing conditions, for identifying the type of infecting germs, and to rule out other conditions.
Treatment of early phase of acute paronychia can be arrested by warm compresses, four to six times a day. Many cases can be prevented at this stage before their progress to accumulation of pus. Once pus has accumulated, antibiotics and pain killers may be needed. Drainage of pus is a very effective means to relieve pain and ensure faster recovery. Elevation of the affected finger or toe is helpful in relieving symptoms.
Treatment of chronic paronychia requires use of locally applied medication along with prolonged use of suitable medicines to kill the germs. It is essential to eliminate predisposing factors for the treatment to be effective in these cases. Special attention is needed to avoid exposure to moisture, chemicals, and detergents while one is on treatment.
Prevention of paronychia involves observing following measures:
1. You should maintain cleanliness of hands, feet and nails.
2. You should avoid injury to the nails and surrounding structures.
3. Your nails should be short and their edges should have proper shape with smooth margins.
4. Nail biting should not be done.
5. Prolonged exposure to wet conditions should be avoided .A through drying and use of drying agents containing alcohol can be considered after such exposure. It is advisable to use cotton lined water proof gloves in wet conditions.
6. The skin fold at the base of nail plate should not be pushed back during manicure.
7. You should attend to predisposing factors like diabetes, exposure to chemicals, and certain medications.
8. You should consult your healthcare provider if your immune status is compromised.
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Dr Vinay Kumar
Senior Consultant Dermatologist
+91-93 199 299 00
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