Paronychia
| Paronychia | |
|---|---|
| Classification and external resources | |
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| ICD-10 | L03.0 |
| ICD-9 | 681.02, 681.11 |
| DiseasesDB | 9663 |
| MedlinePlus | 001444 |
| eMedicine | derm/798 |
| MeSH | D010304 |
In medicine, paronychia (/ˌpærəˈnɪkiə/; Greek: παρονυχία: para-, around, onukh-, nail) is a nail disease that is an often-tender bacterial or fungal infection of the hand or foot where the nail and skin meet at the side or the base of a finger or toenail. The infection can start suddenly (acute paronychia) or gradually (chronic paronychia).[1][2] Paronychia is commonly misapplied as a synonym for whitlow or felon.
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Types[edit]
Paronychia may be divided as follows:[3]
Alternatively, paronychia may be divided as follows:[4]
Signs and symptoms[edit]
The skin typically presents as red and hot. These infections can be painful.
Pus is usually present, along with gradual thickening and browning discoloration of the nail plate.
Acute paronychia is usually caused by bacteria. Claims have also been made that the popular acne medication, isotretinoin, has caused paronychia to develop in patients. Paronychia is often treated with antibiotics, either topical or oral. Chronic paronychia is most often caused by a yeast infection of the soft tissues around the nail but can also be traced to a bacterial infection. If the infection is continuous, the cause is often fungal and needs antifungal cream or paint to be treated.[5]
Cause[edit]
Risk factors include repeatedly washing hands and trauma to the cuticle such as from biting.
Herpes whitlows are frequently found among dentists and dental hygienists.[6] 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.
Painful paronychia in association with a scaly, erythematous, keratotic rash (papules and plaques) of the ears, nose, fingers, and toes, may be indicative of acrokeratosis paraneoplastica, which is associated with squamous cell carcinoma of the larynx.[7]
Paronychia can occur with diabetes, drug-induced immunosuppression,[8] or systemic diseases such as pemphigus.[9]
Treatment[edit]
Warm soaks can be used 3 or 4 times a day for acute paronychia to promote drainage and relieve some of the pain. Most cases of acute paronychia benefit from being treated with antibiotics such as cephalexin or dicloxacillin or amoxicillin .[10] Topical antibiotics or anti-bacterial ointments do not effectively treat paronychia. If there is pus or an abscess involved, the infection may need to be incised and drained. Rarely, a portion of the nail may need to be removed.
Chronic paronychia is treated with topical antibacterial medication such as Mupirocin ointment. A mild topical steroid like hydrocortisone may be added to the antibacterial medication to help reduce inflammation. Steroids should never be used alone on a chronic paronychia.[10]
References[edit]
- ^ Rigopoulos D, Larios G, Gregoriou S, Alevizos A (February 2008). "Acute and chronic paronychia". Am Fam Physician 77 (3): 339–46. PMID 18297959.
- ^ Rockwell PG (March 2001). "Acute and chronic paronychia". Am Fam Physician 63 (6): 1113–6. PMID 11277548.
- ^ James, William D.; Berger, Timothy G. (2006). Andrews' Diseases of the Skin: clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
- ^ Freedberg, et. al. (2003). Fitzpatrick's Dermatology in General Medicine. (6th ed.). McGraw-Hill. ISBN 0-07-138076-0.
- ^ "Doctor's advice Q: Whitlow (paronychia)". bbc.co.uk. Retrieved 2008-05-10.
- ^ Lewis MA (2004). "Herpes simplex virus: an occupational hazard in dentistry". Int Dent J 54 (2): 103–11. doi:10.2956/indj.2004.54.2.103 (inactive 2008-08-12). PMID 15119801.
- ^ Karen Allen, MD (2005-08-17). "eMedicine - Acrokeratosis Neoplastica".
- ^ http://emedicine.medscape.com/article/1106062-clinical
- ^ http://dermatology-s10.cdlib.org/1507/reviews/nail_pemphigus/rashid.html
- ^ a b Heather Brannon, MD http://dermatology.about.com/cs/paronychia/a/paronychia.htm
External links[edit]
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Wikimedia Commons has media related to: Paronychia (disease) |
- "Paronychia Nail Infection". Dermatologic Disease Database. American Osteopathic College of Dermatology. Retrieved 2006-07-12.
- "What Is The Best Way To Treat Paronychias?, Roundtable discussion in Podiatry Today, Volume 15 - Issue 3, March 2002, pp. 58–60.
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