Paronychia - Causes, Symptoms and Treatment Tips

Paronychia is a fairly common superficial infection of the skin around the nail. A paronychial infection usually begins in the lateral nail fold. Occasionally, the infection includes the entire margin of skin around the nail plate. It usually consequent from injury to the area from biting off or picking a hangnail, or from manipulating, trimming, or pushing back the cuticle.

Paronychia is a ostensible infection of the skin around the nails, most commonly caused by staphylococcus bacteria or fungi. It can start suddenly (acute paronychia) or gradually (chronic paronychia). There are two different types of paronychia, acute and chronic anticipating on the amount of time the infection has been present.

Symptoms of Paronychia

• skin lesion located in the skin around the nail, often at the cuticle or at the site of a hangnail or other injury
• onset sudden (bacterial) or gradual (fungal, mixed infection)
• may persist (fungal, mixed infection)
• may be acute or chronic
• redness, localized
• swelling , localized
• pus-filled blisters (especially with bacterial infection)
• swelling of the finger or the cuticle
• nail changes - discoloration, distorted shape, detached

Causes of Paronychia

The causes of acute Paronychia and chronic Paronychia are defind follow :

Acute paronychia usually results from a joltic event, however minor, that breaks down the physical barrier between the nail bed and the nail; this disruption allows the infiltration of infectious organisms.

Acute paronychia can result from seemingly insipid conditions, such as hangnails, or from activities, such as nail biting, finger sucking, manicuring, or artificial nail placement.

Staphylococcus aureus is the most common infecting organism. Organisms, such as Streptococcus and Pseudomonas species, gram-negative bacteria, and anaerobic bacteria are other causative organisms.

Acute (and chronic) paronychia may also occur as a manifestation of other diseases, such as pemphigus vulgaris.

Chronic paronychia is primarily caused by the yeast fungus Candida albicans .

Other exceptional causes of chronic paronychia include bacterial, mycobacterial, or viral infection; metastatic cancer; subungual melanoma; and squamous cell carcinoma.

Chronic paronychia most often develops in persons whose hands are repeatedly exposed to damp environments or in those who have prolonged and repeated contact with irritants such as mild acids, mild alkalis, or other chemicals

Treatment of Paronychia

The treatment of choice depends on the extent of the infection. the treatment list of acute Paronychiaare below:

• Warm water soaks of the affected finger 3-4 times per day until symptoms resolve are helpful.
• Cleocin and Augmentin also have anaerobic activity; henceforth, they are useful in treating patients with paronychia due to oral anaerobes contracted through nail biting or finger sucking.
• Cleocin should be used in place of Augmentin in patients who are allergic to penicillin.
• If the paronychia does not reconcile or if it progresses to an abscess, it should be drained promptly.
• The initial medical treatment includes of the application of topical antifungal agents. Topical miconazole may be used as the initial agent. Oral ketoconazole or fluconazole may be added in more severe cases.
• Patients having diabetes and those who are immuno-compromised require more contentious treatment because the response to therapy is slower in these patients than in others.
• In cases induced by retinoids or protease inhibitors, the paronychia usually dissects if the medication is discontinued.

Prevention tips

• Keep your hands and feet dry and clean.
• Wear rubber gloves with an absorbent cotton lining if your hands are exposed routinely to water or harsh chemicals.
• Be gentle when you manicure your nails. Avoid cutting your cuticles or pushing them back.
• Avoid biting your nails and picking at the skin around your nails.
• If you have diabetes, keep your blood sugar levels within a normal range by following your diet and taking your medications.

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