Paronychia
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| ICD-10 | L03.0 |
| ICD-9 | xxx |
| DiseasesDB | 9663 |
| MedlinePlus | 001444 |
| eMedicine | derm/798 |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-525-6884
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The nail disease paronychia (commonly known as felon or whitlow) is an often tender bacterial or fungal infection where the nail and skin meet at the side or the base of a finger or toenail. It can start suddenly (acute paronychia) or gradually (chronic paronychia).
Description
The cuticle acts as a protective seal, but if it is damaged in any way then pathogens are able to enter the skin and cause infection. Despite the small area affected these infections can be extremely painful as the skin becomes inflamed, hot, red, and throbs continually. Pus is usually present, along with gradual thickening and browning discoloration of the nail plate. If a large amount of pus has collected, then it may be necessary to make a small cut in the skin (sometimes under local anaesthetic) to release it.[1]
Acute paronychia is usually caused by bacteria. This is often treated with antibiotics, sometimes as a cream, other times orally. 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 goes on and on then a fungal infection is often the cause and this needs anti-fungal cream or paint to treat it.
Most often it is trauma to the cuticle that allows infection in. Biting or picking at the cuticle, damage through work and overenthusiastic manicuring are the usual culprits. Individuals who work with their hands in water, such as health care workers and food processors, are quite prone to the fungal type of infection. Excess water weakens the seal and soaps or detergents will remove the protective skin oils, leaving the skin dry and more liable to split.
If someone has a cold sore and puts their finger in their mouth then a herpes infection whitlow may appear. Herpes whitlows are frequently found among dentists and dental hygienists.[2] 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, erathematous, keratotic rash (papules and plaques) of the ears, nose, fingers, and toes, may be indicative of acrokeratosis paraneoplastica, which is associated with squameous cell carcinoma of the larynx.[3]
References
- ↑ Jacobs, J.R. (2006 June-July). Pathophysiology and Management of Paronychia. collegehealth-e.
- ↑ Lewis, M.A. (April 2004). "Herpes simplex virus: an occupational hazard in dentistry". International Dental Journal (2): 103–111. doi:10.2956/indj.2004.54.2.103.
- ↑ Karen Allen, MD. eMedicine - Acrokeratosis Neoplastica.
External links
- Paronychia Nail Infection. Dermatologic Disease Database. American Osteopathic College of Dermatology.
Acknowledgement and Attribution Regarding Sources of Content
Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .
