Saturday, June 13

What is Paronychia? - Nail fold infection

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What is paronychia?

Paronychia (nail fold infection) is an inflammation of the proximal and/or lateral folds of tissue surrounding the nail of a toe or finger.
Paronychia can also be defined as nail fold inflammation caused by bacterial or fungal infection. Nail fold infection typically develops following a breakdown in the bond between the nail plate and the adjacent nail fold and subsequent infection of the skin fold.
Paronychia web definition
The merriam-webster.com defines as: "inflammation of the tissues adjacent to the nail of a finger or toe usually accompanied by infection and pus formation."
The American Heritage Dictionary definition: "Inflammation of the tissue surrounding a fingernail or toenail."
The English Wiktionary defines nail fold infection as: "An infection under the cuticle of a fingernail or toenail."
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The collinsdictionary.com definition: "a bacterial or fungal infection where the nail and skin meet on toes or fingers."

Types of paronychia

Depending upon the suddenness of onset, extent of time taken to resolve and the causative agents, the nail fold infection is termed as acute, chronic, candidal or pyogenic paronychia.

Acute paronychia

A disease lasting less than six weeks is considered acute. The nail fold infection starts usually in the paronychium fold at the side of the nail with symptoms such as local swelling, redness, tenderness and pain. It resolves within six weeks.

A disease lasting more than six weeks is considered chronic. It is a persistent and relapsing condition mostly caused by fungus. The chronic type of nail fold infection occurs in individuals whose hands or feet are subject to moist local environments.

Candidal paronychia

This a nail fold disease caused by fungus, quite often by Candida albicans. Candidal paronychia tends to be chronic and recurrent.

Pyogenic paronychia

The bacterial infection of the nail fold is known as pyogenic paronychia. The skin typically becomes red and hot. Usually an abscess filled with pus is formed. The progression is fast and the condition is very painful. The condition may resolve soon after antibiotic treatment.
Image of paronychia
Paronychia of finger

Nail fold infection

Several factors are known to cause this inflammation and disease. Some are the causes are listed below:
  • Foreign matter getting lodged between nail plate and lateral skin,
  • The binding between the ungual plate and the surrounding skin tissue getting disturbed,
  • biting or picking at a hangnail,
  • finger sucking,
  • frequent contact with chemicals,
  • nail biting,
  • ingrown nail,
  • damage to soft tissue during manicure procedures and
  • physical damage or injury to the soft tissue surrounding the nail.
Certain occupational exposures, certain types of malignancy, immunosuppression and certain systemic diseases may predispose a person to develop paronychia.

Nail fold infection symptoms

The symptoms associated with this condition are apparent. The symptoms include reddening, inflammation, tenderness, pain, formation abscess and discharge of pus from the affected area.

Nail fold infection

Depending upon the condition of the affected nail, several treatment options can be considered. Some of the treatment options are:
  • applying warm compresses,
  • applying emollient lotions,
  • applying topical antibiotics,
  • applying corticosteroids,
  • taking oral antibiotics,
  • surgical incision to drain pus and
  • in severe or recurrent cases of paronychia removing the affected nail is recommended.
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References on paronychia:
1.Rigopoulos D, Larios G, Gregoriou S, Alevizos A. Acute and chronic paronychia. Am Fam Physician. 2008 Feb 1;77(3):339-46.
2.Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014 Mar;22(3):165-74.
3.Duhard É. Paronychia. Presse Med. 2014 Nov;43(11):1216-22.
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Current topic in natural skin care: What is Paronychia and its definition.
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