paronychia

What is Paronychia?

Paronychia is an inflammation or infection of the skin around a fingernail or toenail. It can be acute, meaning it starts suddenly and lasts for less than six weeks, or chronic, meaning it develops gradually over time.

Causes and Symptoms

The condition is usually caused by a bacterial infection, but viral infections can also cause paronychia. The symptoms of paronychia include redness, warmth, and pain along the nail margin. In some cases, the skin around the nail may become swollen or tender to the touch.

• Acute paronychia causes redness, warmth, and pain along the nail margin [5].
• Paronychia is an often tender infection or inflammation around the base of the nail fold [6].

Types and Duration

Paronychia can be acute or chronic. The acute form starts suddenly and lasts for less than six weeks, while the chronic form develops gradually over time.

• Acute paronychia causes redness, warmth, and pain along the nail margin [5].
• Paronychia is an often tender infection or inflammation around the base of the nail fold [6].

References

[1] - A soft tissue infection around a fingernail or toenail that begins as cellulitis but that may progress to a definite abscess. [2] - The inflammation of the skin around a finger or toenail. [3] - Inflammation of the fingers or toes in one or more of the three nail folds. [4] - A skin infection that occurs around the nails. [5] - Acute paronychia causes redness, warmth, and pain along the nail margin. Diagnosis is by inspection. [6] - Paronychia is an often tender infection or inflammation around the base of the nail fold. It can start suddenly (acute paronychia) or gradually (chronic paronychia). [7] - An inflammation involving the lateral and proximal nail folds.

Symptoms of Paronychia

Paronychia is a bacterial or fungal infection that affects the skin around the nail, causing inflammation and pain. The symptoms of paronychia are typically easy to spot and can be treated with little or no damage to your skin and nails [5].

The main symptom of paronychia is a painful, red, swollen area around the nail, often at the cuticle or at the site of a hangnail or other injury [1][6]. This area may become warm and tender to the touch. In some cases, a small collection of pus may form in this area.

Other symptoms of paronychia include:

• Redness and swelling around the nail
• Pain and tenderness when touching the affected area
• Warmth or heat emanating from the affected area
• A pus-filled blister or abscess

These symptoms can occur on either the fingernails or toenails, and may be accompanied by other signs of infection such as fever or chills.

When to Seek Medical Attention

If you notice any of these symptoms, it's essential to seek medical attention from a healthcare professional. They will assess your condition and provide guidance on treatment options [2][3].

References: [1] Context result 1 [2] Context result 2 [3] Context result 3 [5] Context result 5 [6] Context result 6

Diagnostic Tests for Paronychia

Paronychia, an infection of the skin around a finger or toenail, can be diagnosed through various methods. Here are some of the diagnostic tests used to confirm the condition:

• Physical Examination: A healthcare provider can diagnose paronychia by observing the affected area and asking about symptoms. This is usually sufficient for most cases.
• Swab Test: A swab test may be performed to collect a sample of pus or fluid from the infected area, which can then be sent to a lab for testing to determine the cause of the infection (e.g., bacteria or fungi).
• Imaging Tests: In some cases, imaging tests such as X-rays, ultrasounds, or MRIs may be used to rule out other conditions or to check for any underlying issues. However, these are not typically needed unless there is an abscess or other unusual signs.
• Laboratory Tests: While laboratory tests are generally not necessary, they may be ordered in some cases to confirm the diagnosis or to determine the cause of the infection.

Key Points

• A physical examination and medical history are usually sufficient for diagnosing paronychia.
• Imaging tests and laboratory tests may be used in specific situations, such as when there is an abscess or other unusual signs.
• The differential diagnosis of acute paronychia includes conditions such as a felon, squamous cell carcinoma, proximal onychomycosis, pyogenic granuloma, pyoderma gangrenosum, and herpetic whitlow.

References

[1] A healthcare provider can diagnose paronychia by observing the affected area and asking about symptoms. [2] [3] A swab test may be performed to collect a sample of pus or fluid from the infected area. [4] Imaging tests such as X-rays, ultrasounds, or MRIs may be used in specific situations. [5] Laboratory tests are generally not necessary but may be ordered in some cases. [6] [7] The differential diagnosis of acute paronychia includes conditions such as a felon, squamous cell carcinoma, proximal onychomycosis, pyogenic granuloma, pyoderma gangrenosum, and herpetic whitlow. [11]

Treatment Options for Paronychia

Paronychia, an infection of the skin around the nail, can be treated with various medications depending on its severity and cause. Here are some common drug treatment options:

• Topical antibiotics: For minor infections, antibiotic creams or ointments such as flucloxacillin or erythromycin may be prescribed to treat paronychia [6].
• Oral antibiotics: In more severe cases, oral antibiotics like amoxicillin and clavulanic acid (Augmentin), clindamycin (Cleocin), or trimethoprim and sulfamethoxazole (TMP/SMZ) may be considered to cover community-acquired MRSA and anaerobic bacteria [4].
• Combination of topical antibiotic and corticosteroid: The combination of a topical antibiotic with a corticosteroid such as betamethasone (Diprolene) is safe and effective for treating uncomplicated paronychia [2][3].
• Anti-fungal medications: In chronic cases of paronychia, your doctor may prescribe an anti-fungal medication to treat fungal infections [5].

Additional Treatment Options

In some cases, other treatments may be necessary:

• Sampling pus or fluid: Your doctor may sample pus or fluid from the affected area and prescribe an oral antibiotic based on the results.
• Anti-inflammatory medications: In some cases, your doctor may prescribe anti-inflammatory medications to reduce pain and swelling.

References:

[1] May 10, 2022 — Oral antibiotics with gram-positive coverage against S aureus, such as amoxicillin and clavulanic acid (Augmentin), clindamycin (Cleocin), or or ... [4] May 10, 2022 — Trimethoprim and sulfamethoxazole (TMP/SMZ), doxycycline, or clindamycin may be considered to cover community-acquired MRSA and anaerobic ... [5] Jun 12, 2024 — The doctor may sample pus or fluid and prescribe an oral antibiotic. In chronic cases of paronychia, your doctor may prescribe an anti-fungal ... [6] Jun 4, 2024 — Antibiotics commonly used for paronychia include flucloxacillin or erythromycin. In a more minor infection, an antibiotic cream may be enough - ...

Differential Diagnosis of Paronychia

Paronychia, an inflammation involving the lateral and proximal nail folds, can be confused with other conditions that present similar symptoms. The differential diagnosis for paronychia includes:

• Acute bacterial paronychia: A common condition caused by a bacterial infection, which can lead to pus formation and abscesses.
• Herpetic whitlow: A viral infection of the pulp of the fingertip and perionychium, characterized by grouped clear vesicles on an erythematous base. [1]
• Felon: An infection in the finger pad or pulp, which can be differentiated from paronychia by its location and severity.
• Chronic paronychia: A long-standing inflammation of the nail fold, which can be caused by repeated trauma, infections, or other factors.
• Psoriasis: A skin condition that can involve the proximal nail fold and mimic acute paronychia. [4]
• Reiter syndrome: A type of arthritis that can also affect the nail folds and cause inflammation similar to paronychia.

Other conditions to consider

• Cellulitis: A superficial infection that presents as erythema and swelling, but without any area of fluctuance.
• Onychomycosis: A fungal infection of the nail plate or nail bed.
• Subungual tumors: Growths under the nail plate that can cause inflammation and pain.
• Nail psoriasis: A skin condition that affects the nails and can cause inflammation similar to paronychia.

References

[1] Herpetic whitlow is caused by herpes simplex virus 1 (60% of cases) or herpes simplex virus 2 (40% of cases). [Context #1]

[4] Psoriasis and Reiter syndrome may also involve the proximal nail fold and can mimic acute paronychia. [Context #4]

Note: The above information is based on the search results provided in the context, which includes a list of relevant articles and websites related to paronychia and its differential diagnosis.