Paronychia: Meaning, Diagnosis and Overview

What is Paronychia?

Paronychia is an infection of the skin around a fingernail or toenail. The infected area can become swollen, red, and painful. Sometimes a pus-filled blister may form. Most of the time, paronychia is no big deal and can be treated at home. In rare cases, the infection can spread to the rest of the finger or toe.
There are two different types of paronychia, acute and chronic:
Acute paronychia – this usually appears as a sudden, very painful area of swelling, warmth and redness around a fingernail or toenail, usually after an injury to the area.
Chronic paronychia – this is an infection that usually develops slowly, causing gradual swelling, tenderness and redness of the skin around the nails.

Recovery Time

With proper treatment, an acute paronychia usually heals within 5 to 10 days. A chronic paronychia may require several weeks of antifungal medication. Even after proper medical therapy, a paronychia may return if you injure the skin again or forget to keep the nail area dry.

Diagnosis

 Diagnosis is done by examining the affected area. However, if there is an accumulation of pus, the doctor may take a sample of the pus to be tested in the laboratory for bacteria or fungi.

FAQs prepared by doctor

Q1. What is paronychia?
Paronychia is an infection of the skin around a fingernail or toenail. The infected area can become swollen, red, and painful. Sometimes a pus-filled blister may form. The infection can spread to the rest of the finger or toe.

Q2. Is paronychia felon and whitlow same?
No, Felon occurs in the closed space of the fatty tissues of the finger tip and pulp. This usually requires surgical drainage and antibiotics. If not treated early, destruction of the soft tissues and even bone can occur.
Whitlow is a viral infection of the hand, usually on the fingers, caused by a herpes virus. This is more commonly seen in healthcare workers whose hands are exposed to the saliva of patients carrying herpes. The condition, characterized by small, swollen, painful blisters, and sometimes numbness, is typically treated conservatively and typically resolves in several weeks without many after-effects.

Q3. I have paronychia, what should I do now?
You should wear gloves to prevent contact with irritating substances, such as water, soap, detergent, metal scrubbing pads, scouring pads, scouring powder and other chemicals. The toenails are trimmed about once a month. Do not trim cuticles or use cuticle removers. Soaking in hot water two or three times a day for 15 minutes reduces swelling and pain and assists in healing. Warm compresses applied to the finger or toe can also reduce pain and swelling. Soak hands or feet in one quart of apple cider vinegar with one quart of warm water for 30 minutes to draw out the infection.

Q4. When shall one consult a doctor?
When there is pus near your nail or under it or fever or have milder symptoms like tenderness, mild redness, minimal swelling that last for seven days or more.

Q5. I am diabetic, shall I be extra cautious?
Yes, considering the immune compromised nature and delayed healing in diabetics, they should be little more careful against paronychia. The toe paronychia should be monitored for signs of cellulitis or more severe infection (e.g., extension of edema or erythema, lymphadenopathy, fever).
 



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