From the Guidelines
Paronychia and felon are distinct infections requiring different treatment approaches, with paronychia involving the skin fold around the nail and felon affecting the pulp space at the fingertip. Paronychia typically presents with redness, swelling, and tenderness around the nail fold, often with pus collection, and can be acute or chronic [ 1 ]. The treatment for paronychia includes gentle skin care, topical povidone iodine 2%, and topical antibiotics/corticosteroids, with the severity of the condition guiding the intensity of the intervention [ 1 ]. In contrast, a felon is a more serious infection of the fingertip pulp, presenting with severe throbbing pain, tense swelling, and erythema, and requires prompt surgical drainage to prevent tissue necrosis and potential osteomyelitis [ 1 ]. Key differences in treatment approaches include the use of oral antibiotics for paronychia and the necessity of surgical intervention for felons. Prevention strategies for both conditions involve avoiding trauma to the fingers, not biting nails, and practicing proper hand hygiene. Given the potential for serious complications, particularly with felons, prompt medical attention is crucial if either condition is suspected, with treatment guided by the severity of symptoms and the specific anatomical structures involved [ 1(https://doi.org/10.1016/j.annonc.2021.01.071, https://doi.org/10.1016/j.jaad.2022.02.043) ].
Some key considerations in managing paronychia include:
- Gentle skin care instructions
- Topical povidone iodine 2%
- Topical antibiotics/corticosteroids
- Monitoring for change in severity and adjusting treatment accordingly
- Consideration of oral antibiotics for more severe cases
- Prevention of further irritation and trauma to the affected area
For felons, the primary considerations are:
- Prompt surgical drainage to relieve pressure and prevent tissue necrosis
- Antibiotic therapy to address potential bacterial infection
- Pain management
- Follow-up care to ensure resolution of the infection and prevention of complications
Both conditions highlight the importance of timely and appropriate medical intervention to prevent long-term damage and promote optimal recovery.
From the Research
Comparison of Paronychia and Felon
- Paronychia and felon are the most common infections of the hand, with paronychia being an infection of the eponychial nail folds and felon being an infection of the fingertip 2, 3, 4.
- Both conditions can be treated with surgical excision, but the approach may vary depending on the location and severity of the infection 2, 4.
- Paronychia can be caused by trauma, oral trauma, or contamination, and can be treated with incision and drainage, and antibiotic therapy in some cases 5, 6.
- Felon, on the other hand, is a more severe infection that can be extremely painful and requires prompt treatment to prevent complications such as spread to the bones or flexor tendon sheath 4.
Treatment Approaches
- Surgical excision without antibiotic coverage can be an effective treatment for uncomplicated paronychia and felon in patients who are not at risk 2.
- However, in cases where the patient is immunosuppressed or has a complicated infection, antibiotic therapy may be necessary 3, 6.
- Incision and drainage, as well as local wound care, are important components of treatment for both paronychia and felon 3, 6.
Key Differences
- Paronychia tends to affect the nail folds, while felon affects the fingertip 4.
- Paronychia can be caused by a variety of factors, including trauma and contamination, while felon is often caused by a bacterial infection 5, 6.
- The treatment approach for paronychia and felon may vary depending on the severity and location of the infection, as well as the patient's overall health status 2, 3, 4.