Differential Diagnosis for Patient Biting Cuticles with Possible Infection
- Single most likely diagnosis:
- Paronychia: This is the most likely diagnosis given the patient's habit of biting her cuticles, which can lead to infection. Paronychia is an infection of the skin around the nail, often caused by bacterial infection, and can be acute or chronic.
- Other Likely diagnoses:
- Onychophagia with secondary infection: Onychophagia refers to the habit of biting one's nails or cuticles, which can lead to infection due to the introduction of bacteria into the bitten area.
- Dermatitis: Irritation from biting or other factors could lead to dermatitis, an inflammation of the skin that can present with redness, itching, and sometimes infection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Herpetic whitlow: Although less common, herpetic whitlow is a viral infection caused by herpes simplex virus that can occur on the fingers, including around the nails. It's crucial to distinguish it from bacterial infections due to its different treatment approach.
- Osteomyelitis: In rare cases, an infection around the nail can spread to the bone, causing osteomyelitis, a bone infection that requires prompt and aggressive treatment.
- Rare diagnoses:
- Eczema herpeticum: A rare but serious complication of atopic dermatitis (eczema) where the skin becomes infected with the herpes simplex virus, leading to widespread vesicular lesions.
- Autoimmune disorders: Certain autoimmune conditions can cause skin lesions or rashes that might resemble an infected cuticle bite, though these would typically have other distinguishing features and systemic symptoms.