From the Guidelines
Recurrent finger paronychia is best managed by a dermatologist, as they specialize in conditions affecting the skin, nails, and hair, making them well-equipped to diagnose and treat this persistent nail fold infection.
Treatment Approach
The treatment approach for recurrent finger paronychia typically involves a combination of topical and oral medications, as well as lifestyle modifications.
- Topical antifungals like clotrimazole or ketoconazole may be applied twice daily for 2-4 weeks for fungal paronychia, as suggested by 1.
- Oral antifungals such as fluconazole 150-300mg weekly for 2-3 months may also be prescribed for fungal paronychia.
- For bacterial paronychia, topical antibiotics like mupirocin or oral antibiotics such as cephalexin 500mg four times daily for 7-10 days may be prescribed, as indicated by 1.
Specialty Involvement
While dermatologists are the primary specialists for managing recurrent finger paronychia, hand surgeons may also be involved in severe or complicated cases, particularly those requiring minor surgical procedures like nail avulsion or marsupialization of the proximal nail fold.
- Dermatologists are suited for this condition because they understand the complex interplay between fungal, bacterial, and inflammatory factors that contribute to chronic paronychia, as discussed in 1.
- The most recent and highest quality study, 1, supports the role of dermatologists in managing paronychia, including the use of topical povidone-iodine, dilute vinegar soaks, and mid to high potency topical steroid ointment.
From the Research
Specialty for Recurrent Finger Paronychia
The specialty that treats recurrent finger paronychia includes:
- Dermatology: for chronic paronychia, which is a form of contact dermatitis and is frequently non-infective 2
- Primary care or family medicine: for acute and chronic paronychia, as treatment options include warm compresses, topical antibiotics, and oral antibiotics 3, 4
- Orthopedic surgery: for acute and chronic paronychia of the hand, as treatment may involve surgical incision and drainage or en bloc excision of the proximal nail fold 5
- Infectious disease: for cases of paronychia caused by bacterial or fungal pathogens, as treatment may involve antibiotics or antifungals 3, 4, 6
Treatment Options
Treatment options for recurrent finger paronychia may include:
- Topical antibiotics and corticosteroids 3, 4
- Oral antibiotics 3, 4
- Surgical incision and drainage 3, 5
- En bloc excision of the proximal nail fold 3
- Topical antifungals and corticosteroids 6
- Emollient lotions and moisturizers 3
Prevention
Prevention of recurrent finger paronychia may involve: