Differential Diagnosis for Infected Nail Cuticle
- Single most likely diagnosis
- Paronychia: This is the most common diagnosis for an infected nail cuticle. It is an infection of the skin around the nail (perionyx) of the finger or toe. Paronychia is usually caused by bacterial infection, often due to Staphylococcus aureus, and can be treated with antibiotics, warm compresses, and good hygiene.
- Other Likely diagnoses
- Onychomycosis (Fungal Nail Infection): While this condition primarily affects the nail itself, the infection can spread to the surrounding cuticle, causing inflammation and infection. Treatment involves antifungal medications.
- Eczema/Dermatitis: This can cause inflammation and infection of the skin around the nail, including the cuticle. Treatment involves topical corticosteroids and avoiding irritants.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Herpetic Whitlow: A viral infection caused by herpes simplex virus, which can mimic bacterial paronychia but requires antiviral treatment. Missing this diagnosis could lead to prolonged infection and potential spread.
- Osteomyelitis: A bone infection that could occur if the infection spreads from the nail cuticle to the bone. This condition requires prompt antibiotic treatment and potentially surgery to prevent serious complications.
- Rare diagnoses
- Squamous Cell Carcinoma: Although rare, this type of skin cancer can present as a chronic infection or inflammation around the nail. Biopsy and appropriate cancer treatment would be necessary.
- Melanonychia: A condition where a benign or malignant melanocytic lesion is present in the nail matrix, potentially causing inflammation of the surrounding skin, including the cuticle. Diagnosis requires a biopsy, and treatment depends on whether the lesion is benign or malignant.