From the Guidelines
Paronychia is an infection of the skin around the fingernail or toenail, typically presenting as redness, swelling, pain, and sometimes pus collection around the nail fold, and can be managed with preventive measures such as gentle skin care, avoidance of repeated friction and trauma, and regular trimming of the nails. The management of paronychia involves preventive measures, including patient education on gentle skin care instructions, preventive correction of nail curvature, avoidance of repeated friction and trauma, wearing gloves while cleaning, and avoiding biting nails or cutting nails too short 1. Therapeutic management of paronychia includes conservative management with high-potency topical corticosteroids alone or combined with topical antibiotics, silver nitrate chemical cauterisation, and taping with stretchable tapes, as well as topical povidone iodine 2% b.i.d. for grade 1 and 2 paronychia 1. Some key points to consider in the management of paronychia include:
- Preventive management with patient education and gentle skin care instructions
- Avoidance of repeated friction and trauma
- Regular trimming of the nails to prevent excessive pressure
- Use of antimicrobial soaps and washing with cleansers and water
- Daily application of topical emollients to cuticles and periungual tissues
- Wearing comfortable well-fitting shoes and cotton socks
- Monitoring for early symptoms suggestive of pyogenic granuloma
- Therapeutic management with conservative measures, such as topical corticosteroids and antibiotics, for mild cases, and surgical treatment with partial nail plate removal for intolerable grade 2 or grade 3 paronychia/pyogenic granuloma 1.
From the Research
Definition of Paronychia
- Paronychia is defined as inflammation of the fingers or toes in one or more of the three nail folds 2
- It is an infection afflicting the eponychial nail folds of the hand or foot 3
- Paronychia is an inflammation of the folds of tissue surrounding the nail of a toe or finger 4
- It is a localized, superficial infection or abscess of the paronychial tissues of the hands or, less commonly, the feet 5
Causes of Paronychia
- Acute paronychia is caused by polymicrobial infections after the protective nail barrier has been breached 2
- Trauma resulting in inoculation of the nail fold is the most common predisposing factor to paronychia 3
- Direct or indirect trauma to the cuticle or nail fold enables pathogens to inoculate the nail, resulting in infection 4
- Any disruption of the seal between the proximal nail fold and the nail plate can cause acute infections of the eponychial space by providing a portal of entry for bacteria 5