Paronychia

Alternative names

Infection - skin around the nail

Definition

Paronychia is a superficial infection of the skin around the nails, most commonly caused by staphylococcus bacteria or fungi.

Causes, incidence, and risk factors

Paronychia is a fairly common superficial infection of the skin around the nail. It usually results from injury to the area from biting off or picking a hangnail, or from manipulating, trimming, or pushing back the cuticle.

Disorders include:

• bacterial paronychia (caused by bacteria)
  
• Candida paronychia (caused by a specific type of yeast)
  
• fungal paronychia (caused by a fungus other than Candida)
  

Paronychia may include a combined bacterial and fungal infection. Fungal paronychia may accompany fungal nail infection.

Fungal paronychia is common among people with diabetes and among people who have their hands in water for long periods of time.

Symptoms

• skin lesion located in the skin around the nail, often at the cuticle or at the site of a hangnail or other injury
  
• painful
  
• onset sudden (bacterial) or gradual (fungal, mixed infection)
  
• may persist (fungal, mixed infection)
  
• may be acute or chronic
  
• redness, localized
  
• swelling, localized
  
• pus-filled blisters (especially with bacterial infection)
  
• swelling of the finger or the cuticle
  
• nail changes
  o discoloration
  o distorted shape
  o detached
  

Signs and tests
The health care provider primarily bases the diagnosis on the appearance of the skin lesion.

Aspiration and culture of pus or fluid from the area may reveal the organism causing the infection.

Treatment

Treatment goals are to eliminate the infection and relieve the symptoms.

In bacterial paronychia, hot water soaks 2 or 3 times per day reduce inflammation and pain. Topical or oral antibiotics may be prescribed. In severe cases, your physician may cut and drain the lesion with a sharp instrument.

Fungal paronychia may be treated with topical or oral antifungals. The hands should be kept dry, or, topical drying agents such as Castellani's paint should be applied.