title: Acute and chronic paronychia.
abstract: Paronychia is an inflammation of the folds of tissue surrounding the nail of a toe or finger. Paronychia may be classified as either acute or chronic. The main factor associated with the development of acute paronychia is direct or indirect trauma to the cuticle or nail fold. This enables pathogens to inoculate the nail, resulting in infection. Treatment options for acute paronychia include warm compresses; topical antibiotics, with or without corticosteroids; oral antibiotics; or surgical incision and drainage for more severe cases. Chronic paronychia is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. The patient should avoid exposure to contact irritants; treatment of underlying inflammation and infection is recommended, using a combination of a broad-spectrum topical antifungal agent and a corticosteroid. Application of emollient lotions may be beneficial. Topical steroid creams are more effective than systemic antifungals in the treatment of chronic paronychia. In recalcitrant chronic paronychia, en bloc excision of the proximal nail fold is an option. Alternatively, an eponychial marsupialization, with or without nail removal, may be performed.
authors.affiliation: Department of Dermatology, University of Athens Medical School, Andreas Sygros Hospital, Athens, Greece. drigop@hol.gr
authors.forename: Dimitris
authors.initials: D
authors.lastname: Rigopoulos
authors.forename: George
authors.initials: G
authors.lastname: Larios
authors.forename: Stamatis
authors.initials: S
authors.lastname: Gregoriou
authors.forename: Alevizos
authors.initials: A
authors.lastname: Alevizos
mesh_terms: D000208:Acute Disease; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D009260:Nail Diseases / Q000175:diagnosis / Q000628:therapy; D010304:Paronychia / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000628:therapy
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D000998:Antiviral Agents; D003879:Dermatologic Agents