title: Clinical and cytologic features of antibiotic-resistant acute paronychia.
abstract: BACKGROUND
  Acute paronychia usually is treated as a bacterial infection, but antibiotic-resistant acute paronychia may be caused by other infectious and noninfectious problems.
  
  
  OBJECTIVE
  We sought to describe the clinical, etiologic, cytologic, and therapeutic features of antibiotic-resistant acute paronychia.
  
  
  METHODS
  A retrospective review of medical records and cytology was performed in 58 patients (age, 1 month-91 years; 36 children and adolescents [62%] and 22 adults [38%]) who had antibiotic-resistant acute paronychias.
  
  
  RESULTS
  Causes of paronychia included bacteria (25 patients [43%]), viruses (21 patients [36%]), fungi (5 patients [9%]), drugs (3 patients [5%]), pemphigus vulgaris (3 patients [5%]), and trauma (1 patient [2%]). Diagnostic cytologic findings were noted in 54 patients (93%); no diagnostic cytologic findings were present with drug-induced (3 patients) or traumatic (1 patient) paronychia. The most common predisposing factors were the habits of finger- or thumb-sucking (14 patients [24%]) and nail-biting (11 patients [19%]). Complications included id reaction with erythema multiforme in 3 patients (5%).
  
  
  CONCLUSIONS
  Limitations include retrospective study design from 1 treatment center.
  
  
  CONCLUSIONS
  Antibiotic-resistant acute paronychia may be infectious or noninfectious. Cytologic examination with Tzanck smear may be useful diagnostically and may prevent unnecessary use of antibiotics and surgical drainage.
authors.affiliation: Başkent University Faculty of Medicine, Department of Dermatology, Adana Hospital, Adana, Turkey. Electronic address: sivandr@hotmail.com.
authors.forename: Murat
authors.initials: M
authors.lastname: Durdu
authors.affiliation: Department of Dermatology, Second University of Naples, Naples, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ruocco
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D002179:Candidiasis, Cutaneous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D004352:Drug Resistance, Microbial; D005386:Fingersucking / Q000009:adverse effects; D006560:Herpes Labialis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D007223:Infant; D008875:Middle Aged; D009259:Nail Biting / Q000009:adverse effects; D010304:Paronychia / Q000188:drug therapy* / Q000209:etiology* / Q000473:pathology; D010392:Pemphigus / Q000150:complications; D012189:Retrospective Studies; D013207:Staphylococcal Skin Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D013283:Stomatitis, Herpetic / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014947:Wounds and Injuries / Q000150:complications; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D000998:Antiviral Agents
keywords: Tzanck smear; diagnosis; erythema multiforme; fungus; herpes virus; infectious diseases; orf virus; pemphigus vulgaris