Paronychia
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1- Introduction
2- Anatomical Overview
3- Causes
4- Treatment
Introduction
Anatomical Overview
The nail folds, hair follicles, and sebaceous glands are common sites for entrance into the underlying tissues of pathogenic organisms such as Staphylococcus aureus. Infection occurring between the nail and the nail fold is called a paronychia. Infection of the hair follicle and sebaceous gland is responsible for the com- mon boil. A carbuncle is a staphylococcal infection of the superficial fascia. It frequently occurs in the nape of the neck and usually starts as an infection of a hair follicle or a group of hair follicles.
Causes
Bacterial Infection: The most common cause of acute paronychia is a bacterial infection, often due to organisms such as Staphylococcus aureus or Streptococcus species. Bacteria can enter the skin around the nail fold through small cuts, hangnails, or other breaks in the skin, leading to inflammation and infection.
Fungal Infection: Fungal paronychia, also known as candidal paronychia, is typically caused by Candida species, particularly Candida albicans. Fungal infections can occur alongside or independently of bacterial infections and are more common in people who have frequent exposure to moisture, such as dishwashers or healthcare workers.
Trauma or Injury: Physical trauma to the nail fold, such as biting or picking at the nails, manicures, or injuries from sharp objects, can create an entry point for bacteria or fungi, increasing the risk of infection and inflammation.
Chronic Moisture Exposure: Prolonged exposure to moisture or immersion in water can weaken the skin around the nails, making it more susceptible to infection. This is commonly seen in people whose occupations involve frequent handwashing, such as healthcare workers, or those who engage in activities like dishwashing or swimming.
Nail Fungus: Chronic paronychia may be associated with underlying nail fungus (onychomycosis), which weakens the nail structure and increases susceptibility to bacterial or fungal infections of the surrounding skin.
Compromised Immune System: Conditions that weaken the immune system, such as diabetes, HIV/AIDS, or autoimmune disorders, can increase the risk of developing paronychia or predispose individuals to more severe or recurrent infections.
Chemical Irritants: Exposure to harsh chemicals, detergents, or irritants can irritate the skin around the nails, leading to inflammation and increasing the risk of infection.
Treatment
Warm Water Soaks: Soak the affected finger or toe in warm water several times a day for about 15 minutes each time. This can help reduce pain and swelling, as well as promote drainage of any pus.
Antibacterial Ointments: Applying over-the-counter antibacterial ointments like Neosporin or Bacitracin can help prevent the infection from spreading and promote healing.
Oral Antibiotics: If the infection is severe or if there’s an abscess, your doctor may prescribe oral antibiotics to help clear the infection.
Drainage: If there’s an abscess or a large amount of pus, your doctor may need to drain it. This is typically done by making a small incision to allow the pus to drain out. Don’t attempt to do this yourself, as it can lead to further complications.
Pain Relief: Over-the-counter pain relievers like ibuprofen or acetaminophen can help alleviate pain and reduce inflammation.
Keep it Dry and Clean: Keep the affected area clean and dry. Avoid exposing it to excess moisture, as this can worsen the infection.
Avoid Aggravating Factors: Try to avoid activities that may worsen the condition, such as biting or picking at the nails.