Name = PAGENAME
DiseasesDB = 9663
ICD10 = ICD10|L|03|0|l|00
ICD9 = ICD9|681.02, ICD9|681.11
MedlinePlus = 001444
eMedicineSubj = derm
eMedicineTopic = 798
MeshID = D010304
nail diseaseparonychia (commonly misidentified as a synonym for felon or whitlow, the latter two of which refer to a deep space infection of the distalend of a digit) is an often tender bacterial or fungal hand infectionwhere the nail and skin meet at the side or the base of a finger or toenail. It can start suddenly (acute paronychia) or gradually (chronic paronychia).
Dr. Rob Hicks writes on the BBC website:
cuticleacts as a protective seal but if it's damaged in any way bacteria can enter the skin and cause infection. These infections can be extremely painful as the skin becomes inflamed, hot, red and throbs continually.Cite web
title=Doctor's advice Q: Whitlow (paronychia)
Pusis usually present, along with gradual thickening and browning discoloration of the nail plate.
If a large amount of
pushas collected, then it may be necessary to make a small cut in the skin (sometimes under local anaesthetic) to release it.cite web | author=Jacobs, J.R. | url=http://www.collegehealth-e.org/3/n04.htm | title=Pathophysiology and Management of Paronychia | publisher=collegehealth-e | Issue=3 | date=2006 June-July | pp. 10–12]
Acute paronychia is usually caused by bacteria. This is often treated with
antibiotics, sometimes as a cream, other times orally. Chronic paronychia is most often caused by a yeast infectionof the soft tissues around the nail but can also be traced to a bacterial infection. If the infection goes on and on then a fungal infectionis often the cause and this needs anti-fungal cream or paint to treat it.
Hicks writes further about the causes:
Whitlows are common, especially for people who have to repeatedly wash their hands. Excess water weakens the seal, while
soapsand detergentsremove the protective skin oils leaving the skin dry and more liable to split.
Most often, trauma to the cuticle allows infection in. Biting or picking at the cuticle, damage through work and overenthusiastic manicuring are the usual culprits.
Individuals who work with their hands in water, such as health care workers and food processors, are quite prone to the fungal type of infection.
Herpeswhitlows are frequently found among dentists and dental hygienists.cite journal |author=Lewis MA |title=Herpes simplex virus: an occupational hazard in dentistry |journal=Int Dent J |volume=54 |issue=2 |pages=103–11 |year=2004 |pmid=15119801 |doi=10.2956/indj.2004.54.2.103 |url=http://www.atypon-link.com/FDI/doi/abs/10.2956/indj.2004.54.2.103 |doi_brokendate=2008-08-12] Prosector's paronychia is a primary inoculation of tuberculosisof the skin and nails, named after its association with prosectors, who prepare specimens for dissection. Paronychia around the entire nail is sometimes referred to as "runaround paronychia".
Painful paronychia in association with a scaly,
erathematous, keratotic rash( papulesand plaques) of the ears, nose, fingers, and toes, may be indicative of acrokeratosis paraneoplastica, which is associated with squameouscell carcinomaof the larynx.cite web | title=eMedicine - Acrokeratosis Neoplastica | author= Karen Allen, MD | url=http://www.emedicine.com/derm/topic6.htm | date=2005-08-17 ]
* [http://www.podiatrytoday.com/article/255 "What Is The Best Way To Treat Paronychias?,] Roundtable discussion in "
Podiatry Today," Volume 15 - Issue 3, March 2002, pp. 58-60.
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