The term paronychia refers to an infection of the nail fold caused by microbes, resulting in significant inflammation of the periungual tissue and, in some cases, the formation of a purulent abscess.
Paronychia can occur on any finger; however, it is more commonly seen on the hands—particularly the index, middle finger, and thumb.
Paronychia is classified as acute or chronic, depending on its duration.
Acute paronychia is one of the most common infections, which manifests itself superficially, when there is a break in the continuity of the skin (e.g. microtrauma), the nail fold and the epinychium are removed for some reason. This condition allows the entry of pathogenic microorganisms.
Infection of the soft tissues of the perionilla is most commonly caused by Staphylococcus aureus and Streptococcus pyogenes, while Candida spp. and Pseudomonas aeruginosa can cause secondary infection in the context of chronic paronychia.
Acute paronychia usually develops rapidly. It is characterized by painful redness (erythema), swelling (edema), and the inflammation may extend to the eponychium. The swelling is often severe enough to cause separation of the nail fold from the nail plate, and a pus-filled collection (abscess) may form at the site. It is commonly observed in situations such as nail-biting (onychophagia), following minor trauma during a manicure, after exposure to detergents, or in childhood as a result of thumb-sucking.
Its treatment is simple. Antibiotic therapy is administered, locally or systemically. In some cases, surgical opening may be necessary.
Chronic paronychia is a common inflammation that develops slowly over time. It typically affects individuals who frequently expose their hands to moist environments, such as homemakers, pastry chefs, kitchen workers, and children who often suck their fingers. The inflammation extends around the entire nail, causing abnormalities on one or both lateral edges of the nail.
Symptoms:
Chronic paronychia leads to gradual swelling, tenderness, and redness around the nail.
In some cases, it may cause yellow, brown, or black discoloration near, on the side of, or at the free edge of the nail.
Due to the chronic nature of the condition, changes in the nail’s shape, color, and surface may persist for months—even after the inflammation has resolved—since nails grow slowly. In some cases, the nail may become detached.
Treatment:
Treatment requires eliminating or protecting the nail from the underlying cause of the infection and applying a topical cream containing triamcinolone/clotrimazole or other medication, as deemed appropriate based on clinical findings.
To minimize the risk of nail infections, individuals can follow these recommendations:
Moisturize regularly after washing hands.
Avoid nail-biting or sucking on fingers.
Ensure proper care and grooming of the nails and fingers. If you are unable to do it yourself, consult a qualified and certified professional.
Limit prolonged exposure of the fingers to moisture.