Paronychia

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Paronychia Classification and external resources
Paronychia
ICD-10	L03.0
ICD-9	xxx
DiseasesDB	9663
MedlinePlus	001444
eMedicine	derm/798

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Media
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Evidence Based Medicine
Cochrane Collaboration on Paronychia Bandolier on Paronychia TRIP on Paronychia
Clinical Trials
Ongoing Trials on Paronychia at Clinical Trials.gov Trial results on Paronychia Clinical Trials on Paronychia at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Paronychia NICE Guidance on Paronychia NHS PRODIGY Guidance FDA on Paronychia CDC on Paronychia
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Definitions of Paronychia
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The nail disease paronychia (commonly known as felon or whitlow) is an often tender bacterial or fungal infection where 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).

Description

The cuticle acts as a protective seal, but if it is damaged in any way then pathogens are able to enter the skin and cause infection. Despite the small area affected these infections can be extremely painful as the skin becomes inflamed, hot, red, and throbs continually. Pus is usually present, along with gradual thickening and browning discoloration of the nail plate. If a large amount of pus has collected, then it may be necessary to make a small cut in the skin (sometimes under local anaesthetic) to release it.^[1]

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 infection of 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 infection is often the cause and this needs anti-fungal cream or paint to treat it.

Most often it is trauma to the cuticle that 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. Excess water weakens the seal and soaps or detergents will remove the protective skin oils, leaving the skin dry and more liable to split.

If someone has a cold sore and puts their finger in their mouth then a herpes infection whitlow may appear. Herpes whitlows are frequently found among dentists and dental hygienists.^[1] Prosector's paronychia is a primary inoculation of tuberculosis of 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, erythematous, keratotic rash (papules and plaques) of the ears, nose, fingers, and toes, may be indicative of acrokeratosis paraneoplastica, which is associated with squamous cell carcinoma of the larynx.^[1]

References

External links

• Paronychia Nail Infection. Dermatologic Disease Database. American Osteopathic College of Dermatology.

v • d • e Diseases of the skin and subcutaneous tissue (integumentary system) (L, 680-709)
Infections	Staphylococcus (Staphylococcal scalded skin syndrome, Impetigo, Boil, Carbuncle) - Cellulitis (Paronychia) - Acute lymphadenitis - Pilonidal cyst - Corynebacterium (Erythrasma) - Pimple (Pustule)
Bullous disorders	acantholysis (Pemphigus, Transient acantholytic dermatosis) - Pemphigoid (Bullous, Mucous membrane, Gestational) - Dermatitis herpetiformis
Inflammatory	Dermatitis and eczema Atopic dermatitis - Seborrhoeic dermatitis (Dandruff, Cradle cap) - Contact dermatitis (Diaper rash, Urushiol-induced contact dermatitis) - Erythroderma - Lichen simplex chronicus/Prurigo nodularis - Itch (Pruritus ani) - Nummular dermatitis - Dyshidrosis - Pityriasis alba Papulosquamous disorders Psoriasis (Psoriatic arthritis) - Parapsoriasis (Pityriasis lichenoides et varioliformis acuta, Pityriasis lichenoides chronica, Lymphomatoid papulosis) - other pityriasis (Pityriasis rosea, Pityriasis rubra pilaris) - other lichenoid (Lichen planus, Lichen nitidus) Urticaria and erythema Urticaria: Dermatographic urticaria - Cholinergic urticaria Erythema multiforme/drug eruptions: Stevens-Johnson syndrome - Toxic epidermal necrolysis - Erythema nodosum Other erythema: Erythema annulare centrifugum - Erythema marginatum - Necrolytic migratory erythema - Erythema toxicum
Radiation-related disorders	Sunburn - Actinic keratosis - Polymorphous light eruption - Radiodermatitis - Erythema ab igne
Pigmentation disorder	hypopigmentation (Albinism, Vitiligo) - hyperpigmentation (Melasma, Freckle, Café au lait spot, Lentigo/Liver spot, Acanthosis nigricans)
Other	keratosis/hyperkeratosis (Seborrheic keratosis, Callus) - other epidermal thickening (Ichthyosis acquisita, Palmoplantar keratoderma) skin ulcer (Pyoderma gangrenosum, Bedsore) atrophic (Lichen sclerosus, Acrodermatitis chronica atrophicans) necrobiosis (Granuloma annulare, Necrobiosis lipoidica) - other granuloma (Granuloma faciale, Pyogenic granuloma) vasculitis (Livedoid vasculitis, Erythema elevatum diutinum) Keloid - Systemic lupus erythematosus - Morphea - Calcinosis cutis - Sclerodactyly - Ainhum
Disorders of skin appendages	Nail Ingrown nail - Onychogryposis - Beau's lines - Yellow nail syndrome - Leukonychia Hair Hair loss Alopecia areata (Alopecia totalis, Alopecia universalis, Ophiasis) Androgenic alopecia - Hypotrichosis - Telogen effluvium - Traction alopecia - Lichen planopilaris - Trichorrhexis nodosa Other Hypertrichosis (Hirsutism) Acneiform eruption (Acne vulgaris, Chloracne, Blackhead) - Rosacea (Perioral dermatitis, Rhinophyma) follicular cysts (Epidermoid cyst, Sebaceous cyst, Steatocystoma multiplex) Pseudofolliculitis barbae - Hidradenitis suppurativa - Folliculitis Sweat glands eccrine (Miliaria, Anhidrosis) - apocrine (Body odor, Chromhidrosis, Fox-Fordyce disease)
see also congenital, neoplasia

v • d • e WikiDoc Research Resources for Paronychia
Articles on Paronychia	Most recent articles on Paronychia • Most cited articles on Paronychia • Review articles on Paronychia • Articles on Paronychia in N Eng J Med, Lancet, BMJ
Media (Slides, Video, Images, MP3) on Paronychia	Powerpoint slides on Paronychia • Images of Paronychia • Photos of Paronychia • Podcasts & MP3s on Paronychia • Videos on Paronychia
Evidence Based Medicine Regarding Paronychia	Cochrane Collaboration on Paronychia • Bandolier on Paronychia • TRIP on Paronychia
Cost Effectiveness of Paronychia	Cost Effectiveness of Paronychia
Clinical Trials Involving Paronychia	Ongoing Trials on Paronychia at Clinical Trials.gov • Trial results on Paronychia • Clinical Trials on Paronychia at Google
Guidelines / Policies / Government Resources (FDA/CDC) Regarding Paronychia	US National Guidelines Clearinghouse on Paronychia • NICE Guidance on Paronychia • NHS PRODIGY Guidance • FDA on Paronychia • CDC on Paronychia
Textbook Information on Paronychia	Books and Textbook Information on Paronychia
Pharmacology Resources on Paronychia	Dosing of Paronychia • Drug interactions with Paronychia • Side effects of Paronychia • Allergic reactions to Paronychia • Overdose information on Paronychia • Carcinogenicity information on Paronychia • Paronychia in pregnancy • Pharmacokinetics of Paronychia •
Genetics, Pharmacogenomics, and Proteinomics of Paronychia	Genetics of Paronychia • Pharmacogenomics of Paronychia • Proteomics of Paronychia
Newstories on Paronychia	Paronychia in the news • Be alerted to news on Paronychia • News trends on Paronychia
Commentary on Paronychia	Blogs on Paronychia
Patient Resources on Paronychia	Patient resources on Paronychia • Discussion groups on Paronychia • Patient Handouts on Paronychia • Directions to Hospitals Treating Paronychia • Risk calculators and risk factors for Paronychia
Healthcare Provider Resources on Paronychia	Symptoms of Paronychia • Causes & Risk Factors for Paronychia • Diagnostic studies for Paronychia • Treatment of Paronychia
Continuing Medical Education (CME) Programs on Paronychia	CME Programs on Paronychia
International Resources on Paronychia	Paronychia en Espanol • Paronychia en Francais
Business Resources on Paronychia	Paronychia in the Marketplace • Patents on Paronychia
Informatics Resources on Paronychia	List of terms related to Paronychia

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Acknowledgement and Attribution Regarding Sources of Content

Some of the initial content on this page may be incorporated in part from copyleft sources in the public domain including wikis such as Wikipedia and AskDrWiki. Drug information for patients came from the The National Library of Medicine. Infectious disease information may have come from the Centers for Disease Control (CDC). Differential Diagnoses are drawn from clinicians as well as an amalgamation of 3 sources: 1.The Disease Database; 2. Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:3; 3. Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:7 .