Paronychia

Paronychia is a common, relatively benign, infection that occurs on the skin around the nails. It is typically the result of an injury to the area, as when a hangnail is picked or bitten off. Paronychia presents as a painful swelling around the nail that may include blisters filled with pus and changes to the nail's overall appearance. There are three pathogens that may be responsible for paronychia: bacteria, candida (a particular kind of yeast), and other types of fungus.

Types of Paronycha

Bacterial Paronychia

Typically, bacterial paronychia has a sudden onset and is more likely to include blisters. Patients are instructed to soak the affected area in hot water several times a day to reduce swelling and alleviate pain. In addition, physicians usually prescribe topical or oral antibiotic medication. In severe cases, an abscess may develop at the site and have to be cut and drained by the physician or part of the nail may need to be removed to facilitate healing.

Fungal Paronychia

When paronychia is caused by candida or some other fungus, it tends to develop more slowly. It more commonly occurs in patients who have an underlying fungal nail condition, suffer from diabetes or submerge their hands in water for prolonged periods. In order to treat fungal paronychia, patients are advised to keep their hands dry, sometimes with the assistance of a skin-drying agent. Anti-fungal medication is also prescribed.

Diagnosis of Paronychia

A physical examination is usually sufficient to diagnose a case of paronychia. It may be necessary, however, to send a sample of drained pus for a laboratory analysis. This will determine whether the infection is bacterial or fungal, which particular pathogen is causing the condition, and which particular medication will provide the most effective treatment.

Prognosis of Paronychia

Almost all cases of paronychia respond well to treatment, particularly if treated promptly. Fungal infections, however, take considerably longer to heal than bacterial ones, often several months.

In some severe cases, permanent changes to the appearance of the nail may occur and in very rare instances the local infection may spread to the adjacent tendons or bones or invade the bloodstream.

Additional Resources

• MedlinePlus
• National Institutes of Health
• Centers for Disease Control and Prevention
• Eunice Kennedy Shriver National Institute of Child Health and Human Development
• U.S. Department of Health & Human Services
• U.S. National Library of Medicine
• WebMD