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Paronychia

Nancy Nguyen, D.O. Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Superficial inflammation of the lateral and posterior nail folds surrounding the fingernail or toenail. Develops after breakdown of barrier between nail plate and the adjacent nail f...

DIAGNOSIS

HISTORY

  • Localized pain or tenderness, swelling, and erythema of posterior or lateral nail folds

    • Acute: fairly rapid onset (2-5 days after trauma)

    • Chronic: at least 6 weeks’ duration

  • Previous tra...

TREATMENT

GENERAL MEASURES

  • Acute inflammation without abscess: warm water soaks or antiseptic soaks, and topical antibiotics. Consider oral antibiotics for more severe cases that do not respond to topi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Acute: Postdrainage care consists of warm soaks or antiseptic soaks. Follow up in 24-48 hours after I&D to monitor for worsening infection.

  • Chronic: Avoid freq...

REFERENCES

1
Leggit JC. Acute and Chronic Paronychia. Am Fam Physician. 2017 Jul 1;96(1):44-51.
2
Lomax A, Thornton J, Singh D. Toenail paronychia. Foot Ankle Surg. 2016 Dec;22(4):219-223.
3
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ADDITIONAL READING

Iorizzo  M. Tips to treat the 5 most common nail disorders: brittle nails, onycholysis, paronychia, psoriasis, onychomycosis. Dermatol Clin.  2015; 33(2): ...

SEE ALSO

Onychomycosis, Retronychia 

CODES

ICD10

  • L03.019 Cellulitis of unspecified finger

  • L03.039 Cellulitis of unspecified toe

  • L03.011 Cellulitis of right finger

  • L03.012 Cellulitis of left finger

  • L03.031 Cellulitis of right toe

  • L03.032 Cellul...

CLINICAL PEARLS

  • Consider incision and drainage when appropriate.

  • For chronic paronychia, topical steroid is first-line treatment. Consider other differentials in nonresponders (e.g., rare causes: Rayna...

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