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Paronychia

Nancy V. Nguyen, DO Reviewed 06/2020
 


BASICS

DESCRIPTION

  • Superficial inflammation of the lateral and posterior nail folds surrounding the fingernail or toenail

  • Acute: characterized by pain, erythema, and swelling lasting less than 6 weeks; ...

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: warm compresses/soaks, elevation, splint protection if pain severe

  • Abscesses should be drained

    • Consider digital block anesthesia. Then, insert nail elevator or hypodermi...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Acute: Postdrainage care consists of warm soaks or soaking with Burow solution or acetic acid BID–TID × 2 to 3 days unless Swiss roll technique used (1)[C].

  • Chroni...

REFERENCES

1
Leggit JC. Acute and chronic paronychia. Am Fam Physician.  2017;96(1):44–51.
2
Relhan V, Goel K, Bansal S, et al. Management of chronic paronychia. Indian J Dermatol.  2014;59(1):...

ADDITIONAL READING

  • Goto H, Yoshikawa S, Mori K, et al. Effective treatments for paronychia cased by oncology pharmacotherapy. J Dermatol.  2016;43(6):670–673.

  • Hengge UR, Bardeli V. Images in clini...

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 tetanus booster when indicated.

  • Consider incision and drainage when appropriate.

  • For chronic paronychia, topical steroid is first-line treatment. Consider other differentials in...

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