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Paronychia

Nancy Nguyen, DO Reviewed 04/2024
 


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 (2). Consider oral antibiotics for more severe cases that do not respond to...

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;96(1):44–51.
2
Relhan V, Bansal A. Acute and chronic paronychia revisited: a narrative review. J Cutan Aesthet Surg. 2022;15(1...

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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