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Paronychia, Emergency Medicine

Gene Ma Reviewed 06/2017



  • Disruption of the seal between the nail plate and the nail fold may allow entry of bacteria into the eponychial space.

  • Inflammation of the nail folds surrounding the nail plate



Signs and Symptoms

  • Pain, warmth, and swelling to the proximal and lateral nail folds, often 2–5 days after trauma

  • Symptoms must be present for 6 wk to meet criteria for a chronic paronychia.



Ed Treatment/Procedures

Acute Paronychia

  • Early paronychia without purulence may be managed with warm-water soaks 4 times a day with or without oral antibiotics; may also consider topical antib...



Admission Criteria

Admission is not needed for paronychia alone. 

Discharge Criteria

  • Patients with uncomplicated paronychias may be discharged with appropriate follow-up instructions...

Pearls and Pitfalls

  • Acute paronychias respond well to decompression with or without antibiotics.

  • Chronic paronychias are largely a result of chronic exposure to allergens/irritants.

  • Reiter syndrome and ...

Additional Reading

  • Dahdah  MJ, Scher  RK. Nail diseases related to nail cosmetics. Dermatol Clin.  2006;24(2):233–239,vii.

  • Jebson  PJ. Infections of the fingertip. Paronychias and felons. Hand Cli...



  • 112.3 Candidiasis of skin and nails

  • 681.02 Onychia and paronychia of finger

  • 681.9 Cellulitis and abscess of unspecified digit

  • 681.11 Onychia and paronychia of toe


  • B37.2 Candidiasis of skin ...

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