Paronychia

Definition

 

Paronychia is skin around nail plate

 

Eponychia is skin covering base of nail plate

 

Pathology

 

1.  Due to foreign material between nail plate and paronychium 

 

2.  By hang nail traumatising paronychium

 

Aetiology

 

Acute

- typically polymicrobial 

- aerobes and anaerobes

- Staph aureus, group A Strep, Eikinella corrodens

- Bacteroides, gram positive cocci and Fusobacterium nucleatum

 

Chronic paronychia

- atypical mycobacterium

- fungal infection

- gout

- carcinoma

 

Management

 

Non operative

- warm soaks

- splinting 

- antibiotics (Augmentin)

 

Operative

 

Decompress and drainage of abscess may be necessary

- lift nail fold off plate +/- wedge resection

- avoid eponychial nail fold incision