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Nails—Paronychia/Infection
Published in Charles Theisler, Adjuvant Medical Care, 2023
Paronychia, or an ingrown nail, is caused by the introduction of bacteria into the nail fold, which can cause cellulitis and/or abscess formation. Generally, nail grooming behaviors, nail biting, and wet work are the causes of acute or chronic paronychia.1 Typically, there is pain, redness, and swelling around the base or sides of the nail.
Diseases of the Nails
Published in Ayşe Serap Karadağ, Lawrence Charles Parish, Jordan V. Wang, Roxburgh's Common Skin Diseases, 2022
Clinical presentation: When there is pruritus, superinfection due to Staphylococcus aureus is common. The nails are shiny and buffed from constant rubbing. Additional complications include bacterial paronychia and even underlying osteomyelitis.
Acute paronychia
Published in Robert Baran, Dimitris Rigopoulos, Chander Grover, Eckart Haneke, Nail Therapies, 2021
The most common cause of acute paronychia is direct or indirect trauma to the cuticle or the nail fold. Such trauma may be relatively minor, resulting from ordinary events, such as dishwashing, injury from a splinter or thorn, onychophagia (nail biting), biting or picking at a hangnail, finger sucking, ingrown nail, manicure procedures (trimming or pushing back the cuticles), artificial nail application, or other nail manipulation. Such trauma enables bacterial inoculation of the nail and subsequent infection. The most common causative pathogen is Staphylococcus aureus, although Streptococcus pyogenes, Pseudomonas pyocyanea, and Proteus vulgaris can also cause paronychia. In patients with exposure to oral flora, other anaerobic Gram-negative bacteria may also be involved. Acute paronychia can also develop as a complication of an episode of chronic paronychia. Acute paronychia can also occur as a manifestation of other disorders affecting the digits, such as pemphigus vulgaris, lichen planus, psoriasis, acrodermatitis enteropathica, diabetes mellitus, drugs (acitretin, indinavir), or tumors (Bowen’s disease, keratoacanthoma).
The ambulatory care burden of nail conditions in the United States
Published in Journal of Dermatological Treatment, 2021
Shari R. Lipner, Julie E. Hancock, Alan B. Fleischer
Of the five nail diagnoses studied, nail disease NEC was the only diagnosis primarily made by dermatologists (Figure 3). Dermatologists were the specialty for 44.6% (95% CI: 22.4–67.0) of these visits, general practitioners saw 25.7% (95% CI: 7.68–43.7) of these visits, pediatricians saw 12.5% (95% CI: 0.00–25.2), and other physicians saw 17.1% (95% CI: 0.00–45.7). General and family practitioners were consulted for the largest proportion of finger paronychia, toe paronychia, and the diagnosis nail diseases NOS: 26.4% (95% CI: 6.31–46.6), 43.3% (95% CI: 14.4–72.3), and 35.6% (95% CI: 3.90–67.2), respectively. Visits for dermatophytosis were split between dermatologists (26.4% [95% CI: 20.1–32.5]), pediatricians (26.2% [95% CI: 15.7–36.7]), and general practitioners (40.3% [95% CI: 31.6–48.0]).
Safety of EGFR-TKIs for EGFR mutation-positive non-small cell lung cancer
Published in Expert Opinion on Drug Safety, 2020
Jia-Ying Zhou, Si-Yang Liu, Yi-Long Wu
The pathogenesis of paronychia is unclear; it occurs most frequently 4–8 weeks after commencement of treatment with EGFR-TKIs, can affect any fingernail or toenail, and is inconvenient to the patient [47]. We recommended that patients avoid trauma to the nail (e.g. biting the nail, tearing the skin around the nail, and clipping the nails too short) because this can exacerbate paronychia. In addition, topical steroids should be avoided. When there is too much granulation tissue around the nail groove, silver nitrate may be applied as required. Bacterial culture and antibiotic treatment should be performed in cases in which the appearance of the skin indicates repeated bacterial infection [46].
Optimal diagnosis and management of common nail disorders
Published in Annals of Medicine, 2022
Paronychia is defined as inflammation or infection of the proximal or lateral nail folds. This condition can be classified into acute, chronic or chemotherapy-associated paronychia (CAP) based on duration of symptoms and aetiology [47,48]. Infections are responsible for the acute subtype, while irritants and allergens are common causes of chronic paronychia [49]. Certain chemotherapeutic agents are responsible for CAP. Nevertheless, all subtypes involve a breach in the protective barrier in the nail fold. Women are more commonly affected than men. Common risk factors include trauma, use of artificial nails and manicuring, ingrown nails and nail biting [49].