paronyki

Paronychia is an infection of the skin around a nail, most often involving the nail folds adjacent to the fingernail or toenail. It can affect one or more nails and may involve the surrounding soft tissue.

There are acute and chronic forms. Acute paronychia develops quickly after minor trauma or nail-biting and presents with pain, redness, swelling, and sometimes pus. Chronic paronychia evolves over weeks with repeated moisture exposure and irritants and often features a flaking or swollen cuticle, burning sensation, and less pronounced pus.

Most acute cases are bacterial, mainly Staphylococcus aureus and Streptococcus species. Chronic cases often involve fungal organisms, especially Candida species, and may be mixed. Predisposing factors include wet work, frequent hand immersion, nail-biting, eczema around the nails, diabetes, and immunosuppression.

Diagnosis is usually clinical. Cultures or microscopy may be used if the infection is atypical or not responding to treatment. Management includes regular warm soaks, keeping nails dry between treatments, and avoiding nail trauma. Mild cases may respond to topical antiseptics or topical antibiotics. Abscess or spreading infection may require incision and drainage. If systemic signs or cellulitis is present, or if symptoms persist, oral antibiotics effective against Staphylococcus and Streptococcus are used; in chronic or suspected candidal involvement, add antifungal therapy.

With appropriate treatment, prognosis is generally good. Recurrence is common in chronic paronychia; prevention includes protective gloves during wet work, proper nail hygiene, avoiding nail-biting or skin picking, and managing skin conditions such as dermatitis.