Paronychia

Paronychia is inflammation of the proximal or lateral nail fold, the soft tissue that seals the base and sides of the nail plate. It is classified by duration. Acute paronychia lasts less than 6 weeks and chronic paronychia persists longer than 6 weeks (DermNet; StatPearls). Acute paronychia develops over hours, usually affects one fold of a single digit and is most often bacterial. Chronic paronychia develops gradually, often involves several digits and behaves mainly as an irritant or dermatitis-type inflammation of the fold. Candida and Pseudomonas are often cultured from chronic lesions, but they are generally regarded as colonizers rather than the primary cause, so antifungal therapy is not routine (AAFP 2017). Acute paronychia is one of the most common hand infections seen in primary care and is about 3 times more common in women than in men (AAFP 2017). Most acute cases in healthy people settle completely within a few days and rarely recur (DermNet). The condition matters for nursing because a small, painful fold infection can spread to the fingertip pulp, the flexor tendon sheath, bone or the...