What to do if paronychia causes redness, swelling and pain

Paronychia is a common disease that often occurs in patients who live in a humid environment for a long time or soak in water for a long time. Paronychia can cause local soft tissue damage after it occurs and requires internal medication to recover. For more serious patients, surgical nail removal is required, but rest is required after the operation.

Causes/Paronychia

Paronychia is mostly caused by punctures, abrasions, ingrown nails or pulling out "inserted skin thorns" of the nail groove and surrounding tissues. Subungual abscess is often caused by the spread of paronychia, infection caused by subungual puncture, or secondary infection of subungual hematoma caused by fingertip compression injury. The main pathogen is Staphylococcus aureus.

Clinical manifestations/ paronychia

At the beginning, one side of the nail groove will become red, swollen and painful, and it may become purulent and infected within a short period of time. It may spread to the base of the nail and the opposite nail groove, forming perionychia, or it may spread to the subungual area to form a subungual abscess. At this time, the pain intensifies and the swelling is obvious. Yellow-white pus can be seen under the nail floating up the nail. If not treated in time, it may develop into purulent dactylitis and even cause phalangeal osteomyelitis. It may also become chronic paronychia, persistent paronychia or subungual abscess. Because the infection is relatively superficial, the systemic symptoms are often not obvious.

Examination/Paronychia

Sometimes the white blood cell count may increase, but no positive findings are found on X-ray examination.

Diagnosis/Paronychia

Based on medical history, clinical manifestations and laboratory tests, diagnosis is generally not difficult.

Treatment/Paronychia

In the early stages, hot compresses, physical therapy, external compresses, and the application of iodine amines or antibiotics can be used.

If there is pus, a longitudinal incision can be made at the nail groove for drainage. When the infection has spread to the subcutaneous area around the nail base, a longitudinal incision can be made in the nail grooves on both sides, the epithelial sheet on the nail root can be turned up, the root of the nail can be removed, and a small piece of vaseline gauze or latex sheet can be placed for drainage. If pus has accumulated under the nail bed, the nail should be removed or the nail above the abscess cavity should be trimmed. When removing nails, be careful to avoid damaging the nail bed to prevent deformities of the new nails in the future.