Dermatology - Paronychia

Dermatology - Paronychia
The nails can suffer chronic damage as a result of either mechanical or chemical harm to the cuticle.
Women, individuals working with food, housecleaners, and patients with a medical history of atopy, psoriasis, and lichen planus are at a heightened risk. Predisposing variables for trauma to the cuticle include the use of oral retinoids or indinavir.
The individual is experiencing chronic inflammation in the proximal nail fold and matrix, resulting in dermatitis. This inflammation is caused by conditions such as eczema or psoriasis, and is characterized by the loss of cuticle and separation of the nail plate from the proximal nail fold.
The index, middle, and ring fingers of the dominant hand exhibit erythema and edema in the proximal and lateral nail folds, with the absence of the cuticle. Occasionally, ongoing mild inflammation might suddenly worsen into subacute painful episodes, causing discolored horizontal ridges on the sides. Frequent secondary infection/colonization occurs, particularly with Candida spp., Pseudomonas aeruginosa, or Staphylococcus aureus. The nail plate may exhibit discoloration, namely a green undersurface caused by Pseudomonas infection. Infection is linked to distressing acute inflammation.

The diagnosis is established through a thorough analysis of the patient's medical history, a comprehensive clinical examination, and the evaluation of any probable underlying disorders and medications.

Manage the dermatitis by using glucocorticoids, such as topical and intralesional triamcinolone, along with a brief regimen of prednisone. Administer suitable antibiotic agents to address subsequent infections.