Management of chronic paronychia

Area of Science:

• Dermatology
• Inflammatory Disorders
• Nail Diseases

Background:

• Chronic paronychia is a common, recalcitrant inflammatory disorder affecting the proximal nail fold.
• It presents with redness, tenderness, and swelling, often seen in individuals with frequent hand exposure to irritants.
• Pathophysiology involves repeated inflammation leading to fibrosis and impaired cuticle formation, increasing susceptibility.

Purpose of the Study:

• To review current epidemiological data on chronic paronychia.
• To discuss the pathophysiology and challenges associated with this condition.
• To recommend a practical management approach.

Main Methods:

• Literature review of epidemiological studies.
• Analysis of current understanding of chronic paronychia pathophysiology.
• Discussion of therapeutic challenges and management strategies.

Main Results:

• Topical steroid creams demonstrate higher efficacy compared to previous mainstay antifungal therapies.
• Surgical interventions, including proximal nail fold excision or marsupialization, are options for recalcitrant cases.
• Preventive measures are crucial, forming the cornerstone of management.

Conclusions:

• Chronic paronychia requires a multifactorial management approach, emphasizing prevention.
• Topical steroids offer a more effective treatment than antifungals.
• Advanced therapies and surgical options are available for refractory cases.