Toenail paronychia

Area of Science:

• Dermatology
• Infectious Diseases
• Surgical Pathology

Background:

• Paronychia is defined as inflammation of the nail fold tissues.
• It presents in acute and chronic forms, often associated with ingrowing toenails.
• Acute paronychia arises from disruptions in the nail fold seal, allowing microbial entry.

Purpose of the Study:

• To review the etiology and management of acute and chronic paronychia.
• To differentiate treatment strategies based on associated conditions like ingrowing toenails.
• To present a treatment algorithm for paronychia.

Main Methods:

• Literature review of paronychia management.
• Analysis of treatment approaches for acute and chronic paronychia.
• Inclusion of surgical techniques and antibiotic therapy considerations.

Main Results:

• Acute paronychia treatment focuses on the underlying cause (e.g., ingrowing toenail).
• Antibiotics may suffice for early acute infections; surgical drainage is often necessary, preferably via an intra-sulcal approach.
• Chronic paronychia is less common on feet, often non-infective dermatitis, but may have secondary fungal colonization; malignancy should be considered in refractory cases.

Conclusions:

• Treatment for paronychia depends on its type (acute/chronic) and association with other conditions.
• Surgical intervention, particularly the intra-sulcal approach, is crucial for abscess drainage in acute paronychia.
• Chronic paronychia requires dermatological evaluation, and persistent cases warrant investigation for underlying serious conditions.