What is paronychia and how is it characterized?

Updated: Oct 09, 2020
  • Author: Elizabeth M Billingsley, MD; Chief Editor: William D James, MD  more...
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Answer

Paronychia is a soft tissue infection around a fingernail. More specifically, it is a superficial infection of epithelium lateral to the nail plate that begins as cellulitis but that may progress to a definite abscess. [1] The 2 forms of paronychia, acute and chronic, usually differ in etiology, infectious agent, and treatment and are often considered separate entities. [2]

The acute infection, which is painful and purulent, is most frequently caused by staphylococci, although it commonly has mixed aerobic and anaerobic flora. [7] The patient's condition and discomfort are markedly improved by a simple drainage procedure. Chronic paronychial infections are usually fungal, rather than bacterial, in nature (see the images below).

Classic presentation of paronychia, with erythema Classic presentation of paronychia, with erythema and pus surrounding the nail bed. In this case, the paronychia was due to infection after a hangnail was removed.
In this case of paronychia, no pus or fluctuance i In this case of paronychia, no pus or fluctuance is involved in the nail bed itself.
Typical appearance of paronychia. Typical appearance of paronychia.

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