Which factors increase the risk of chronic paronychia?

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

Chronic paronychia most often occurs in persons whose hands are repeatedly exposed to moist environments or in those who have prolonged and repeated contact with irritants such as mild acids, mild alkalis, or other chemicals. People who are most susceptible include housekeepers, dishwashers, bartenders, florists, bakers, and swimmers. In addition, individuals who are immunocompromised, such as those with human immunodeficiency virus (HIV) infection or those undergoing steroid therapy, are predisposed to paronychia.

Other conditions associated with abnormalities of the nail fold that predispose individuals to chronic paronychia include psoriasis, mucocutaneous candidiasis, and drug toxicity from medications such as retinoids, epidermal growth factor receptor inhibitors (cetuximab) (tyrosine kinase inhibitors [neratinib, afatinib]), [13, 14] and protease inhibitors. [15, 16] Of particular interest is the antiretroviral drug indinavir, which induces retinoidlike effects and remains the most frequent cause of chronic paronychia in patients with HIV disease.


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