What history suggests paronychia?

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

Patients may give a history of the following [9, 28] :

  • Nail biting

  • Finger sucking

  • Trivial finger trauma

  • Finger exposure to chemical irritants

  • Use of acrylic nails or nail glue

  • Sculpted nails

  • Frequent hand immersion in water

Also query patients about the duration of symptoms and a history of nail infections and previous treatment.

Because paronychia has been known to initiate from malignant lesions, any history of prior malignancy or a pigmented, irregular appearance of surrounding tissue should result in appropriate suspicion and referral for biopsy.

Painless swelling or severe swelling that radiates requires an expanded differential diagnosis. [29] Painless swelling lateral to the nail plate in a patient with osteoarthritis should prompt investigation for a mucous cyst.


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