Summary
定义
Paronychia is the inflammation of the nail apparatus. Acute paronychias are infections of the periungual tissues, usually presenting with an acutely painful, purulent infection. Chronic paronychia represents barrier damage to the protective nail tissues, including the cuticle and the proximal and lateral nail folds. The altered nail barrier predisposes the nail to irritant dermatitis, most importantly from water, soap, chemicals, and microbes. Avoidance of such irritants is the hallmark of treatment.[Figure caption and citation for the preceding image starts]: Acute paronychiaFrom the collection of Dr N.J. Jellinek and Professor C.R. Daniel III [Citation ends].
[Figure caption and citation for the preceding image starts]: Chronic paronychiaFrom the collection of Dr N.J. Jellinek and Professor C.R. Daniel III [Citation ends].
[Figure caption and citation for the preceding image starts]: Chronic paronychiaFrom the collection of Dr N.J. Jellinek and Professor C.R. Daniel III [Citation ends].
病史和体格检查
关键诊断因素
- presence of risk factors
- pain, swelling, drainage (acute)
- swollen, purulent nail fold (acute)
- nail plate irregularities (chronic)
- swelling/redness of nail folds (chronic)
- pink, swollen nail folds (chronic)
- missing cuticle (chronic)
- underlying nail plate abnormalities (chronic)
危险因素
- microscopic or macroscopic injury to the nail folds (acute)
- occupational risks (acute and chronic)
- barrier damage to the nail folds, cuticle (chronic)
- ingrown nail
- medications (chronic)
- toddler and adult
- female
诊断性检查
首要检查
- swab for Gram stain, culture, and sensitivity (acute or acute-on-chronic)
- swab for Tzanck smear (acute, herpetic)
需考虑的检查
- potassium hydroxide or fungal culture (chronic)
- x-ray
- MRI
- biopsy of skin/bone
治疗流程
acute paronychia
chronic paronychia
retronychia
撰稿人
作者
Shirin Zaheri, MBBS, BSc, MRCP
Dermatology Consultant
Charing Cross Hospital
Imperial College NHS Trust
London
UK
利益声明
SZ declares that she has no competing interests.
Khawar Hussain, BSc, MRCP, FHEA
Specialty Registrar in Dermatology
Charing Cross Hospital
Imperial College NHS Trust
London
UK
利益声明
KH has been reimbursed by Sanofi for conference travel expenses.
鸣谢
Dr Shirin Zaheri and Dr Khawar Hussain would like to gratefully acknowledge Dr Catherine Hardman, Dr Nathaniel J. Jellinek, Professor C. Ralph Daniel III, and Dr Shaimaa Nassar, previous contributors to this topic.
利益声明
NJJ, CH, and SN declare that they have no competing interests. CRD is an author of a number of references cited in this topic.
同行评议者
Shehla Admani, MD
Clinical Assistant Professor of Dermatology
Stanford University School of Medicine
San Jose
CA
利益声明
SA declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Daniel CR 3rd. Paronychia. Dermatol Clin. 1985 Jul;3(3):461-4. 摘要
Relhan V, Goel K, Bansal S, et al. Management of chronic paronychia. Indian J Dermatol. 2014 Jan;59(1):15-20.全文 摘要
Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014 Mar;22(3):165-74. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Herpetic whitlow
- Arthropod bite or sting
- Traumatic injury
更多 鉴别诊断患者教育信息
Dermatitis
Fungal nail infections
更多 患者教育信息
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