Causes and risk factors
Depending upon the causation, paronychia is classified into two types: Acute and chronic. Acute paronychia can be caused due to any trauma which disrupts the barrier between the nail bed and the nail which facilitates infection. This disruption can be caused due to nail biting, finger sucking, use of unsterile manicure instrument. Careless nail pairing is one of the commonest causes. Bacterial infection (staphylococci, streptococci, etc.), is the most common infection causing acute complaints of the nail bed, while the chronic one is most commonly caused due to fungal infection. People working in moist environments like bakers, florists, housekeepers, etc., are more commonly prone to such infection. People with weak immune system like those suffering from HIV commonly suffer from this infection. Certain medications and some diseases like psoriasis, mucocutaneous candidiasis, and pemphigus vulgaris predispose infection of the nail bed.
Clinical presentation
In acute complaints, the patient is generally healthy, but may complain of pain on both sides of the nail bed along with swelling and tenderness. In case the infection is deep, suppuration at the base of the nail bed is also seen, while those with chronic complaints, the symptoms reoccur periodically. The complaints persist for more than 6 months. They are triggered on exposure to the causative factor.
Investigations
Usually the diagnosis can be confirmed on the basis of the history narrated by the patient and the physical examination carried out. Blood test and cultures can be done to find out the causative organism. Certain other sets of investigations can also be advised.
Treatment
Usually in mild cases without any suppuration, daily soaking the fingers in warm water 3-4 times a day helps to resolve the complaints. In immunocompromised people, administration of antibiotics or antifungal medications is done. In case where suppuration supervenes, surgical drainage is needed.
Other modes of treatment:
Certain other modes of treatment can also be helpful in coping up with the symptoms. Taking into consideration the symptoms in a holistic way, homoeopathy can offer a good aid for the relief of the symptoms. The Ayurvedic system of medicine which uses herbs and synthetic derivates can also be beneficial in combating the complaints.
