-IBIS-1.5.0-
tx
cutaneous system
paronychia
diagnoses

definition and etiology

definition: an acute or chronic superficial infection of the epithelium lateral to the nail; aka "whitlow"

etiology: The infection usually develops from a break in the tissue from minor trauma (e.g. breaking a hangnail or manicuring), or from long-term irritation (e.g. soapy water exposure). The associated microorganisms include staphylococcus (especially after minor trauma), candida (especially with chronic exposure to water and detergents), pseudomonas, herpes simplex and proteus.

signs and symptoms

signs and symptoms:
• superficial infection beginning next to the nail; it is red, swollen and painful; may have purulent exudate
• "run-around" infection, involving the whole surrounding epithelium of the nail
• herpetic whitlow will exhibit vesicles and may be extremely painful
• the nail-bed may lift and the nail distorted

course and prognosis

Prognosis is usually excellent, with the infection resolving within 5 days. Chronically infected nails as seen in nail biters or those with continued occupational insult, for example, may become distorted. If the infections develop to a pustular stage, lancing is often the conventional approach (except in herpetic). If the infection begins to spread into the nearby tendon sheaths, then rapid surgery is indicated. Occupational exposure in the leading cause of chronicity.

differential diagnosis

• foreign body reaction


footnotes