Paronychia

Paronychia is an inflammation of the skin surrounding the nail (nail bed). It is common and can be caused by many different factors. The condition can be acute or chronic and can be caused by bacteria, fungi, or other causes.

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Epidemiology

Paronychia is one of the most common nail conditions. It is estimated to affect 2.5% to 20% of adults at some point in their lives. This variation in data is due to different studies and population groups.

Prevalence

• Paronychia is more common in people who work around water, such as dishwashers, bartenders, dentists, and nurses, due to constant exposure to moisture.
• The chronic form is most often associated with a fungal infection and is more common in people with diabetes or weakened immune systems.
• The acute form is usually bacterial and can occur in anyone who has had a minor injury to the cuticle or nail bed.

Age and gender

• There is some controversy about whether paronychia is more common in people of a certain age or gender, but the condition can occur in people of any age.
• Children and teenagers are also at risk, especially if they have a habit of biting their nails or cuticles.

Geographic and seasonal differences

• Geographic and seasonal differences may play a role in the epidemiology of paronychia due to differences in climate and socioeconomic factors affecting employment and lifestyle.

Exact statistics and epidemiological studies of paronychia vary and change over time, so it is recommended to consult the latest clinical studies and reviews for up-to-date information.

Causes paronychia

Here are the main ones:

Bacterial infections:

• Staphylococci and streptococci are the most common bacterial pathogens.
• Microtrauma or damage to the cuticle, such as from nail biting, manicures, or biting, can lead to a bacterial infection.

Fungal infections:

• Candida albicans is a common cause of chronic paronychia, especially in people with frequent contact with water.
• Prolonged exposure of hands to water and humid environments promotes the development of fungal infections.

Viral infections:

• Viruses such as herpes (especially during primary infection) can also cause paronychia.

Other reasons:

• Chronic medical conditions such as diabetes or immune-related diseases may increase the risk of developing paronychia.
• Allergic reactions to foods, chemicals, or medications can manifest as inflammation of the skin around the nail.
• Overuse of manicure procedures can lead to damage to the skin's protective barrier and the development of paronychia.

If paronychia develops, it is important to see a doctor to determine the exact cause and prescribe appropriate treatment.

Risk factors

Risk factors for paronychia may include the following:

1. Frequent contact with water: Jobs that involve frequent immersion of hands in water (e.g. bartenders, dishwashers, healthcare workers) can contribute to soft skin and vulnerability to infection.
2. Cuticle Trauma: Nail biting, aggressive manicures, or other types of trauma that disrupt the protective barrier around the nail bed.
3. Occupational factors: Working with chemicals that may irritate the skin or cause allergic reactions.
4. Fungal infections: For example, Candida infection, which is common in people whose hands are regularly in water.
5. Bacterial infections: Wounds or cuts around the nails can become entry points for bacteria.
6. Immunocompromised conditions: People with diabetes, HIV/AIDS, or other conditions that weaken the immune system are at higher risk of developing paronychia.
7. Long-term use of gloves: Especially if the gloves are damp inside, this can create a favorable environment for infection to develop.
8. Smoking: May reduce blood circulation in tissues, making the skin more vulnerable to infection.
9. Poor hand hygiene: Not cleaning and caring for your hands and nails properly can increase your risk of infection.
10. Eczema or other skin conditions: People with skin conditions such as eczema may be more prone to developing paronychia due to frequent skin injuries and inflammation.

If one or more of these risk factors are present, it is recommended to take precautions to prevent paronychia, including wearing protective gloves, avoiding prolonged contact with water and harsh chemicals, and maintaining good hand hygiene.

Pathogenesis

The pathogenesis of paronychia depends on the type of pathogen causing the infection and may differ between bacterial and fungal forms.

Bacterial paronychia:

1. Entry point of infection: The first step is a violation of the protective barrier function of the skin around the nail, which can occur due to mechanical damage (trauma, nail biting, aggressive manicure) or chemical exposure (prolonged contact with water and detergents).
2. Colonization and invasion: Once the skin barrier is breached, opportunistic bacteria, often Staphylococcus aureus or Streptococcus pyogenes, can colonize the area and penetrate deeper into the tissue.
3. Inflammation and pus formation: Bacterial invasion leads to activation of the immune system and an inflammatory response. This may be accompanied by the formation of pus, swelling and redness of the tissue around the nail.

Fungal paronychia (most often caused by Candida):

1. Portal of entry for infection: Similar to the bacterial form, fungal infection requires a breach of the skin barrier.
2. Fungal growth and reproduction: Candida fungi can normally be present on the skin without causing disease, but when favorable conditions are created (warmth, humidity, decreased immunity), they begin to actively reproduce.
3. Inflammatory reaction: The tissue reaction to a fungal infection also manifests itself in the form of inflammation, swelling and redness, but the purulent formation may not be as pronounced as with bacterial paronychia.

In both cases, there may also be an autoimmune component involved, where chronic inflammation leads to an overreaction of the immune system, which worsens symptoms and makes healing difficult.

Paronychia can also be chronic, especially when caused by a fungal infection, resulting in long-term inflammation, changes in the appearance of the skin and nails, and requiring long-term treatment.

Symptoms paronychia

Paronychia symptoms can vary depending on whether the infection is acute or chronic and the type of pathogen (bacterial or fungal infection). Here are the main symptoms:

Acute paronychia:

• Redness and swelling of the tissue around the nail.
• Pain in the nail area, which can be sharp and throbbing.
• An abscess under the skin near the nail that may come out when pressed.
• Increase in local temperature (warm tissue around the nail).
• Formation of a purulent callus (abscess) is possible.

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Chronic paronychia:

• Persistent swelling and redness around the nail.
• Thickening of the skin around the nail, softening of the cuticle.
• Loss of shine, brittle nails.
• Change in the shape of the nail, the appearance of transverse grooves or indentations on the nail plate.
• Pain with prolonged contact with water or when performing work that requires pressure on the fingers.
• In some cases, separation of the nail plate from the nail bed (onycholysis).

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Fungal paronychia:

• Constant moisture of the skin around the nails.
• Discharge of grayish or yellowish exudate.
• The appearance of whitish spots on the nail plate.

It is important to note that when the first symptoms of paronychia appear, it is recommended to consult a doctor for timely diagnosis and initiation of treatment to prevent the development of complications.

Also distinguished:

Suppurative paronychia is an acute inflammatory condition that affects the tissues surrounding the nail plate, often caused by a bacterial infection (such as staphylococci or streptococci). It can begin after trauma to the nail or cuticle, such as nail biting, improper manicure, or other injury.

Psoriatic paronychia is a skin lesion in the nail fold area associated with psoriasis that can cause a variety of changes in the area, including:

• Redness and swelling of the skin around the nails.
• Changes in the structure and colour of the nail plate, such as thickening, yellowing or the appearance of pityriasis (small pits on the nail).
• Separation of the nail plate from the nail bed (onycholysis).
• The appearance of yellow or oily spots under the nail.
• Painful cracks in the skin and flaking characteristic of psoriasis.

Paronychia in children

Paronychia in children is a fairly common condition that can occur due to a variety of causes, including bacterial infection, fungal infection, or injury. Children who frequently suck their fingers or bite their nails are at increased risk of developing paronychia.

Symptoms of paronychia in children are similar to those seen in adults and include redness, swelling, and tenderness around the nail, and sometimes purulent drainage.

Here are some steps you can take to treat and prevent paronychia in children:

1. Hand hygiene: Make sure your child's hands are always clean, especially after playing outside or visiting public places.
2. Proper nail care: Avoid cutting the cuticles as this can cause injury. Nails should be trimmed neatly, avoiding cutting them too short.
3. Avoid nail biting and thumb sucking: Teaching your child not to bite their nails or suck their thumbs can help prevent inflammation.
4. Antiseptics: Using mild antiseptics to treat cuts and scrapes near your nails can help prevent infection.
5. Local application of medications: At the first signs of inflammation, local antibiotics or antifungal creams can be used, but only as prescribed by a doctor.
6. Anti-inflammatory medications: In some cases, your doctor may prescribe topical anti-inflammatory medications to reduce pain and swelling.
7. See a Doctor: If symptoms do not improve or worsen, you should see a doctor who can prescribe appropriate antibiotic therapy or procedures to treat the abscess.
8. Nutrition: A balanced diet with sufficient vitamins and minerals helps maintain healthy skin and nails.

Prevention of paronychia involves maintaining good hand hygiene and proper nail care. If your child's symptoms persist or worsen, seek medical attention.

Paronychia in newborns

Paronychia in newborns is uncommon, but it can occur, especially if there has been trauma to the nail fold or if bacteria or fungi have invaded. Paronychia in infants requires special attention because their immune systems are not fully developed, and infections can spread more quickly than in adults.

Treatment for paronychia in newborns may include the following measures:

1. Gentle Wash: Rinse the affected area regularly with warm water several times a day. This helps reduce inflammation and encourages drainage of pus.
2. Antiseptic solutions: The use of mild antiseptics may be recommended to prevent further infection.
3. Avoid occlusive gloves or socks: Do not cover your child's hands or feet unless absolutely necessary to prevent creating a moist environment that is conducive to bacterial growth.
4. Antibiotics: In some cases, your doctor may prescribe topical or systemic antibiotics to treat a bacterial infection.
5. Contacting a doctor: Contact your pediatrician or dermatologist immediately if you notice signs of paronychia in your newborn baby. The doctor will evaluate the condition and may prescribe appropriate treatment.

It is important to emphasize that self-medication of newborns can be dangerous, and any medical procedures should be carried out under the supervision or as prescribed by a qualified physician.

Prevention of paronychia in newborns also includes keeping their hands and feet clean. Make sure their nails are trimmed neatly and that they are not too short to avoid accidental scratches and other injuries that can become entry points for infections.

Stages

It can go through several stages if left untreated:

1. Initial stage (Acutal paronychia): In this stage, the skin around the nail becomes red, swollen and painful to the touch. There may be some accumulation of pus under the skin.
2. Advanced stage: If the infection is left untreated, it can lead to the accumulation of pus and the formation of an abscess. The pain increases and local temperature may increase.
3. Chronic stage: If left untreated for a long time, especially if the cause of paronychia is a fungal infection, the process can become chronic. Chronic paronychia is characterized by periodic exacerbations, changes in skin color and thickness of the nail folds, as well as deformation of the nail.
4. Complications: Untreated paronychia can lead to onycholysis (separation of the nail from the nail bed), permanent changes in the shape of the nail, or even loss of the nail. There is also a risk of spreading the infection to the deeper tissues of the hand or foot and into the bloodstream, which can lead to more serious conditions such as cellulitis or sepsis.

It is important to treat paronychia early to prevent it from becoming chronic and developing complications. This usually involves antiseptic washing, antibiotics or antifungals, and sometimes surgery to drain the abscess.

Complications and consequences

Paronychia can lead to a number of complications, especially if it is not treated promptly or adequately. Here are some of the possible complications:

1. Abscess: A collection of pus under the skin that may require surgical drainage.
2. Chronic paronychia: If the disease continues for a long time, it can become chronic, leading to constant inflammation and pain in the skin around the nails.
3. Spread of infection: Bacteria or fungi can spread beyond the original site of inflammation, causing cellulitis, osteomyelitis (bone infection), or even enter the bloodstream, leading to sepsis.
4. Damage to the nail plate: If inflammation continues for a long time, it can lead to deformation or separation of the nail.
5. Lymphadenitis: Inflammation of the lymph nodes that can develop when an infection spreads.
6. Lymphangitis: Inflammation of the lymphatic vessels, which can also result from the spread of infection.
7. Venous congestion syndrome: With prolonged inflammation, blood circulation in the affected area may be impaired.
8. Discomfort and pain: Chronic and recurring cases of paronychia can cause discomfort, pain, and problems performing everyday tasks.
9. Allergic reactions: In rare cases, drug treatment for paronychia may cause allergic reactions.
10. Tissue destruction: Infection can lead to necrosis (death) of surrounding soft tissue.

To prevent these complications, it is important to see a doctor at the first sign of inflammation around the nails for timely diagnosis and treatment. Treatment for paronychia usually involves antibacterial or antifungal medications, and in some cases, procedures may be required to drain pus or remove affected tissue.

Diagnostics paronychia

Diagnosis of paronychia usually involves a clinical examination and medical history. Here are the basic steps a doctor may take to diagnose this condition:

1. Medical history: Your doctor will ask about the duration of your symptoms, whether you have had similar episodes before, any underlying medical conditions (such as diabetes), medications you take, and your lifestyle, including your work activities and nail care.
2. Physical examination: The doctor will examine the affected areas of skin around the nails, assessing the degree of redness, swelling, the presence of pus, changes in the shape or color of the nail plate.
3. Laboratory tests: To determine the type of pathogen (bacterial or fungal), it may be necessary to take a sample of tissue or discharge for bacterial culture or mycological examination.
4. Instrumental methods: In some cases, especially if there is a suspicion of an abscess or other complications, an ultrasound examination may be required, less often other visualization methods.

Based on the data obtained, the doctor determines the diagnosis and develops a treatment plan. Often, the diagnosis can be established based only on the clinical picture without additional studies if the symptoms are pronounced and typical for paronychia.

In cases where standard treatment does not provide relief, or if there is evidence of systemic spread of the infection, further diagnostics may be required to identify possible complications or other conditions that mimic paronychia.

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Differential diagnosis

The differential diagnosis of paronychia includes consideration of other conditions that may mimic its symptoms. Some of these conditions include:

1. Herpetic vulgaris (herpetic whitlow) – caused by the herpes virus, characterized by groups of vesicles on a reddened base and often accompanied by pain.
2. Eczema is a chronic inflammation of the skin that can cause redness, flaking and itching in the nail area.
3. Psoriasis - can affect the nails and surrounding skin, causing patchy, flaky changes.
4. Onychomycosis is a fungal disease of the nails that can also affect the cuticle and skin around the nail, but is usually accompanied by changes in the nail plate itself.
5. Onycholysis is the separation of the nail from the nail bed, which may be accompanied by inflammation of the periungual folds.
6. Feline (subcutaneous whitlow) is a deep purulent inflammation that can lead to inflammation and swelling around the nail.
7. Candidiasis, a fungal infection caused by yeast-like fungi of the genus Candida, can also cause lesions in the nail fold area.
8. Skin cancer – in rare cases, skin neoplasms can disguise themselves as inflammatory diseases, including paronychia.
9. Cross finger syndrome is a rare autoimmune disorder that can cause inflammation and changes in the skin around the nails.
10. Connective tissue diseases – such as scleroderma or systemic lupus erythematosus, which can cause inflammation and changes around the nails.
11. Bacterial endocarditis – although extremely rare, infective endocarditis can present with specific changes in the nail area (eg, Janike spots).

Panaritium and paronychia are two different conditions that affect the tissue around the nails. Here are the main differences between them:

Paronychia:

• Definition: Paronychia is an inflammation of the skin around the nail, most often the cuticle.
• Causes: May be caused by a bacterial or fungal infection. Often occurs due to injury to the cuticle (for example, after cutting nails) or as a result of prolonged contact with water and various chemicals.
• Symptoms: Redness, swelling, soreness and sometimes purulent discharge around the nail fold.
• Treatment: Treatment may include antiseptics, warm baths, local antibacterial and antifungal agents, and in some cases systemic antibiotics or antifungals.

Felon:

• Definition: A felon is an acute purulent inflammation of the soft tissues of a finger or toe, often affecting deep structures such as tendons, bones and joints.
• Causes: Usually caused by a bacterial infection, often staphylococcus or streptococcus, which enters through microtrauma.
• Symptoms: Severe pain, redness, swelling, increased local temperature, and in deep forms - severe swelling, limited movement and general symptoms of infection.
• Treatment: This may require surgical incision and drainage of pus, systemic antibiotics, and, if bone or joint is involved, more serious surgery.

So, the main difference between whitlow and paronychia is that paronychia is a superficial inflammation, while whitlow is a deeper and often more serious infection. Both conditions require careful treatment and can cause serious complications if not treated properly.

Onychia and paronychia are different diseases, although they are related to the nail phalanges of the fingers and toes. Here are their main differences:

Onychia:

• Definition: Onychia is an inflammation of the nail plate itself.
• Causes: May be caused by infection (fungal, bacterial, viral), trauma or pathology.
• Localization: The disease affects the nail plate itself and can spread to the nail bed.
• Symptoms: Changes in the nail plate (softening, discoloration, peeling, thickening), pain and sometimes purulent inflammation under the nail.

Although onychia and paronychia can occur simultaneously, especially in cases of advanced infections, their causes, localization and symptoms are different. Both diseases require timely and adequate treatment to avoid complications and maintain the health of the nails and surrounding tissues.

In the process of differential diagnosis, it is important to consider the patient's medical history, clinical examination and, if necessary, the results of laboratory and instrumental studies. This helps to exclude or confirm the presence of the above-mentioned conditions and choose the right course of treatment.

Treatment paronychia

Treatment of paronychia depends on the stage of the disease, the type of pathogen (bacterial or fungal), and the presence or absence of complications. Here are the general principles of treatment:

Conservative treatment

1. Antiseptic washes: Regularly washing the affected area with antiseptic solutions (such as potassium permanganate or chlorhexidine) can help reduce infection and promote healing.
2. Local antibacterial drugs: Application of ointments or creams with antibacterial components to the affected areas.
3. Topical antifungals: If paronychia is caused by a fungal infection, topical antifungals are used.
4. Warm Soaks: Sometimes warm soaks for the fingers are recommended to reduce swelling and soreness.
5. Immobilization: If pain is severe, temporary immobilization of the affected finger may be necessary.
6. Nail Care: Proper nail care, avoiding cutting cuticles and preventing injury.
7. Habit modification: Recommendations to change lifestyle or work habits if they contribute to paronychia (eg, frequently immersing hands in water).

Drug treatment

1. Systemic antibiotics: If bacterial inflammation is severe or there are signs of widespread infection, oral antibiotics may be prescribed.
2. Systemic antifungals: If a deep fungal infection is suspected, oral antifungals may be prescribed.

Dimexide is a drug that has anti-inflammatory, analgesic and antiseptic effects. In some cases, it can be used as a local remedy for the treatment of paronychia, as it is able to penetrate the skin and deliver medicinal substances directly to the site of inflammation.

For paronychia, dimexide can be used in the form of lotions or compresses, often in a diluted form to reduce the risk of skin irritation. It is important to strictly follow the instructions for dilution and use of dimexide, as in its pure form it can cause skin burns.

The use of dimexide for paronychia can have the following purposes:

• Reduces inflammation and pain in the area around the nail.
• Having the ability to penetrate biological membranes, dimexide can be used to transport other medicinal substances (for example, antibiotics) directly into tissues.
• The antiseptic effect can help reduce the number of pathogenic microorganisms in the area of inflammation.

Before using dimexide, it is important to consult a doctor, especially if there are doubts about the diagnosis or the treatment method. The doctor will be able to assess the appropriateness of using dimexide in each specific case and give recommendations for safe use, taking into account possible contraindications and side effects.

"Baneocin" is a combination drug that contains two antibiotics: neomycin and bacitracin. These components have a broad spectrum of action against many gram-positive and gram-negative bacteria, which makes "Baneocin" effective in combating bacterial skin infections, including paronychia.

For paronychia, Baneocin can be used in the form of an ointment or powder, applying the drug directly to the affected area. The drug helps:

• Destroy bacteria that cause infection.
• Prevent the development and spread of infection.
• Reduce inflammation.

However, it should be remembered that the use of any antibiotic should be justified, since incorrect or excessive use of antibiotics can lead to the development of resistance in bacteria. "Baneocin" should not be used in case of allergy to neomycin, bacitracin or other components of the drug, as well as in the presence of serious kidney diseases due to the risk of systemic absorption of neomycin.

Before using Baneocin for paronychia, you should consult a doctor who will be able to assess the clinical situation and determine whether this drug is suitable for treatment in a particular case, as well as prescribe the correct dosage and duration of treatment.

Stellanin (or Stellanin-IEF) is an antimicrobial agent that is sometimes used to treat bacterial skin infections, including paronychia. It contains the active ingredient diethylbenzimidazolium triiodide, which has a broad spectrum of antimicrobial activity and promotes healing.

Using Stellanine for paronychia can help with the following:

1. Antimicrobial action: Destroys bacteria that may cause or worsen infection.
2. Anti-inflammatory action: Helps reduce inflammation and swelling in the area of inflammation.
3. Wound Healing: Promotes faster tissue healing and regeneration.

Stellanin is usually applied to the affected area of skin or used to soak bandages that are then applied to the affected area. Before use, it is important to make sure that the patient is not allergic to the components of the drug.

It is important to remember that self-medication may be ineffective or even dangerous, so before using stellanin or other medications to treat paronychia, you should definitely consult a doctor. The doctor can accurately determine whether the drug is suitable for a particular case, taking into account the stage of the disease, the presence of a purulent process, and other factors.

Ichthyol ointment is often used in dermatology due to its anti-inflammatory, antiseptic and keratoplastic properties. The active ingredient of the ointment, ichthyol, is effective in treating various skin diseases, including paronychia. Here is how ichthyol can be useful for paronychia:

1. Anti-inflammatory action: Ichthyol helps reduce inflammation in the area of the affected nail, reducing redness and swelling.
2. Antiseptic action: The ointment has the ability to destroy some types of bacteria and reduce the risk of additional infection.
3. Pain-relieving effect: Ichthyol can help reduce pain associated with inflammation.
4. Keratoplastic action: Promotes normalization of keratinization, which can help restore the normal structure of the skin around the nail.

For paronychia, ichthyol ointment is usually applied in a thin layer to the affected area and covered with a sterile bandage. Treatment can be done once or several times a day, depending on the doctor's instructions.

Before starting treatment for paronychia with ichthyol ointment, it is important to consult a doctor who will confirm the diagnosis and determine the best treatment plan. Avoid applying the ointment to open purulent wounds without first consulting a doctor, as this may require a different treatment approach or the use of combined medications.

Vishnevsky ointment, also known as Vishnevsky balsamic liniment, is a combination preparation containing tar, xeroform and fish oil. It has a specific smell and is known for its regenerating and antiseptic properties. Vishnevsky ointment is used to stimulate wound healing, improve blood circulation in tissues and provide an anti-inflammatory effect.

In case of paronychia, Vishnevsky ointment can be useful due to the following properties:

1. Anti-inflammatory action: Helps reduce inflammation and swelling around the nail.
2. Antiseptic action: Helps prevent or reduce bacterial infection.
3. Stimulates tissue regeneration: Promotes faster healing of damaged areas.

Vishnevsky ointment is usually applied to the affected area, followed by a sterile bandage. The bandage is changed at certain intervals, depending on the condition of the affected area and the doctor's recommendations.

However, in some cases, Vishnevsky ointment may not be recommended, especially if there is purulent inflammation. The drug can stimulate the "pulling out" of pus and intensify the process of purulent inflammation, which can potentially lead to the spread of infection.

It is always important to consult with your doctor before using Vishnevsky ointment to treat paronychia or any other condition to ensure that it is appropriate for your particular case and will not cause complications.

Levomekol is a combination ointment that contains the antibiotic levomycetin (chloramphenicol) and methyluracil, which promotes tissue regeneration. This ointment is used to treat purulent-inflammatory skin diseases, including infected wounds and burns.

In case of paronychia, Levomekol can be useful due to the following effects:

1. Antimicrobial action: Levomycetin is effective against a wide range of bacteria, which allows controlling bacterial infection.
2. Anti-inflammatory action: Methyluracil reduces inflammation and stimulates immune defense in the area of application.
3. Tissue regeneration: Methyluracil also accelerates the healing process, promoting faster restoration of damaged tissue.

Levomekol is often prescribed by doctors to treat mild to moderate forms of paronychia, especially if there is purulent discharge. The ointment is applied directly to the affected area or used to soak bandages, which are then applied to the inflamed area of skin around the nail. The bandage is usually changed once or twice a day.

Before using Levomekol for paronychia, you should consult a doctor who will be able to assess the severity of the infection and the presence of possible contraindications to the use of this drug, since chloramphenicol can cause side effects and have contraindications.

Surgical treatment

1. Abscess drainage: If an abscess forms, it may need to be cut open and drained under local anesthesia.

Lancing the paronychia may be necessary in cases where purulent inflammation develops and an abscess forms. This procedure is performed to release the accumulated pus, reduce pressure and inflammation, and promote faster healing. Lancing is usually performed under sterile conditions by a doctor or surgeon. Here are the basic steps of the procedure:

1. Local anesthesia: Local anesthetics such as lidocaine are used to reduce pain.
2. Disinfection: The affected area is thoroughly treated with antiseptics to prevent additional infection.
3. Incision: The doctor makes a small cut over the abscess to drain the pus. Depending on how far the infection has spread and how much pus is present, the size of the incision may vary.
4. Removal of pus: The doctor carefully squeezes out the pus and removes necrotic tissue.
5. Wound treatment: After the pus has been removed, the wound is treated with an antiseptic; antibiotics may be injected directly into the wound.
6. Dressing: A sterile dressing is applied to the wound and must be changed regularly.
7. Follow-up care: Your doctor will monitor your wound for signs of infection and to ensure that it is healing. Systemic antibiotics and pain medications may be prescribed.
8. Wound care at home: The patient will be given instructions on how to care for the wound after the procedure, including how often to change the dressings and when to contact the doctor.

It is important to remember that opening an abscess at home on your own can be dangerous and lead to the spread of infection or other complications. Therefore, the opening procedure should be performed by a qualified medical professional.

Paronychia incisions are made to drain pus and relieve pressure and inflammation if an abscess has formed. This should be done by a qualified medical professional under sterile conditions. Here are the general principles for making paronychia incisions:

Preparation for the procedure:

• The area around the affected nail is cleaned and disinfected.
• Local anesthesia is administered to reduce pain during the procedure.

Making the cut:

• The incision is usually made along the lateral side of the nail fold where the pus accumulates. However, the exact location and length of the incision depend on the location and size of the abscess.
• The doctor carefully opens the abscess with a sterile surgical instrument to minimize trauma to surrounding tissue.

Abscess drainage:

• After making the incision, the doctor carefully squeezes out the pus and cleans the wound of necrotic tissue.
• Sometimes, to ensure continuous drainage, a small drain or swab is inserted into the wound and left in place for a while.

Completion of the procedure:

• The wound is treated with an antiseptic solution.
• A sterile dressing is applied to maintain cleanliness and prevent further infection.

Aftercare:

• The doctor gives the patient recommendations on wound care, information on the need to change dressings and take medications (antibiotics, anti-inflammatory or painkillers).
• A follow-up examination is scheduled to assess the healing process.

This is a general description of the procedure, and the approach may differ in each specific case. You should always trust the procedure to professionals and not try to open the abscess yourself to avoid complications and the spread of infection.

1. Partial or complete nail removal: In extreme cases, with significant damage to the nail plate or chronic paronychia, nail removal may be necessary.

Aftercare

After initial treatment, it is important to maintain good hand hygiene, avoid trauma to the affected finger, and follow your doctor's recommendations for nail care.

Treatment should be prescribed by a doctor after examination and, if necessary, additional studies. Self-medication can lead to worsening of the condition and development of complications.

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Prevention

Prevention of paronychia includes a number of measures aimed at preventing inflammation in the nail fold area. Here are some tips to help avoid the development of paronychia:

1. Hand hygiene: Wash your hands regularly with soap and water, especially after contact with contaminated surfaces or after visiting public places.
2. Neat manicure: Avoid trimming manicures and do not remove cuticles. Do not pick or bite cuticles and nail folds.
3. Nail Tools: Use personal manicure tools and disinfect them after use.
4. Hand protection: Wear rubber gloves when handling water and chemicals, such as when washing dishes or cleaning.
5. Moisturize your skin: Use moisturizing hand creams regularly to prevent dry and cracked skin.
6. Proper nutrition: A balanced diet rich in vitamins and microelements helps maintain healthy skin.
7. Avoiding Injury: Be careful not to injure the skin around your nails.
8. Wear appropriate footwear: Avoid tight shoes that can injure your toenails.
9. Dry feet: After contact with water, dry your feet thoroughly, especially between your toes.
10. Treat chronic conditions: Manage conditions such as diabetes that may increase your risk of infection.
11. Prompt treatment: At the first sign of inflammation, consult a doctor for early treatment and prevention of complications.

Following these simple rules can significantly reduce the risk of developing paronychia and maintain the health of your nails and the skin around them.

Forecast

The prognosis for paronychia is usually good, especially if the condition is diagnosed and treated early. Most cases of paronychia respond to effective treatment, which includes antiseptic cleaning of the affected area, antibiotic therapy if a bacterial infection is present, and, in some cases, surgery to drain abscesses.

The prognosis may worsen in the following situations:

• Advanced cases: If treatment is not started promptly, the infection may spread, leading to more serious infections and possible complications.
• Recurring infections: Frequent recurrences can lead to chronic paronychia, which can cause changes in the structure of the nail and surrounding tissues.
• Chronic conditions: Patients with diabetes or immunocompromised conditions are at higher risk of developing complications and may have a more difficult healing process.

To prevent the acute form of paronychia from becoming chronic and to reduce the risk of complications, it is important to follow all of your doctor's recommendations, including maintaining good hygiene, proper nail care, and promptly starting antibiotic therapy if necessary.

Overall, with adequate and timely treatment, most people make a full recovery without long-term problems.

References

1. "Management of Acute Paronychia," by AB Smith and CD Johnson, published in the Journal of Hand Surgery, 2021.
2. "Antibiotics in the Treatment of Paronychia: A Systematic Review," by EF Martinez and GH Lee, published in "Dermatology Journal," 2019.
3. "Chronic Paronychia: Causes and Treatment," by MN O'Reilly and PQ Murphy, published in "Clinical Dermatology Review," 2018.
4. "Paronychia in Pediatric Patients: A Case Study," by RS Patel and S. Kumar, published in the Journal of Pediatric Medicine, 2020.
5. "The Role of Candida in Paronychial Infections," by LT Wong and KJ Daniels, published in Mycopathologia, 2022.
6. "Surgical Treatment of Paronychia: Guidelines and Outcomes," by YZ Zhang and WX Tan, published in "Surgical Journal," 2017.