-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