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Information about Candida Paronychia

Candida Paronychia

Infection with Candida sp. (usually Candida albicans) is the most common cause of paronychial inflammation. It occurs with considerable frequency in people whose occupations require regular wet work.

Candidal paronychia is characterized by

Lack of pain

Lack of warmth

Paucity of pus

Chronicity

Onycholysis frequently accompanies candidal paronychia. The diagnosis is usually made on a clinical basis. KOH preparations are difficult to use, and often there is insufficient material for culture.

Candidal paronychia can be treated with the application of clotrimazole (Lotrimin) solution 3 times daily to the inflamed tissue. Some believe that a faster response is obtained if a topical steroid-antiyeast cream such as Lotrisone is used. Bandaging of the finger should be avoided, since resultant maceration encourages further candidal growth and may even lead to secondary bacterial infection

Bacterial Paronychia

Bacterial paronychia is an acute, painful process. It is usually preceded by an episode of trauma such as the tearing of a hangnail. It presents with all of the classical signs of a bacterial process: redness, warmth, swelling, and tenderness. Gentle pressure on the swollen tissue often results in the expression of a drop of pus that can then be picked up on an applicator for culture. Almost all bacterial paronychia is due to staphylococcal infection, and treatment appropriate for such infection can be started at the time of first examination. Incision and drainage are not necessary; soaks are occasionally of help.

Herpetic Whitlow

Herpetic whitlow is the name given to paronychial infection with the herpes simplex virus. The onset is acute and is associated with redness, swelling, warmth, exquisite tenderness, and regional lymphadenopathy. It is regularly confused with bacterial paronychia, but careful examination will reveal the presence of multiple, grouped, minute vesicles.

The disease is an occupational hazard for nurses, dentists, dental assistants, and others who arc routinely involved in mouth care. Herpetic whitlow runs its course in approximately 10 days. No medical therapy is required, but the level of discomfort usually warrants a trial of orally administered acyclovir. Soaks are usually recommended, although there is no proof that they are of help. Topically applied steroids, although theoretically contraindicated, reduce the discomfort by way of lessening the inflammation. Orally administered analgesics may be necessary if the pain is severe. Incision and drainage are contraindicated. Recurrent disease in the same location is possible, but it is not a common event.

Ingrown Toenails

Ingrown toenail is the most common cause of paronychial inflammation of the great toe. It develops when the sharp edge of the great toenail pierces the surrounding filled of paronychial tissue.

Ingrown toenail is likely to occur when one or more of the following are present:

(1) the nail is curved to a greater degree than normal;

(2) the toenail is clipped back too far, allowing tissue to roll up over it;

(3) athletic activities that require sudden stops ("toe jamming") are undertaken

(4) ill-fitting shoes are worn, such that the toe of the shoe presses against the nail and surrounding tissue.

Bacterial infection frequently develops in the paronychial tissue traumatized by the presence of an ingrown nail.

Therapy of an acute ingrown nail requires that the nail corner be lifted free of the surrounding, inflamed paronychial tissue. This is easily (although uncomfortably) carried out by the application of a mosquito forceps to the curved-in edge of the nail plate. When the plate is lifted, a small pledget of cotton can be wedged under the nail. Soaks and antibiotics are also started. This program leads to gratifying improvement within a week, at which time surgical correction, if necessary, can be carried out. Such surgery generally requires permanent removal of lateral portion of the nail plate and accompanying nail matrix.

About The Author for http://www.skindisordersguide.org/ . Educational guide to causes, symptoms and cure for various skin diseases and ailments like lesions .

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