Chronic Paronychia

(See also Overview of Nail Disorders Overview of Nail Disorders A variety of disorders can affect nails, including deformities, trauma, infections of the nail, paronychia, retronychia, and ingrown toenails. Nail changes may occur in many systemic conditions... read more .)

Chronic paronychia is an inflammatory disorder of the nail fold skin. It occurs most often in people whose hands are chronically wet (eg, dishwashers, bartenders, housekeepers), particularly if they have hand eczema, are diabetic, or are immunocompromised. Candida is often present, but its role in etiology is unclear; fungal eradication does not always resolve the condition. The condition may be an irritant dermatitis Contact Dermatitis Contact dermatitis is inflammation of the skin caused by direct contact with irritants (irritant contact dermatitis) or allergens (allergic contact dermatitis). Symptoms include pruritus and... read more with secondary fungal colonization.

The nail fold may be red and tender with repeated bouts of inflammation and often becomes fibrotic. Unlike acute paronychia Acute Paronychia Paronychia is infection of the periungual tissues. Acute paronychia causes redness, warmth, and pain along the nail margin. Diagnosis is by inspection. Treatment is with antistaphylococcal antibiotics... read more , there is almost never pus accumulation. There is often loss of the cuticle and notable separation of the nail fold from the nail plate. This separation leaves a space that allows entry of irritants and microorganisms. The nail may become dystrophic over the long term.

Diagnosis of chronic paronychia is clinical.