| Common
problems affecting the nail unit (nail and the skin around and
under the nail) are:
Paronychia:
It is the painful swelling of the nail fold; it can be acute or
chronic.
-
Acute paronychia:
Usually caused by bacterial infection following trauma to the nail
folds
-
Chronic paronychia:
Caused by fungal infection; secondary to the destruction of the cuticle due
to detergents and water. It is common in individuals who do wet jobs - house wives, hotel workers, maids, gardeners
etc. It is also common
in diabetics.
Paronychia can
lead to nail changes in the form of ridging, scaling and
discoloration.
Paronychia is often caused by trauma to the
nail unit...
Treatment:
Acute
paronychia
- if pus is present, incision and drainage should be done.
Antibiotics should be directed against the most common pathogen
Staphylococcus aureus and the drug of choice is cloxacillin.
Prevention is by
avoiding trauma to the nail unit during manicure.
Chronic
paronychia
- It can sometimes present with acute exacerbation due to
secondary bacterial infection and a course of antibiotics as
mentioned above would be needed. In addition, systemic antifungals
like fluconazole or itraconazole (for moulds) or terbinafine (for
dermatophytes) should be taken for 3-4 months for finger nails and
4-6 months for toe nails.
Preventive
measures:
- Do not use
harsh detergents
- Wipe the hands dry
every time the hands are washed
- Do not destroy the
cuticle during manicure and pedicure
- Use moisturizers
regularly to prevent chapping and cracking of nail folds
Other common
problems involving the nails are:
- Brittleness of
the nail
- Discoloration
- Pitting an
ridging of the nail
- Separation of
the nail from the nail plate
- In-growing
nail
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