Diseases of the Nails #5
Paronychia is a soft-tissue infection of the crease between the nail and the nail fold (shown). It is the most commonly encountered hand infection, often seen in individuals whose occupation requires frequent contact with water, such as bartenders. Patients typically describe pain and tenderness. Acute paronychia typically develops after minor trauma and can lead to infection, with Staphylococcus aureus as the organism most commonly implicated in infection. Chronic paronychia develops after exposure to moist environments and lasts 6 weeks or longer, with Candida albicans as the most common etiologic agent. On examination, the affected area may appear erythematous and swollen with pus in advanced cases and nail changes in chronic ones. Acute paronychia is treated with warm soaks and oral antibiotics. Chronic paronychia is treated by keeping the lesion dry and by the application of topical antifungals. Surgical intervention may be required in acute or chronic paronychia cases that are refractory to therapy or in which an abscess develops.
http://www.medscape.com/features/slideshow/nail-diseases?src=nl_slide
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