PARONYCHIA ▲ GENERAL INFORMATION A paronychia is an infection around the fold of the fingernail or toenail. It can be caused by aggressive manicuring in this area. Also, bacteria can more easily penetrate skin that is moist (and soapy) for long periods (example: moist soapy hands inside kitchen gloves) or hot and sweaty (example: feet inside tennis shoes in the summer). Many times the cause is not obvious. COMMON SIGNS AND SYMPTOMS • Tenderness and swelling around the nail fold (Fig. 1). • There may be pus in this area as well as under the nail. • The finger or toe can be moved without pain. • There is no fever. Figure 1. DIAGNOSIS The area of the nail fold is red, swollen, and very tender when touched. ● TREATMENT If it is caught early and no pus is present, it can be treated as follows: • Antibiotics • Warm, moist packs as follows: • Dissolve a teaspoon of ordinary salt in a quart of warm (not hot) tap water. • Place a clean washcloth in the solution, squeeze out most of the moisture, and then wrap the cloth around the finger or toe. • Cover the entire hand (or toe) with a piece of plastic (example: the plastic wrapper from the dry cleaner will do). • Cover all this with a dry face towel. • Rest the hand or toe with all the towels wrapped around it on a heating pad set on low. • Do this for 20 to 30 minutes three times per day. • As much as possible, keep the arm or leg elevated on pillows so that it is higher than the heart. If pus has already collected, it will have to be drained. ■ OPERATION • This minor operation is done as an outpatient procedure. • The entire finger or toe will be painted with an antiseptic solution. • A very thin, short needle will be used to inject an anesthetic into the nerve supplying the finger or toe. The finger or toe will become numb. • An incision will be made to release the pus and a dressing applied. • The operation takes less than 30 minutes. POSTOPERATIVE CARE • Arrangements will be made for your return office visit. • You will be given a prescription for antibiotics. • Over-the-counter pain medicine is adequate for any discomfort. ✚ HOME CARE • Resume your usual activities. • You will be shown how to change the dressing as necessary. • You may be asked to soak the finger as described above to help with the healing. • If you get the dressing wet, replace it with a clean, dry one. ✆ CALL OUR OFFICE IF • Your finger swells and hurts as before. • You develop a temperature higher than 1007F. • You have any questions.
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