Paronychia

What Is It?

A paronychia is an infection of the skin that surrounds a toenail or fingernail. There are two different types of paronychia, acute and chronic:

• Acute paronychia - This usually appears as a sudden, very painful area of swelling, warmth and redness around a fingernail or toenail, usually after an injury to the area. An acute paronychia typically is caused by an infection with bacteria that invade the skin where it was injured. The injury can be caused by overaggressive manicuring (especially cutting or tearing the cuticle), biting the edges of the nails or the skin around the nails, picking at the skin near the nails or sucking on the fingers.

• Chronic paronychia - This is an infection that usually develops slowly, causing gradual swelling, tenderness and redness of the skin around the nails. It usually is caused by Candida or some other species of fungus, an organism similar to mushrooms, molds and mildew. It often affects several fingers on the same hand. People who are more likely to get this infection include those with diabetes or workers whose jobs constantly expose their hands to water or chemical solvents. Such jobs include bartending, house cleaning, janitorial work, dentistry, nursing, food service, dishwashing and hairdressing.

Symptoms

An acute paronychia causes throbbing pain, redness, warmth and swelling in the skin around a nail. In some cases, a small collection of pus forms under the skin next to the nail, or underneath the nail itself. Often, only one nail is affected.

A chronic paronychia usually causes less dramatic symptoms than an acute paronychia. Typically, the area around the nail is tender, red and mildly swollen; the cuticle is missing; and the skin around the nail feels moist or "boggy." Several nails on the same hand may be affected at the same time.