Paronychiais an infection of the layer of skin surrounding the nail (known as theperionychium).
Treatments depend on the punch in of infection.
This photo contains content that some people may find graphic or disturbing.
kckate16 / Getty Images
Bacteria are the most common cause of the infection, predominantlyStaphylococcus aureus,but also certain strains of theStreptococcusandPseudomonasbacteria.
Chronic infections are often resulting from the fungusCandida albicans(yeast) and other fungal agents.
Over time, the accumulation of pus may separate the skin from the nail.
In more severe cases, thelymph nodesin your elbow and armpit may swell and your nail may become discolored.
In chronic paronychia,redness and tenderness are usually less noticeable.
The skin around the nail often looks baggy, and the cuticle may separate from the nail bed.
The nail often becomes thickened and discolored with pronounced horizontal grooves on the surface.
Green discoloration can occur in cases ofPseudomonasinfection.
Diagnosis
Acute paronychia is typically diagnosed based on a review of the clinical symptoms.
If pus is oozing, your healthcare provider may make an incision to drain it.
In severe cases, they may culture bacteria from the drained pus to make a definitive diagnosis.
This usually isn’t necessary because the bacteria is usuallyStaphylococcusorStreptococcustype, both of which are treated similarly.
Chronic paronychia tends to be more difficult to diagnose.
Some healthcare providers suggest an acetic acid soak, using one part warm water and one part vinegar.
If you have pus or an abscess, the infection may need to be drained.
In some cases, a portion of the nail may need to be removed.
(Steroids should never be used on their own as they don’t treat the underlying infection.)
American Academy of Family Physicians.Paronychia.
Leggit JC.Acute and chronic paronychia.Am Fam Physician.
2017;96(1):44-51.
American Family Physician.Acute and chronic paronychia.
Allouni A, Yousif A, Akhtar S.Chronic paronychia in a hairdresser.Occupational Medicine.
2014;64(6):468-469. doi.org/10.1093/occmed/kqu075
Centers for Disease Control and Prevention.Candidiasis.
Chiriac A, Brzezinski P, Marincu I, Foia L.Chloronychia: green nail syndrome causedPseudomonas aeruginosain elderly persons.CIA.
2015:2015(10):265-267. doi:10.2147/CIA.S75525
MedlinePlus.Skin lesion KOH Exam.
2014;59(2):e10-e52.
doi:10.1093/cid/ciu296
Relhan V, Goel K, Bansal S, Garg VK.Management of chronic paronychia.Indian J Dermatol.
2014;59(1):15-20. doi:10.4103/0019-5154.123482
