Chronic paronychia

Question 1

manif

Answer 1

Chronic dermatitis of proximal nail fold and matrix: chronic in ammation (eczema, psoriasis) with
loss o cuticle, separation o nail plate rom proximal nail fold

■ Foreign body: Hair, bristle, and wood splinters.
■ Mani estations: First, second, and third ngers o the dominant hand; proximal and lateral nail olds erythematous and swollen; cuticle absent.
■ Secondaryin ection/colonization:Candida spp.,Pseudomonasaeruginosa,orStaphylococcusaureus. Nail plate may become discolored; green undersur ace with Pseudomonas. In ection associated with painful acute inflammation

Question 2

predisposing factors

Answer 2

■ Predisposing actors:
■ Dermatosis: Psoriasis, dermatitis [atopic, irritant (occupational), allergic contact], and lichen planus.
■ Drugs: oral retinoids (isotretinoin, acitretin), indinavir.
■ Foreign body: Hair, bristle, and wood splinters

Question 3

Tx

Answer 3

Protection.
■ Treat the dermatitis with glucocorticoid: topical, intralesional triamcinolone, or a short course o
prednisone.
■ Treat secondary in ection