Dermatology

Question 2

Paronychia

Answer 2

✓ Localised, superficial infection of the skin folds around a nail,
✓ Commonly caused by Staphylococcus aureus.
✓ Risk factors - manicuring, nail biting, trauma and in-growing nails.
✓ Treatment:
✓ Fluctuant pus collection or abscess – incision and drainage
✓ Only very minor localised infection may respond to topical antibiotics
✓ Antibiotics of choice: 1st line: Flucloxacillin or Clarithromycin
✓ Erythromycin is 1st line in pregnancy/breastfeeding if Penicillin allergic.
✓ Indications for a swab: enlarging paronychia, surrounding inflammation, recurrent paronychia, no response to treatment in 2 - 3days, systemic upset, history of MRSA, immunosuppression/Diabetes.