Nail Disorders Flashcards
1
Q
acute paronychia
A
- acute infection of proximal or lateral nail folds
- nail fold is swollen, erythematous and painful +/- abscess formation
- break in integrity of epidermis
2
Q
MC infection in paronychia
A
staph aureas
3
Q
tx of acute paronychia
A
- topical abx
- oral abs
- I&D if abscess present
4
Q
felon
A
- abscess of the distal pad of the fingertip (MC w/ staph)
- may compromise blood flow and lead to necrosis of the skin, pad, or osteomyelitis
5
Q
S/S of a felon
A
- intense throbbing pain
- erythema and swelling
- +/- abscess
6
Q
tx of felon
A
- oral abx
- tetanus if indicated
- consider radiograph
- I&D w/ abscess
7
Q
green nails are caused by infection w/ what?
A
pseudomonas aeruginosa
8
Q
green nails
A
- green to green/black discoloration of the nail
- often associated w/ onycholysis
- likely to have hx of prolonged exposure to water or detergents, or an ungual trauma
9
Q
tx of green nails
A
- trim nail and soak 2-3 X/day in dilute bleach or vinegar solution
- no systemic abx
10
Q
onychomycosis / tinea unguium causative fungi
A
- dermatophyte fungi, mainly trichophyton rubrum is the major cause
- can be from many others
11
Q
presentation of onychomycosis / tinea unguium
A
- white/yellow discoloration of nail w/ subungual hyperkeratosis, onycholysis and thickened nail plate
- +/- pain
- tinea pedis often present
- typically involves distal/lateral subungual portion
- white superficial pattern
- candida in the immune suppressed
12
Q
dx of onychomycosis / tinea unguium
A
- most sensitive: nail clipping in formalin - fungus stains + w/ PAS
- fungal culture
- KOH false negatives common
13
Q
tx of onychomycosis / tinea unguium
A
- fluconazole
- antifungal creams or powders after tx
14
Q
nail psoriasis
A
- nail pitting, onycholysis w/ erythematous border, subungual debris and salmon patches (oil drop sign)
- appear as yellow - red areas of discoloration in the center of nail or border
- can be isolated but is in 50% of those w/ cutaneous psoriasis
15
Q
tx of nail psoriasis
A
- hard to tx
- topical high potency steroids
- calcipotriol
- tazarotene
- IL Kenalog
- acetretin