Paronychia
Paronychia is a skin infection that develops around the nail of at least one finger or toe. It typically develops around the edges of the nail at the bottom or sides. It occurs when bacteria or fungi get under the skin.
The skin infection causes inflammation, swelling and discomfort around the nail. Abscessess containing pus can also form.
Types-
Paronychia can be either acute or chronic depending on the speed of onset, the duration and the infecting agents.
Acute Paronychia –
An acute infection almost always occurs around the fingernails and develops quickly. It is usually the result of damage to the skin around the nails from biting, picking, hangnails,manicures or other physical trauma. Staphylococcus and Enterococcus bacteria are common infecting agents in acute paronychia.
Chronic Paronychia –
Chronic Paronychia can occur on your fingers or toes and it comes on slowly. It lasts for several weeks and often comes back. It is typically caused by more than one infecting agent, often Candida yeast and bacteria. It is more common in people who are constantly working in water. Chronically wet skin and excessive soaking disrupts the natural barrier of the cuticle.This allows yeast and bacteria to grow and get underneath the skin to create an infection.
Symptoms –
• Swelling, tenderness and redness around the nail
• Hardening of the nail
• Puss filled abscesses
• Deformation or damage to the nail
• The nail separated from the nail bed
Causes-
Bacteria or fungi can cause paronychia and common culprits are Staphylococcus aureus and Streptococcus pyogenes bacteria.
Common causes of paronychia are –
• Ingrown nails
• clipping the nails too short
• biting or chewing the nails
• manicures
• excessive exposure of the hands to moisture, including freq uently sucking the finger
Risk factors –
Some people have a higher risk of paronychia such as-
• women
• people with diabetes
• people with weakened immune systems
• people with other skin conditions such as dermatitis
• people whose hands are frequently wet including cleaners
Diagnosis-
A doctor can diagnose paronychia simply by observing it.
Sometimes a sample of pus from your infected nail may be send to the lab it treatment doesn’t seem to be helping. This will determine the exact infecting agent.
Treatment-
Home treatments are often very successful in treating mild cases. If you have a collection of pus under the skin, you can soak the infected area in warm water several times a day and dry it thoroughly afterward. The soaking will encourage the area to drain on its own.
When bacterial infection causes acute parony chica, a doctor may recommend an antibiotic, such asDicloxacillin or clindamycin or Azithromycin.
When a fungal infection causes chronic Paronychia, a doctor will prescribe antifungal medication. These medications are topical and typically include clotrimazole or ketoconazole.
A doctor may also need to drain any pus from surrounding abscesses. For this, they will provide a local anesthetic, then open the nail fold enoughto insert gauze, which will help drain the pus.
Ayurvedic Perspective –
In Ayurveda it is known as Kunakh. The Shothahara, Rakta prasadaka and Strotoshodhaka treatment can improve the condition of the diseased nail.
Kunakh can be correlated with Asthi dushthi, the disease featured with vitiation of Tridosha having Pitta predominance.
Medications –
• Jatyadi Oil has an effect of Vrana shodhaka and Vrana Ropaka due to kledhara properties. for local application, Pichudharana is suggested for 20 min. over the lesion.
• Kaishore Gugglu has Rakta prasadaka properties.
• Gandhaka Rasayan is pitta shamak in nature.
• Sukshma Triphala Vati acts as an anti inflammatory and antibiotic.
• Gandharva Haritaki powder is best for Mridu Shodhana in this condition.
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