PARONYCHIA

Question 1

Paronychia definition

Answer 1

Soft-tissue infection of skin folds around nail

Question 2

Most common demographic group and location for paronychia

Answer 2

1. Children = nail biting, thumb sucking

2. Thumb

Question 3

Most common microorganisms with acute paronychia

Answer 3

1. Staph aureus = most common
2. Children = oropharyngeal organisms
3. Diabetics = mixed bacterial infections

Question 4

Most common microorganism with chronic paronychia

Answer 4

Candida albicans

Question 5

4 main risk factors for chronic paronychia

Answer 5

1. Diabetes
2. Psoriasis
3. Steroids
4. Anti-retroviral drugs

Question 6

Management of acute paronychia

Answer 6

Depends on fluctuance/ collection

1. No fluctuance = warm soaks and antibiotics
   - Augmentin/ clindamycin
2. Fluctuance = surgical drainage and antibiotics
   - partial or complete removal of nail plate
   - elevation of skin fold

Question 7

Management of chronic paronychia

Answer 7

1. Warm soaks and topical anti-fungal (miconazole)

2. Marsupialisation (excision of eponychium overlying germinal matrix) and nail plate removal