Paronychia: Difference between revisions
(added acute and chronic) |
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*Infection of lateral nail fold or perionychium | *Infection of lateral nail fold or perionychium | ||
*Usually caused by minor trauma (e.g. nail-biting, manicures, hangnails) | *Usually caused by minor trauma (e.g. nail-biting, manicures, hangnails) | ||
==Treatment== | ==Treatment== | ||
===Acute=== | |||
*more likely bacterial | |||
*If no fluctuance is identified: | *If no fluctuance is identified: | ||
**Warm soaks, elevation | **Warm soaks, elevation | ||
| Line 12: | Line 16: | ||
*If fluctuance or pus is identified: | *If fluctuance or pus is identified: | ||
**Incise area of greatest fluctuance w/ #11 blade | **Incise area of greatest fluctuance w/ #11 blade | ||
===Chronic=== | |||
*more likely fungal | |||
*XR to r/o FB/osteo | |||
*vinegar/bleach soaks | |||
*topical antifungals vs Diflucan 150mg po qweek x 4-6 weeks | |||
==Disposition== | ==Disposition== | ||
Revision as of 17:59, 31 January 2013
Background
- Infection of lateral nail fold or perionychium
- Usually caused by minor trauma (e.g. nail-biting, manicures, hangnails)
Treatment
Acute
- more likely bacterial
- If no fluctuance is identified:
- Warm soaks, elevation
- TMP/SMX DS 1-2 tab PO x 7-10d + (cephalexin 500mg PO QID x7-10d OR dicloxacillin 500mg PO QID x 7–10d)
- If unclear if wound is fluctuant:
- Have pt apply pressure to distal aspect of affected digit
- A larger than expected area of blanching, reflecting a collection of pus, may identify need for drainage
- If fluctuance or pus is identified:
- Incise area of greatest fluctuance w/ #11 blade
Chronic
- more likely fungal
- XR to r/o FB/osteo
- vinegar/bleach soaks
- topical antifungals vs Diflucan 150mg po qweek x 4-6 weeks
Disposition
- Wound check in 24-48hr
See Also
Source
Tintinelli