: 339

Chronic
Chronic paronychia is an infection of the folds of tissue surrounding the nail of a finger or, less commonly, a toe, lasting more than six weeks. It is a nail disease prevalent in individuals whose hands or feet are subject to moist local environments, and is often due to contact dermatitis. : 660  In chronic paronychia, the cuticle separates from the nail plate, leaving the region between the proximal nail fold and the nail plate vulnerable to infection. : 343  It can be the result of dish washing, finger sucking, aggressively trimming the cuticles, or frequent contact with chemicals (mild alkalis, acids, etc.). Alternatively, paronychia may be divided as follows:
Candidal paronychia is an inflammation of the nail fold produced by C. albicans. : 310 
Pyogenic paronychia is an inflammation of the folds of skin surrounding the nail caused by bacteria. : 254  Generally, acute paronychia is pyogenic, as it is usually caused by a bacterial infection. Differential
Differential diagnosis of paronychia includes:

Cellulitis is a superficial infection and presents as erythema and swelling to the affected portion of the body with no area of fluctuance. Treatment is with oral antibiotics. Whitlow or felon is a subcutaneous infection of the digital pulp space. The area becomes warm, red, tense, and very painful due to the confinement of the infection, creating pressure in the individual compartments created by the septa of the finger pad. These require excision and drainage, usually with a longitudinal incision and blunt dissection to ensure adequate drainage. Herpetic whitlow is a viral infection of the distal finger caused by HSV.
In patients failing topical treatment or more severe cases, oral antibiotics are an option; dicloxacillin or cephalexin can be used. Indications for antibiotics with anaerobic coverage include patients where a concern exists for oral inoculation; this would require the addition of clindamycin or amoxicillin-clavulanate. Antibiotics such as clindamycin or cephalexin are also often used, the first being more effective in areas where MRSA is common. If  signs of an abscess (the presence of pus) are seen, drainage is recommended. Epidemiology
Paronychia is more common in women than in men, by a ratio of three to one. Usually, they affect manual-labor workers or people in occupations that require them to have their hands or feet submerged in water for prolonged periods (e.g., dishwashers). Middle-aged females are at the highest risk of infection. References
External links

"Paronychia Nail Infection". Dermatologic Disease Database. American Osteopathic College of Dermatology. Archived from the original on 2013-03-30. Retrieved 2006-07-12.