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NAIL AFFECTIONS

Paronychia is an infection of the skin that hangs over the side of the nail. It is the most common hand infection.
The infection can start suddenly (acute paronychia) or gradually (chronic paronychia).
This is commonly seen in children due to finger sucking and nail biting.

Cause-
In Acute paronychia the causative organism is bacteria staphylococcus aureus. Other bacteria that are less commonly involved are Streptococcus species and Pseudomonas species. Chronic paronychia is due to repeated irritation such as exposure to water and detergents.

Symptoms-
This type of infection is characterized by pain, redness and swelling of the nail folds. Pus is usually present, along with thickening and discoloration of the nail plate.
In chronic paronychia, the redness and tenderness are less noticeable than the acute infection. The skin around the nail can get boggy. The nail may have a green discoloration due to Pseudomonas infection.

Diagnosis-
Paronychia is diagnosed based on clinical symptoms. Sometimes if there is pus involved, a culture may be taken to determine the bacteria involved. Chronic paronychia is difficult to diagnose. A potassium hydroxide (KOH) test of a smear from the nail fold can sometimes reveal a fungus.

Treatment-
Warm soaks can be used 3 or 4 times a day for acute paronychia to promote drainage and relieve some of the pain.

Prevention-
The following are some guidelines to help prevent paronychia:

  • Do not bite nails or cuticles
  • Do not suck fingers
  • Try to avoid soaking hands in water without wearing waterproof gloves
Onychocryptosis
Also known as ingrown toenail. Ingrown toenails are a very common problem affecting primarily the great toenail. They are caused by sideways growth of the nail edge into the skin of the toe. The abnormal extension of the toenail pushes into the surrounding skin causing discomfort.

Causes-
Some known causes of Onychocryptosis are as follows -
  • Curved toenails
  • Poorly fitting shoes
  • Toenails that are trimmed improperly
  • Abnormally shaped nail plate
  • Trauma to the nail plate or toe
Risk factors-
Some people are simply more prone to ingrown toenails. Some risk factors include
1.Athletic adolescents and children,
2.Tight or narrow shoes (poorly fitted shoes),
3.Repeat injury or trauma to feet,
4.Poor foot hygiene,
5.Poor posture and gait,
6.Congenital foot deformity,
7.Congenital toenail malformation,
8.Very long toes,
9.Naturally short nails,
10.Obesity,
11.Diabetes,
12.Toenail infections,
13.Fungal nail disease,
14.Prior nail surgery,
15.Abnormal nail growths,
16.Arthritis, and
17.Excessive foot sweating.

Symptoms-
Pain is the main symptom of an ingrown toenail - usually just starting as some minor discomfort. This may be just the pressure from the side of the nail or it may be because the nail has actually penetrated the skin down the side of the nail. The toe is not necessarily infected, but this can develop after the nail penetrates the skin to become ingrown. The infection can spread, making the toe red and inflamed (paronychia). A collection of pus may also develop.

Complications-
Ingrown toenails may cause deeper bacterial tissue infection (cellulitis), localized infection of the nail fold (paronychia), and scarring of the nail fold and skin.

Treatment-
Ingrown toenails should be treated as soon as they are recognized. In many cases, people with uninfected ingrown toenails can obtain relief with the following simple regimen:
1.Soak the feet in warm salt water.
2.Dry them thoroughly with a clean towel
3.Avoid tight fitting foot wear
4.If discomfort develops try soaking the foot in a basin of warm water two or three times a day.
5.Apply a mild antiseptic solution to the area
6.Bandage the toe
7.Homeopathic remedies can cure ingrown toenails as well as prevent recurrences.

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