paronychia
Introduction
Introduction to paronychia The growth part of the nail is called methyl or nail, covered by the skin, and the sides of the nail are connected with the wrinkles of the skin to form a nail groove. The paronychia is a purulent infection of the joint between the sides of the nail plate and the skin wrinkles. It is one of the common finger (toe) infectious diseases in the clinic. The pathogen is Staphylococcus aureus on the surface of the skin. Can occur after a variety of minor injuries, early local anti-inflammatory treatment, infection can be controlled. After the abscess is formed, the treatment must be cut open. basic knowledge The proportion of illness: 0.08% Susceptible people: no special people Mode of infection: non-infectious Complications: abscess swelling, purulent finger inflammation
Cause
Cause of paronychia
Cause (35%):
Paronychia is due to the incorrect growth direction of the toe (finger) nail, causing inflammation of the toe (finger) parathyroid tissue, redness, pain, pus and other symptoms, inflammation for a long time, tissue granuloma, toe (finger) The deeper and deeper, the more difficult it is to heal itself, and it is better to go to the big toe.
Pathological changes (30%):
The pathogen invades from the wound and spreads along the sulcus. At this time, the subcutaneous tissue is congested, edema, leukocyte chemotaxis, and then damaged tissue cells are degenerated, necrotic, and liquefied; a semi-annular abscess is formed, and the pus can also spread from the sulcus to the side. The subcutaneous and contralateral sulcus of the root.
Prevention
Paronychia prevention
Properly handle finger barbs, correct nails and prevent ingrown nails; pay attention to labor protection, when there are tiny wounds on the fingers, apply 2.5% iodine, iodophor, etc. to prevent infection.
1, usually love the skin around the nails, do not cause any damage, the nails should not be cut too short, but also can not pull the "barbs" by hand.
2, prevent problems before they happen. Wood thorns, bamboo thorns, sewing needles, fish bone spurs, etc. are the most foreign objects in daily life that can easily stab the sulcus. When you are working or busy with housework, you should be extra careful.
3, usually pay attention to the maintenance of the fingers, after washing hands, wipe a little Vaseline or skin care cream before going to bed, can enhance the disease resistance of the skin around the nail groove.
4, when there are minor injuries to the fingers, you can rub 2% iodine, then bandage with band-aid to prevent infection.
6, if you have suppuration, you should go to the hospital to cut in time, drain the pus. Preventing the spread of infection and causing osteomyelitis
7, if the underlying empyema, the nail should be pulled out, in order to facilitate adequate drainage and complete cure.
Complication
Paronychia complication Complications abscess swollen finger inflammation
Acute paronychia is mostly caused by staphylococcal infection. This kind of bacteria is present on human skin. Generally, it is only pollution and does not cause infection. This is because the human body has local and systemic defense functions, only when the body is defended. The function is reduced, the skin integrity of the nail is destroyed, or the number of pathogenic bacteria, when the virulence is too large, will cause infection. Chronic paronychia is often caused by moisture, impregnation, causing Pseudomonas aeruginosa, fungus (Candida, Infections such as Aspergillus, etc., and common Proteus, if not treated in time, form a sub-abscess, can also develop chronic paronychia and chronic phalange osteomyelitis, chronic sinus, granulation tissue protruding from the sinus ostium.
1. Subarachnoid abscess is not treated promptly, the abscess spreads to the underside, the infection between the deck and the methyl is also affected, the skin around the nail is swollen, the pain is severe, yellow-white pus can be seen under the nail, and some patients will have low fever. , systemic symptoms such as increased white blood cells.
2. Purulent finger inflammation, paronychia is aggravated, the infection spread to the skin of the fingertips, causing the fingers to swell and sting.
Symptom
Symptoms of thyroid inflammation Common symptoms Pustules, body, groove, nails, short nails, embedded in nails, abnormal toenails, long nails, barbed nails, and meat separation
It usually occurs under the skin of one side of the sulcus, which is characterized by redness and swelling of the affected side, pain, and generally no symptoms of systemic infection. If the lesion develops, the lesion becomes pus, the area of the redness is fluctuating, white spots appear, but it is not easy to break. Pus, inflammation can also occur at the root or spread to the other side of the sulcus. When the infection is aggravated, there may be systemic symptoms such as increased pain and fever. Since the nails hinder the discharge of purulent matter, the infection may spread to the deep to form finger inflammation.
1. Refers to the redness, swelling, pain, and then the pus point on one side of the toenail or the bilateral sulcus. The granulation tissue can be seen after pus.
2. When the infection spreads to the nail bed, the local empyema can cause the whole finger, the toenail to float and fall off.
Acute paronychia: often occurs after an injury or minor trauma, characterized by a purulent infection with pain, acute abscess formation (staphylococcus) or erythema and swelling (streptococci).
Chronic paronychia: often caused by repeated minor trauma and exposure to water, irritants and allergens, followed by yeast colonization and secondary bacterial infection. The clinical feature is inflammation of the proximal nail fold, which is characterized by painful erythema, edema, loss of nail skin, and nail bed damage leading to abnormal surface of the deck. Chronic course of disease overlaps with repeated self-limiting acute exacerbations. Tumors can sometimes appear similar to chronic paronychia, such as Bowen's disease, keratoacanthoma, squamous cell carcinoma, endogenous chondroma, and melanoma-free melanoma. Paronychia and pseudo-pyrogenic granuloma may occur when taking certain drugs, such as systemic retinoids, antiretroviral drugs, anti-epidermal growth factor antibodies, and epidermal growth factor tyrosine kinase inhibitors. It can also be caused by some rare causes, such as ingrown toenails and cutaneous leishmaniasis.
Examine
Paronychia check
Generally, there is no special examination method, which can be diagnosed according to the symptoms manifested by paronychia.
White blood cell count and classification count: When unilateral paronychia, there is no obvious change in white blood cells. After the formation of subarachnoid abscess, white blood cell count and neutrophils are significantly increased when systemic poisoning symptoms occur due to bacterial toxin absorption.
The secretions were taken with a swab for bacteriological and mycological examination, and a patch test was performed if necessary.
Diagnosis
Diagnosis and differentiation of paronychia
There is usually no special examination method, which can be diagnosed according to the symptoms of paronychia.
At the beginning, the subcutaneous tissue on the side of the nail is red, swollen, painful, some can subside on their own, and some quickly purulent. The pus spreads from the side of the nail to the subcutaneous and contralateral sulcus of the nail, forming a semi-circular shape. Abscess, paronychia, no systemic symptoms, such as no incision drainage, abscess can spread under the nail, become a subcutaneous abscess, yellow white pus can be seen under the nail, so that the nail is separated from the nail bed, under the nail abscess It can be caused by a foreign body directly stabbing a traumatic hematoma infection under the nail or nail. If it is not treated in time, it can become chronic paronychia or chronic phalange osteomyelitis. When there is chronic paronychia, there is a small purulent sinus beside the nail. The granulation tissue protrudes outward, and chronic paronychia can sometimes be followed by a fungal infection.
