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Candidal paronychia (pediatric) in Child
See also in: Nail and Distal Digit
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Candidal paronychia (pediatric) in Child

See also in: Nail and Distal Digit
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Contributors: Shari Lipner MD, PhD, Lori Prakash DO, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

This summary discusses pediatric patients. Candidal paronychia in adults is addressed separately.

Candidal paronychia is a type of inflammation and infection of the nail folds. There is usually a disruption in the barrier between the nail plate and nail fold with subsequent colonization or infection with the yeast Candida albicans. Candidal paronychia is uncommon in children and infants. Risk factors include excessive thumb-sucking or repeated exposure to wetness. It may also be seen in immunocompromised children, including transplant patients or those with human immunodeficiency virus (HIV) infection. Candidal paronychia can be acute or chronic.

In acute paronychia, there is pain, erythema, and edema of the nail folds. If it progresses, pus may develop. In severe cases, granulation tissue may form and there may be permanent nail dystrophy. The most common causative infective organism in acute paronychia is Staphylococcus aureus (see bacterial paronychia), but C. albicans has been isolated.

In chronic paronychia, there is inflammation of the nail folds that lasts more than 6 weeks. While Candida is often isolated, in most cases, it is colonization rather than a pathogen. It presents with erythema, mild tenderness, and swelling of the nail folds without fluctuance. There is discharge in some cases, and the nail plate may be onycholytic, thickened, and/or yellow. An ingrown nail may be present and contributory. Individuals affected by an inflammatory dermatosis such as eczematous dermatitis and other diseases that can cause onycholysis are at an increased risk. There may be staphylococcal or Pseudomonas superinfection.

Codes

ICD10CM:
B37.2 – Candidiasis of skin and nail

SNOMEDCT:
187017007 – Candidal paronychia

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Paronychia caused by other organisms, including bacterial:
  • Staphylococcus
  • Streptococcus
  • Pseudomonas
  • Hendersonula
  • Scytalidium
  • Fusarium
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Best Tests

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Therapy

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References

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Last Reviewed: 06/29/2017
Last Updated: 07/26/2017
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Candidal paronychia (pediatric) in Child
See also in: Nail and Distal Digit
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Candidal paronychia (pediatric) : Multiple transverse ridges, Nail fold erythema and edema, Nail fold pustule
Clinical image of Candidal paronychia (pediatric)
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