Candidal paronychia
See also in: Nail and Distal DigitAlerts and Notices
Synopsis
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 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. Chronic paronychia is frequently seen in patients with diabetes and immunosuppressed patients as well as those who frequently have their hands in water, such as cooks, dishwashers, bartenders, laundry workers, etc. Individuals affected by an inflammatory dermatosis such as eczematous dermatitis and other diseases that can cause onycholysis are at an increased risk. It is more common in women. There may be staphylococcal or Pseudomonas superinfection.
Codes
ICD10CM:B37.2 – Candidiasis of skin and nail
SNOMEDCT:
187017007 – Candidal paronychia
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Differential Diagnosis & Pitfalls
Paronychia caused by other organisms, including bacterial:- Staphylococcus
- Streptococcus
- Pseudomonas
- Hendersonula
- Scytalidium
- Fusarium
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Last Reviewed:06/27/2017
Last Updated:07/25/2017
Last Updated:07/25/2017