Drug-induced paronychia - Nail and Distal Digit
Alerts and Notices
Synopsis
Acute paronychia is generally due to infectious etiologies, while chronic paronychia is typically due to irritants. Medications are also responsible for some acute and chronic paronychias and correlate with the introduction of the drug. Reported drug culprits include retinoids, lamivudine, cyclosporine, indinavir, azidothymidine (AZT), cephalexin, sulfonamides, cetuximab, gefitinib, fluorouracil (5FU), methotrexate, vandetanib, capecitabine, doxorubicin, and docetaxel. The paronychia typically resolves once the medication is discontinued.
Codes
ICD10CM:T50.995A – Adverse effect of other drugs, medicaments and biological substances, initial encounter
SNOMEDCT:
71906005 – Paronychia
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Bacterial paronychia
- Nail fold dermatitis
- Herpetic whitlow
- Squamous cell carcinoma
- Pustular psoriasis
- Syphilitic chancre
- Ingrown nail
- Onychomycosis
- Cellulitis
- Occupation-related nail changes (eg, contact with pesticides or photo developers)
- Topical application of therapeutic agents (eg, potassium permanganate, copper sulfate, anthralin)
- Tobacco staining
- Artificial nail damage
- Longitudinal melanonychia
- Pecan nails exhibit a diffuse brownish hue of the dorsum of the nail plate.
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:07/20/2017
Last Updated:07/24/2017
Last Updated:07/24/2017
Drug-induced paronychia - Nail and Distal Digit