Felon - Nail and Distal Digit
Patients typically present with acute onset of pain, erythema and edema at the distal fingertip pulp or pad. The distal interphalangeal (DIP) joint is the most proximal point of edema spread in felon. Containment of the abscess within the compartment can lead to high pressures at the fingertip and possible visible sinus formation.
Risk factors include any immunocompromised state, diabetes mellitus, and IV drug use as well as work environments with increased risk of finger trauma.
L03.019 – Cellulitis of unspecified finger
32021005 – Felon
- Paronychia – symptoms typically at the base of the nail; can progress to felon
- Herpetic whitlow – may start with small, clear vesicles; also associated with oral and genital herpes infection
- Cellulitis – can lead to felon
- Crystalline deposition disease
- Rheumatoid arthritis
- Spider bite
- Lobular capillary hemangioma (pyogenic granuloma)
- Pyogenic flexor tenosynovitis – symptoms are on flexor surface
Consider an X-ray to rule out osteomyelitis.