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Chronic paronychia

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Is a multifactorial inflammatory reaction of the proximal nail fold caused by irritants and allergens (1).

In chronic paronychia the patient loses the cuticle of the nail and the proximal, and sometimes the lateral, nail folds become red and bolstered. The separation of the cuticle makes the area between the proximal nail fold and the nail plate prone to bacterial and fungal invasion (1). The nail plate can become discoloured. Pus may be intermittently discharged. Chronic paronychia may occur in association with eczema or psoriasis.

Candida is the usual pathogen although opportunistic pathogens such as Proteus or Pseuodomonas may be involved. Pseudomonas may produce a green or black discolouration.

 

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