Indian Journal of Dermatology
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  Official organ of AADV
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REVIEW ARTICLE
Year : 2014  |  Volume : 59  |  Issue : 1  |  Page : 15-20

Management of chronic paronychia


1 Department of Dermatology, VMMC and Safdurjung Hospital, Delhi, India
2 Specialist, VMMC and Safdurjung Hospital, Delhi, India
3 Director Professor and Head, MAMC, VMMC and Safdurjung Hospital, Delhi, India

Correspondence Address:
Vineet Relhan
35-F, Sector-7, SFS Flats, Jasola Vihar, New Delhi - 25
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5154.123482

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Chronic paronychia is an inflammatory disorder of the nail folds of a toe or finger presenting as redness, tenderness, and swelling. It is recalcitrant dermatoses seen commonly in housewives and housemaids. It is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Repeated bouts of inflammation lead to fibrosis of proximal nail fold with poor generation of cuticle, which in turn exposes the nail further to irritants and allergens. Thus, general preventive measures form cornerstone of the therapy. Though previously anti-fungals were the mainstay of therapy, topical steroid creams have been found to be more effective in the treatment of chronic paronychia. In recalcitrant cases, surgical treatment may be resorted to, which includes en bloc excision of the proximal nail fold or an eponychial marsupialization, with or without nail plate removal. Newer therapies and surgical modalities are being employed in the management of chronic paronychia. In this overview, we review recent epidemiological studies, present current thinking on the pathophysiology leading to chronic paronychia, discuss the challenges chronic paronychia presents, and recommend a commonsense approach to management.


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