NAILS – NAIL BED INFECTION – PARONYCHIA
Any pain or swelling or redness usually indicates infection and inflammation. The infection and inflammation in the nail bed (naga chuthi in Tamil) is medically termed as paronychia. It is also commonly called whitlow (or panaratium). It usually involves the borders of the epithelium (skin layer) which covers the nail. Its intensity often varies from mild infection to felon or abscess.
INCIDENCES – Nail/nail bed problems can affect any person of any age group, but it is commonly seen more in females than males, the reason is not clearly understood. Anyway, researchers point to constant usage of water as the main causative factor. Likewise, those who bite their nails and those who suck their thumb are susceptible to this infection. It is also commonly noted along with diabetes, psoriasis and other autoimmune disorders. Also, it is more commonly seen in immunosuppressive treatments (steroidal therapy and chemotherapy).
CAUSES – Paronychia may be of bacterial origin or fungal or due to other causes. But the most common causative factor is staphylococcus bacteria. Others are:
- Injury – from trauma, in-growing nails, hanging nail, nail biting, thumb sucking, exposure to chemicals or extreme cold temperatures, recurrent use of nail polish remover, etc.
- Working constantly with water
- Infection – bacteria (staphylococcus aureus or streptococcus), fungus, viral, etc.
- Skin diseases – psoriasis, eczema, herpes
- Diseases – diabetes, psoriasis, malignancy
- Drugs and therapy – steroidal and chemotherapy
SYMPTOMS – Inflammation & pain usually starts from the sides of the nail in case of in-growing nails, whereas in the case of infection, it arises from the base of the nail. Normally, it will subside within 5-7 days, but can persist for weeks or months. Also sometimes, it may annoy the sufferer with its recurring tendency. The common symptoms are
- Pain and being sensitive to touch
- Redness and swelling in nail bed
- Discharge of pus when it opens
- Fever may accompany in case of development of complications/inner spreading abscess
DIAGNOSIS – Even though simple physical examination is enough to diagnose the condition, routine blood tests with auto immune antibodies and culture of discharge may be necessary in persistent cases to rule out onychomycosis (fungal infection) and psoriasis. Rarely X-ray and biopsy may be required to rule out the bone involvement and malignancy.
Complications – Any nail complaints should be treated in the initial period itself or otherwise complications often follow. In case of neglected paronychial infections, common complications are:
- Spread of infection into deep spaces of hand causing violent pain all over the hand
- Nail loss
- Deformity of finger
- Keep fingers/toes dry and clean
- Elevate the infected nail/finger to make good venous return/drain and reduce pain
- Hot water fomentation usually comforts by enhancing the blood circulation and diluting infection and by quickening the healing process.
- Trim in-grown nail from edge-to-edge in semi-lunar manner to avoid getting wound and infection
- Remove hanging nails, if any
- Wear gloves while there is risk of injury or chemical contact
- Control sugar levels in case of diabetes
GENERAL TREATMENT – First and foremost approach of modern school of medicine is to start with antibiotic treatment to arrest infection and its spread. Then, depending upon the cause and symptoms, doctor’s switch over to fungicide and other external applications. As drain almost switches off the pain and symptoms immediately, I&D (incision and drainage) will also be a routine follow-up. Trimming of nails will be done especially in case of ingrown nails.
Complications in most of the cases are only due to negligence. But even with good care some patients may develop recurrences. Recurrence of paronychia cannot be
rooted out merely by managing the situation locally in the affected parts (with an array of medicines/applications), i.e. antibiotics or anti-fungal will work for clearing infection at the time of use only.
Homoeopathy proves its efficacy by controlling, curing the disease & preventing the disease by raising the immune power against that disease, so that recurrence can be surely avoided. Also, in Homeopathy, there are medicines to bring out the pus without using the scalpel (knife). So, Homeopathy can treat diseases harmlessly for keeping us in good health.
Homeopathic medicines commonly used in cases of nail bed infection are Acid flour, Acid nit, Anti crud, Alumina, Belladonna, Causticum, Calc sulp, Graphites, Hepasulp, Mezereum, Myristica, Nat sulp, Pyrogen, Sabadilla, Silicea, Sulphur, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.
Dr. S. Chidambaranathan, BHMS, MD (Homeo) 24 E. New Mahalipatti Road Tel: +91-452-233-8833 | +91-984-319-1011 (Mob) E-mail: firstname.lastname@example.org
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The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)