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
MANAGEMENT
·
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.
HOMEOPATHIC APPROACH
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.
for
new hope
Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India
Tel: +91-984-319-1011 (Mob /
Whatsapp)
E-mail: drcheena@gmail.com
(Disclaimer: 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.)