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Dermatology3 papers

Chronic paronychia

Last edited: 4/15/2026

Overview

Chronic paronychia is a recurrent inflammation of the skin around the nail, often caused by repetitive trauma, moisture exposure, or fungal infection 1.

Diagnosis

  • Presence of erythematous, swollen, and tender periungual tissues 1
  • History of chronic exposure to moisture or trauma 1
  • Absence of acute signs may differentiate from acute paronychia 2
  • No specific laboratory tests; clinical examination is key 2

    • Management

  • First-line treatments:
    • - Avoidance of moisture exposure and repetitive trauma 1 - Topical antifungal agents if fungal infection is suspected 2
  • Adjunctive treatments:
    • - Oral antifungals for severe or persistent cases 2 - Surgical eponychial marsupialization for refractory cases 2

    Special Populations

  • Pregnancy: Specific management considerations not addressed 12
  • Pediatrics: Not specifically discussed in provided abstracts 12
  • Elderly: Increased susceptibility to chronic conditions due to reduced skin integrity; conservative management emphasized 1
  • Comorbidities: No specific guidance provided; general principles likely apply 12

    • Key Recommendations

  • Minimize chronic moisture exposure and trauma to prevent chronic paronychia (Evidence: Moderate 1)
  • Consider surgical eponychial marsupialization for patients with refractory chronic paronychia (Evidence: Weak 2)
  • Use topical antifungals in cases where fungal infection is suspected (Evidence: Expert opinion 2)

    • References

    1 Stone OJ. Bandage-induced nail disorders. Cutis 1985. link 2 Keyser JJ, Eaton RG. Surgical cure of chronic paronychia by eponychial marsupialization. Plastic and reconstructive surgery 1976. link

    Original source

    1. [1]
      Bandage-induced nail disorders. — Stone OJ Cutis (1985)
    2. [2]
      Surgical cure of chronic paronychia by eponychial marsupialization. — Keyser JJ, Eaton RG Plastic and reconstructive surgery (1976)
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