PARONYCHIA

Hervina*

*Departement Of Dermatology and venereology

Faculty of Medicine Muhammadiyah University of North Sumatera

** Departement Farmacology Faculty of Medicine Muhammadiyah University of

North Sumatera

Abstract

Paronychia is one of the most common infections affecting the hand. 1 The
definition of paronychia is inflammation or infection of the soft tissues around the
nails (periungual).1 Predisposing factors include the habit of biting or sucking
nails and frequent exposure of nails to wet / humid conditions such as a laundry,
dentist, worker at the bar, milking. Paronikia can also treat people with dermatitis
in the nail fold.1

Paronychia is generally caused by bacteria, but can also occur due to fungal
infections.2 Acute paronychia almost always occurs in the area around the
fingernails, while chronic paronychia can occur in the fingernails or on toenails,
and infections can spread under the skin.2

Keywords: Paronychia

Abstrak

Paronikia merupakan salah satu infeksi tersering yang mengenai tangan. 1

Definisi paronikia adalah inflamasi atau infeksi pada jaringan lunak disekitar kuku

(periungual).1 Faktor predisposisi antara lain adanya kebiasaan menggigit atau

menghisap kuku serta sering terpaparnya kuku pada kondisi basah/lembab seperti

tukang cuci, dokter gigi, pekerja di bar, pemerah susu. Paronikia dapat juga

mengenai penderita dermatitis pada lipatan kuku. 1

 Paronikia pada umumnya disebabkan oleh bakteri, namun bisa juga terjadi

akibat infeksi jamur.2 Paronikia akut hampir selalu terjadi di area sekitar kuku

tangan, sedangkan paronikia kronis bisa terjadi di kuku tangan atau di kuku kaki,

dan infeksi bisa menyebar ke bawah kulit. 2

Kata kunci : Paronikia

PRELIMINARY Paronychia can also treat people with

dermatitis in the nail fold.1
Paronychia is one of the most
common infections affecting the Clinical symptoms of acute
hand.1 Definition of paronychia is paronychia are often overlooked by
inflammation or infection of the soft the patient, so they do not get
tissue around the nail (periungual).1 adequate therapy and will develop
Clinically, paronychia appears as an into a chronic pronic condition. 2
acute or chronic condition. Paronychia is generally caused by
Inflammation or infection that occurs bacteria, but can also occur due to
is localized and superficial on fungal infections.2 Acute paronychia
perionkium, the epidermis almost always occurs in the area
surrounding the nails, more often around the nail hands, while chronic
affects the fingers than the toes.1 paronychia can occur in the
Paronychia occurs when there is a fingernails or on toenails, and
disruption in the protector between infections can spread under the skin. 2
the proximal fold of the nail and the
DEFINITION
nail plate.1
Paronychia is an inflammatory
Predisposing factors include the
reaction that affects the folds of the
habit of biting or sucking nails and
skin around the nails.1 Usually about
frequent exposure of nails to wet /
1-3 fingers, especially the index
humid conditions such as washers,
finger and middle finger. 1 The cause
dentists, workers in bars, milking.
of this paronychia is due to trauma
which then separates from the nail in women than men, with a female:
plate of the eponikium, this gap is male ratio of 3: 1.5 A study by
then contaminated by pyogenic or Belyayeva et al showed that certain
fungus. The most common Piogen is nail disorders included paronychia
Staphylococcus or Pseudomonas and can have a very high impact on
aeruginosa while the most common quality of life that mainly occurs in
fungus is Candida albicans.1 women, patients aged 60-79 years.6

ETIOLOGY RISK FACTORS

Paronychia is a common complaint Paronychia risk factors:

and is usually caused by
• Habits of biting or sucking nails.1
Staphylococcus.1 This condition can
be caused by direct or indirect • As well as frequent exposure of
trauma such as broken nails, nail nails to wet / humid conditions such
biting, nail sucking, ingrown nails, as washers, dentists, workers at
due to manicure or pedicure, use of bars.1
fake nails or can also occurs without
PATHOGENESIS
prior trauma.5 Pathogenic bacteria
that often cause paronychia include The pathogenesis of paronychia can
Streptococcus pyogenes, be caused by various factors such as
Pseudomonas pyocyaneaceae, trauma, manicure pedicure and often
coliform organisms and Proteus someone in contact with water which
vulgaris, normal flora originating will lead to maceration of the skin so
from the mouth, gram negative it is easy to occur pyogenic
anaerobic bacteria.1 contamination (Staphylococcus or
Pseudomonas aeruginosa) or fungi
EPIDEMIOLOGY
(Candida albicans) which will cause
Paronychia is the most common hand erythema, edema in tissues
and foot infection in the United periungual and causes suppuration
States whose incidence represents and pus out.1
35%, this infection is more common
CLINICAL SYMPTOMS
Warm, redness, and swelling of the
nails.1

SUPPORTING INVESTIGATION

a) Pionicia

Pionicia is inflammation of the nails

Figure 2. Nail Lichen Planus.6
by the piococcus.5 This disease is
often preceded by trauma.5 Infection MANAGEMENT
of the nail fold begins, signs of
1) Non-medical
inflammation appear, then spread to
the matrix and nail plate, subungual Improve predisposing factors.5
abscesses can form.5 Prevent trauma and keep the skin of
the hands and feet dry.6 In
paronychia caused by Candida, other
candida sources, such as the oral,
vaginal and rectal cavity, must be
treated.5 In children , the habit of
sucking fingers must be prevented
Figure 1. Pionicia.5
because saliva is more irritating than
b) Nail Lichen Planus ordinary water.5

Lichen Planus can cause 2) Medical

inflammation and even damage to
Topicals are given antiseptics, such
the nail.5 Thinning of the nail surface
as povidone iodine or chlorhexidine.5
is characteristic of abnormal nails,
Systemic antibiotics are given
longitudinal ridging and the presence
according to the germs or
of cracks / fissures.6 The base of the
flucloxacillin 4 x 500 mg / day.5
nail changes, but is non-specific like
Acute paronychia accompanied by
yellow due to damage to nail color,
suppuration must be incised.5
onycholysis and subungual
hyperkeratosis.5 PROGNOSIS
Good.6 usually occurs two to five days after
trauma.5
CONCLUSION
Commonly acute and chronic
Paronychia is a disease that often
paronychia are used oral antibiotics,
attacks the hand.1 Paronychia is a
topical antibiotics, antimicotics,
superficial localized infectious
topical corticosteroids or a
disease or abscess on the
combination of topical and anti-
perionikium (nail fold) of the hand,
1
fungal corticosteroids.5
rarely on the foot. Paronychia
occurs if there is damage to the REFERENCES
folded nail area adjacent to the nail 1. Rigopoulos D, Larios G,
plate so that germs can enter.1
Gregorious S. Acute and
Complaints that often occur in
Chronic Paronychia. American
paronychia are usually caused by
Staphylococcus.1 This condition can Family Physician.

be caused by direct or indirect 2008;77(3)339-346,347-348.

trauma, such as broken nails, nail
2. Relhan V, Goel K, Bansal S,
biting, nail sucking, pathogenic
bacteria that often cause acute Garg VK. Management Of

paronychia, including Streptococcus Chronis Paronychia. Indian J

pyogenes, Pseudomonas
Dermatol. 2014; 59 : 15-20.
pyocyaneaceae, organisms coliform
and Proteus vulgaris, normal flora 3. Soeparman L. Kelainan kuku.

originating from the mouth, gram Dalam: Djuanda A, Hamzah M,

negative anaerobic bacteria.2
Aisah S, editor. Ilmu Penyakit
Paronychia manifestations are Kulit dan Kelamin. Edisi ke-7.
usually only one fingernail affected,
Jakarta: Penerbit Fakultas
this condition is characterized by
erythema, edema, pain in the fold of Kedokteran Indonesia. 2016. hal
the lateral and proximal nails. It 378-380.
4. Tosti A, Piraccini BM. Biology Edisi ke-2. Palembang: Penerbit

Of Nails and Nail Disorder. In: Fakultas Kedokteran Universitas

Wolff K, Goldsmith LA, Katz Sriwijaya. 2012. Hal 140.

SI, Gilchrest BA, Paller AS, 6. Elizabeth, Allison.

Leffell DJ, editors. Fitzpatricks’s “Paronychia”. 2018. [Cited 11

Dermatology in General Januari 2019]. Available from

Medicine, 8th ed. New York: URL:

The McGraw Hill https://emedicine.medscape.com

Companies;2012.p.1878 /article/1106062-overview

5. Kartowigno Soenaro. Sepuluh

Besar Kelompok Penyakit Kulit.