Paronychia: causes, signs, treatment, prevention
Patients who fall ill with a paronychia are surprised: "Such a small - and such malicious".Indeed, the size of the lesion is negligible, but the pain and functional discomfort associated with this disease is greater than expected.
Paronihija( also in medicine the name "paronychias" has taken root, both terms are equivalent) is an inflammatory or inflammatory-purulent disease of the peri-osedal cushion. But often inflammation on the roller does not stop - there is no such that he was involved in the process, and absolutely alongside any conditional line were absolutely healthy tissues of the finger.Therefore, disease is also called the near-panic panic .Contents: Why Paronychia appears Diagnosis Possible complications Treatment of paronychia Prevention
Nature is conceived so that skin of the hands of the hands and feet is stronger than the skin covering the other parts of the body. This is due to the fact that these parts of the body most often literally come into contact with the outside world: the brushes are sharp, hot, prickly, chemically aggressive, and the feet are in close contact with the shoes( directly or indirectly through socks and pantyhose).
But in this process the palmar and plantar surfaces of the hands and feet are applied, the skin of which, in the process of evolution, has become more hardy. But the skin of the back side - in particular, the skin of the finger near the nail plate - is not as strong. Therefore, they are forced to tolerate the negative impact of aggressive factors. If the margin of safety is small - a paronychia may occur.
Causes of paronychia:
- regular mechanical trauma of the nail rollers( for example, rubbing the fingers with a tight shoe, ripped barbs , splinters getting into the peri-oral roller);
- close contact with chemical agents - it does not have to be acids, alkalis or professional chemicals, often is in contact with poor-quality detergent or the chemical nails on the nail roller's microenrols that we use in our own kitchen - the same vinegar;
- the effect of high temperature - paronychia is more likely to affect women practicing hand washing in hot water;
- fungal diseases;
- dirty brushes and feet.
In some cases, the paronychia can act as a professional disease( that is, associated with the implementation of professional obligations). In the at-risk group:
- surgeons, before the operation or manipulation, treating the skin of hands with antiseptics, which are often quite aggressive;
- shoemakers, constantly in contact with shoe glue;
- employees of chemical laboratories that are at risk of falling into unprotected skin;
- babysitter, often washing hands in hot water
and so on.
But most often paronychia occurs due to improperly executed circumfluoric beads during manicure and pedicure.
- is a very rough move away from manicure tools of the cornified cuticle( the edge of the peri-osedal cushion that adjoins the nail plate);
- inaccuracy of the master, who can injure a peri-oral roller when cutting the cuticle;
- cuticle removal without its preliminary softening;
- poorly sharpened manicure scissors, because of what cuticle is not cut, but breaks out with "meat".
In practically all cases paronychia occurs with the involvement of an infectious agent. Aseptic inflammatory lesion of the peri-ogate roller can develop only under sterile conditions, which is impossible in practice, because a person does not live in a sterile spacesuit , and the treatment of his brushes in everyday life or during work is never accompanied by the complete destruction of any microorganisms( evenSurgeons when treating brushes with antiseptics).
The most common infectious causative agents of paronychia are :
- pyogenic cocci;
- of staphylococci.
In children, the paronychia often develops due to streptococci and staphylococci .
In its development the paronychia goes through the following stages:
- infiltration( inflammation accompanied by tissue tightening);
- resolution( release of pus from the tissues outside - requires surgical care);
- cleansing from purulent contents( it's very rare on its own);
- filling the cavity of the former ulcer with tissues.
Most often there is a paronychia in the field of the brush, rather than the foot.
Even at the initial stage of the disease development, when the clinical picture is still fuzzy, recognition of the paronychia does not constitute difficulties - due to the localization of the disease. Surgeons joke: "Near the nail can not develop appendicitis - so the diagnosis is clear."Symptoms of paronychia:
- pain in the area of the peri-oral groove - first aching, obtuse character, then as formation and accumulation of pus - characteristic twitching or pulsating( patients note that at the site of the lesion they clearly feel "pulsation of the blood"); sometimes the pain is so intense that, before going to the clinic, patients can not fall asleep all night;
- swelling of the tissues, which can start from the peri-osophilic bead, but then spreads along the soft tissues of the distal( more distant from the center of the body) phalanx, and in neglected cases - and the middle phalanx;
- soreness in the nail area, especially when pressing on it;
- because of the pain and swelling of the soft tissues - a decrease in the functions of the finger, the inability to bend and unbend it in the nearest joint to the paronychia;
- characteristic change in the color of the skin in the place of the lesion - the skin turns red, then becomes cyanotic and as if transparent from the inside;
- at the stage of suppuration - a cluster under the epidermis of a characteristic greenish-gray cloudy pus;
- temperature increase of tissues;
- in advanced cases - an increase in body temperature to 37.5-38.3 degrees Celsius, and in complicated "purulent" cases - even higher.
The development of the disease from the moment of skin damage in the area of the okolonogite roller and before the appearance of a pronounced symptomatology can take place very quickly and take several hours.
There are a number of jumpers in the tissues and hands and feet, in which infection and pus, even in the smallest amounts, quickly spread to surrounding tissues.Therefore, with a weakened immune response of the body or its general weakening, as well as with the paronychia neglect, complications of this disease may occur:
- exfoliation of the nail plate;
- panaritium - as a result of drawing a finger into the process of neighboring tissues;
- phlegmon of the hand or foot - the spread of the inflammatory-purulent process throughout the brush; in the clinic there were cases when, with the rapid development of phlegmon, after 8-10-12 hours the brush became like a ball;
- Regional lymphadenitis is inflammation of the ulnar and axillary lymph nodes due to the fact that the infectious component of the disease( microorganisms that provoked the paronychia) has spread to them;
- sepsis - the spread of an infectious agent throughout the bloodstream, and with it - throughout the body;
- because of the spread of the pathogen - the formation of multiple secondary purulent foci in the body.
Treatment of paronychia
If the inflammation develops, but there is still no pus, the paronychia is treated conservatively:
- rest of the finger and hand;
- if the paronychia has developed on the toe of the foot - getting rid of the finger from the pressure of the shoes;
- to alleviate the pain syndrome, try not to keep the brush or foot with the affected finger in the down position;
- antibacterial therapy with broad-spectrum antibiotics( in uncomplicated cases, tablet forms are used, in the advanced and complicated - injections);
- physiotherapy( in particular, UHF).
If pus appeared, the purulent focus should be immediately opened under local anesthesia, the tissues should be cleaned of pus and the drainage of should be introduced - tubules or rubber strips for outflow of purulent contents, which in the first day can still form in the place of suppuration evenAfter his autopsy. This procedure, which is considered an operation, is performed exclusively by a surgeon in a dressing or polyclinic setting.
Surgical( surgical) method of treatment is necessarily supplemented with antibiotic therapy. After opening of the focus, the postoperative wound is washed and changed for 3 to 4 days daily( with uncomplicated form).In doing so, you should ensure maximum shake of the finger and brush - do not perform any work.
If the nail in the lesion site begins to peel off - it is removed under local anesthesia.
To protect yourself from the risk of developing paronychia, you should carefully protect the delicate skin of the peri-oral roller from all kinds of aggressors - high temperature, chemical compounds, mechanical factors . Fungal skin damage as a potential provoker of paronychia should be immediately cured.Manicure and pedicure should be done as carefully as possible, with adherence to all the rules.
If the burrs begin to appear, you must immediately disaccustom yourself from the habit of ripping or gnawing them. The hangnails should be carefully trimmed with a manicure scissors, ideally after that process the place of "microoperations" with an antiseptic - half diluted alcohol, brilliant green or iodine.
Kovtonyuk Oksana Vladimirovna, medical reviewer, surgeon, consulting physician