In recalcitrant chronic paronychia, en bloc excision of the proximal nail fold is an option. Topical steroid creams are more effective than systemic antifungals in the treatment of chronic paronychia. Application of emollient lotions may be beneficial. The patient should avoid exposure to contact irritants treatment of underlying inflammation and infection is recommended, using a combination of a broad-spectrum topical antifungal agent and a corticosteroid. Chronic paronychia is a multifactorial inflammatory reaction of the proximal nail fold to irritants and allergens. Treatment options for acute paronychia include warm compresses topical antibiotics, with or without corticosteroids oral antibiotics or surgical incision and drainage for more severe cases. This enables pathogens to inoculate the nail, resulting in infection. The main factor associated with the development of acute paronychia is direct or indirect trauma to the cuticle or nail fold. Paronychia may be classified as either acute or chronic. Paronychia is an inflammation of the folds of tissue surrounding the nail of a toe or finger.
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