Evaluation of role of Candida in patients with chronic paronychia.

Background: Chronic paronychia, earlier considered to be an infection due to Candida, is currently being considered as a dermatitis of the nail fold. Irritant, allergic and protein contact dermatitis are the suggested major pathogenic mechanisms. Hypersensitivity to Candida is more likely to be the etiology, rather than the infection itself. Aims: To assess the clinico‑etiological profiles of patients with chronic paronychia and to determine the role of contact sensitization and hypersensitivity to Candida. Methods: All consecutive patients of chronic paronychia attending the dermatology outpatient department (OPD) were assessed for risk factors, number of nails affected, clinical presentation and presence of fungus, patch tested for contact allergy and prick tested for hypersensitivity to Candida allergen. Results: A total of 80 patients of chronic paronychia were recruited into our study. There was female preponderance (66 patients, 82.5%), with the most common group affected being housewives (47 patients, 58.8%). Frequent washing of hands (64 patients, 80%) was the most common risk factor. Fungal culture was positive in 56.1% (41 patients), the predominant species cultured was Candida albicans (15 patients, 36.5%). Patch testing with Indian standard series was positive in 27.1% patients (19 out of 70 patients tested), with nickel being the most common allergen. Prick test with Candida allergen was positive in 47.6% patients (31 out of 65 patients tested). Limitations: Prick test and patch test provide indirect evidence of hypersensitivity, with inherent limitations. Conclusion: Our study shows that chronic paronychia is probably a form of hand dermatitis associated with prolonged wet work, and that there is a higher incidence of contact sensitization and Candida hypersensitivity in these patients.

A Case of Chronic Paronychia Accompanied by Cutaneous Ossification / 대한피부과학회지

Cutaneous bone formation may be primary or secondary. If it is primary, there are no preceding cutaneous lesions. If it is secondary, bone forms through metaplasia within a preexisting lesion caused by inflammation, traumatic injury, and a neoplastic tumor. Paronychia is inflammation of the proximal nail fold and presents as painful periungual erythema, sometimes with associated purulence. Chronic paronychia is most commonly related to mechanical or chemical factors. Here, we report a case of chronic paronychia accompanied by cutaneous ossification in a 33-year-old woman who presented with a 2-year history of recurrent paronychia on the left first finger.

Three Cases of Retronychia / 대한피부과학회지

Retroncyhia shows ingrowth of the nail toward the proximal nail folds. Initial events start from minor trauma of the digital pulp that disturbs longitudinal nail growth. This disturbed growth of the nail changes the growth direction to the proximal nail folds, leading to persistent paronychia, formation of granulation tissue, and other nail changes. Simple avulsion is curative and can improve most symptoms. There are few reports about retronychia in the English literature, and we report 3 cases of retronychia here.