Paronychia: The Daily PANCE Blueprint

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Paronychia: The Daily PANCE Blueprint

A 52-year-old patient presents with sudden painful redness and swelling around the fingernail after frequent nail biting. There is no fluctuance on exam. What is the most appropriate initial treatment?

A. Oral antifungal medication
B. Surgical drainage
C. IV fluids and IV antibiotics
D. Systemic corticosteroids
E. Topical antibiotics and warm water soaks

Answer and topic summary

The answer is E. Topical antibiotics and warm water soaks

Acute paronychia is a very common condition defined by inflammation of the nail folds. The most common bacterial causes are Staph aureus and Strep pyogenes. Risk factors include manicures, nail biting, and picking at nails. Clinical features include sudden onset of painful erythema and swelling. Sometimes an abscess will be present. In this patient’s case, there was no fluctuance and so topical antibiotic and warm water soaks would be appropriate.

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Smarty PANCE Content Blueprint Review:

Covered under ⇒ PANCE Blueprint Dermatology ⇒ Disorders of the Hair and Nails ⇒ Paronychia

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