Pathophysiology

Acute paronychia results from trauma to the cuticle or nail fold allowing bacteria or yeast to enter. Aggressive manicuring can contribute to this process in adults while nail biting and thumb sucking contribute in children. Excessive water exposure also softens the cuticle allowing for easier entry of organisms. Continued water exposure prevents the reforming of the cuticle, thus providing an environment for colonization of the area with bacteria or yeast. This process results in a chronic paronychia. The most common organisms found in acute paronychia include Staphylococcal and group A Streptococcal species. The organisms most likely involved in chronic cases are Candida, Staphylococcus, and pseudomonas.

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