Snapshot A 25-year-old woman presents to the nail clinic for a painful middle finger. She obtains regular manicures, changing colors every 2 weeks. She recently had one a week ago and started feeling pain near the nail on her left middle finger. Her current medications include isotretinoin for treatment of acne. Physical exam reveals an erythematous proximal nail fold of the middle finger. When applying pressure to the nail plate, some pus drains from the nail. She is prescribed frequent warm soaks with chlorhexidine and oral antibiotics. Introduction Clinical definition login to view 7 more bullets Epidemiology Incidence login to view 1 more bullet Risk factors login to view 14 more bullets Etiology Acute paronychia login to view 5 more bullets Chronic paronychia login to view 2 more bullets Pathogenesis login to view 5 more bullets Presentation Symptoms login to view 1 more bullet Physical exam login to view 12 more bullets Studies Diagnosis is usually based on clinical history and physical exam Differential Trauma Herpetic whitlow login to view 1 more bullet Psoriasis Felon login to view 4 more bullets Treatment Conservative login to view 8 more bullets Medical login to view 19 more bullets Operative login to view 3 more bullets Complications Permanent nail plate dystrophy Prognosis Acute paronychia typically responsive to treatment Chronic paronychia is responsive to treatment, though responds very slowly login to view 1 more bullet