The patient will come with finger or toe pain that is either chronic and recurrent in nature or has developed rapidly over the past several hours, accompanied by redness and swelling of the nail fold. This also occurs with individuals whose hands are frequently macerated. The third variety of paronychia is a subungual abscess, which occurs in the same location as a subungual hematoma, between the nail plate and the nail bed. When candidiasis is suspected, the area should be kept dry and treated with local applications of nystatin.
Surgical followup is important.
Fungal nail infections can be treated with topical preparations like Fungi-Nail. A more aggressive approach, and one more likely to be successful, is to sharply excise the affected portion of the nail, nailbed and matrix down to the periosteum of the distal phalynx. The patient is instructed to soak the toe in warm water for 20 min bid. There is no need usually to make an incision and therefore a digital block should not be necessary. The patient should be informed that if the paronychia quickly recurs, excision of a portion of the nail might be required.