ABSTRACT
The most common cause of acute paronychia is direct or indirect trauma to the cuticle or the nail fold. Such trauma may be relatively minor, resulting from ordinary events, such as dishwashing, injury from a splinter or thorn, onychophagia (nail biting), biting or picking at a hangnail, fi nger sucking, ingrown nail, manicure procedures (trimming or pushing back the cuticles), artifi cial nail application, or other nail manipulation. Such trauma enables bacterial inoculation of the nail and subsequent infection. The most common causative pathogen is Staphylococcus aureus, although Streptococcus pyogenes, Pseudomonas pyocyanea, and Proteus vulgaris can also cause paronychia. In patients with exposure to oral fl ora, other anaerobic gram-negative bacteria may also be involved. Acute paronychia can also develop as a complication of an episode of chronic paronychia. Acute paronychia can also occur as a manifestation of other disorders affecting the digits, such as pemphigus vulgaris, lichen planus, psoriasis, acrodermatitis enteropathica, diabetes mellitus, drugs (acitretin, indinavir etc.), or tumors (Bowen’s disease, keratoacanthoma etc.).
