Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Quality in Sport

Whitlow, felon and paronychia - a clinical review of superficial hand infections
  • Home
  • /
  • Whitlow, felon and paronychia - a clinical review of superficial hand infections
  1. Home /
  2. Archives /
  3. Vol. 24 (2024) /
  4. Health Sciences

Whitlow, felon and paronychia - a clinical review of superficial hand infections

Authors

  • Mikołaj Domański Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0004-1581-6640
  • Natalia Wierzejska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0006-5373-400X
  • Barbara Kopczyńska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0007-5944-0165
  • Oliwia Czyżniewska School of Medicine, Collegium Medicum, University of Warmia and Mazury, Oczapowskiego 2, 10-719 Olsztyn, Warmińsko-mazurskie, Poland https://orcid.org/0009-0003-0388-0269
  • Karolina Czupryńska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0007-8932-2688
  • Karina Otręba Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0009-9655-5353
  • Julia Szałajska Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0007-8866-5419
  • Maria Wojcieszek Medical University of Warsaw, Żwirki i Wigury 61, 02-091 Warsaw, Poland https://orcid.org/0009-0008-3807-7317

DOI:

https://doi.org/10.12775/QS.2024.24.55531

Keywords

paronychia, nail diseases, skin diseases, infections

Abstract

Paronychia, felon and herpetic whitlow are common superficial hand infections. Although having similarities there are many differences between clinical presentation and treatment. Paronychia can present as acute and chronic condition. Treatment options varies from medical to surgical therapy. Formed abscesses may require drainage and possible antibiotic course. Herpetic whitlow is rare manifestation of hand infection with unique treatment options. Chronic infections differs in etiology and clinical presentation and need specialized treatment. Role of noninfectious causes should always be considered, including malignancy if no adequate treatment response is gained.  Making correct diagnosis, followed by adequate treatment will prevent huge range of complications. Article reviews common hand infections, presentation, diagnosis and treatment strategies.

References

Patel DB, Emmanuel NB, Stevanovic M V., et al. Hand Infections: Anatomy, Types and Spread of Infection, Imaging Findings, and Treatment Options. https://doi.org/101148/rg347130101. 2014;34(7):1968-1986. doi:10.1148/RG.347130101

Barger J, Garg R, Wang F, Chen N. Fingertip Infections. Hand Clin. 2020;36(3):313-321. doi:10.1016/J.HCL.2020.03.004

Jebson PJL. INFECTIONS OF THE FINGERTIP: Paronychias and Felons. Hand Clin. 1998;14(4):547-555. doi:10.1016/S0749-0712(21)00416-9

Shafritz AB, Coppage JM. Acute and chronic paronychia of the hand. J Am Acad Orthop Surg. 2014;22(3):165-174. doi:10.5435/JAAOS-22-03-165

Lomax A, Thornton J, Singh D. Toenail paronychia. Foot Ankle Surg. 2016;22(4):219-223. doi:10.1016/J.FAS.2015.09.003

Shin JO, Roh D, Son JH, et al. Onychophagia: detailed clinical characteristics. Int J Dermatol. 2022;61(3):331-336. doi:10.1111/IJD.15861

Fowler JR, Ilyas AM. Epidemiology of Adult Acute Hand Infections at an Urban Medical Center. J Hand Surg Am. 2013;38(6):1189-1193. doi:10.1016/J.JHSA.2013.03.013

Dellinger EP, Wertz MJ, Miller SD, Coyle MB. Hand infections. Bacteriology and treatment: a prospective study. Arch Surg. 1988;123(6):745-750. doi:10.1001/ARCHSURG.1988.01400300091016

Chang P. Diagnosis using the proximal and lateral nail folds. Dermatol Clin. 2015;33(2):207-241. doi:10.1016/J.DET.2014.12.004

Houshian S, Seyedipour S, Wedderkopp N, Ellis M, Ain A. Epidemiology of bacterial hand infections. International Journal of Infectious Diseases. 2006;10:315-319. doi:10.1016/j.ijid.2005.06.009

Periungual Tissue Disorders. A Text Atlas of Nail Disorders. Published online March 6, 2021:125-176. doi:10.3109/9780203427200-10/PERIUNGUAL-TISSUE-DISORDERS-ROBERT-BARAN

Spiegel JD, Szabo RM. A protocol for the treatment of severe infections of the hand. J Hand Surg Am. 1988;13(2):254-259. doi:10.1016/S0363-5023(88)80060-1

Tomczak H, Dańczak-Pazdrowska A, Polańska A, et al. Microbiological analysis of acute infections of the nail fold on the basis of bait thread test. Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii. 2017;34(2):110. doi:10.5114/ADA.2017.67072

Durdu M, Ruocco V. Clinical and cytologic features of antibiotic-resistant acute paronychia. J Am Acad Dermatol. 2014;70(1). doi:10.1016/J.JAAD.2013.09.042

NASIR A, NASIR L. Counseling on Early Childhood Concerns: Sleep Issues, Thumb-Sucking, Picky Eating, School Readiness, and Oral Health. Am Fam Physician. 2015;92(4):274-278. Accessed May 5, 2024. https://www.aafp.org/pubs/afp/issues/2015/0815/p274.html

Milbar HC, Forrestel AK, Rubin AI. Acute Paronychia and Onychomadesis after a “Russian” Manicure: A New, Aggressive, and Destructive Form of Manicure for Dermatologists to Recognize. Skin Appendage Disord. 2022;8(6):497-499. doi:10.1159/000525023

Rabarin F, Jeudy J, Cesari B, et al. Acute finger-tip infection: Management and treatment. A 103-case series. Orthopaedics & Traumatology: Surgery & Research. 2017;103(6):933-936. doi:10.1016/J.OTSR.2017.03.024

HOCHMAN LG. Paronychia: more than just an abscess. Int J Dermatol. 1995;34(6):385-386. doi:10.1111/J.1365-4362.1995.TB04436.X

Ritting AW, O’Malley MP, Rodner CM. Acute Paronychia. J Hand Surg Am. 2012;37(5):1068-1070. doi:10.1016/J.JHSA.2011.11.021

Saul D, Roch J, Lehmann W, Dresing K. [Oberst’s block anesthesia]. Oper Orthop Traumatol. 2020;32(1):18-22. doi:10.1007/S00064-019-00633-Y

Szinnai G, Schaad UB, Heininger U. Multiple herpetic whitlow lesions in a 4-year-old girl: case report and review of the literature. Eur J Pediatr. 2001;160(9):528-533. doi:10.1007/S004310100800

Pierrart J, Delgrande D, Mamane W, Tordjman D, Masmejean EH. Acute felon and paronychia: Antibiotics not necessary after surgical treatment. Prospective study of 46 patients. Hand Surg Rehabil. 2016;35(1):40-43. doi:10.1016/J.HANSUR.2015.12.003

Kapellen TM, Galler A, Kiess W. Higher frequency of paronychia (nail bed infections) in pediatric and adolescent patients with type 1 diabetes mellitus than in non-diabetic peers. J Pediatr Endocrinol Metab. 2003;16(5):751-758. doi:10.1515/JPEM.2003.16.5.751

Pierrart J, Delgrande D, Mamane W, Tordjman D, Masmejean EH. Acute felon and paronychia: Antibiotics not necessary after surgical treatment. Prospective study of 46 patients. Hand Surg Rehabil. 2016;35(1):40-43. doi:10.1016/J.HANSUR.2015.12.003

ROCKWELL PG. Acute and Chronic Paronychia. Am Fam Physician. 2001;63(6):1113-1117. Accessed May 6, 2024. https://www.aafp.org/pubs/afp/issues/2001/0315/p1113.html

Al-Qattan MM, Helmi AA. Chronic hand infections. J Hand Surg Am. 2014;39(8):1636-1645. doi:10.1016/J.JHSA.2014.04.003

Rigopoulos D, Gregoriou S, Belyayeva E, Larios G, Kontochristopoulos G, Katsambas A. Efficacy and safety of tacrolimus ointment 0.1% vs. betamethasone 17-valerate 0.1% in the treatment of chronic paronychia: an unblinded randomized study. Br J Dermatol. 2009;160(4):858-860. doi:10.1111/J.1365-2133.2008.08988.X

Tosti A, Piraccini BM, Ghetti E, Colombo MD. Topical steroids versus systemic antifungals in the treatment of chronic paronychia: An open, randomized double-blind and double dummy study. J Am Acad Dermatol. 2002;47(1):73-76. doi:10.1067/MJD.2002.122191

Litaiem N, Drissi H, Zeglaoui F, Khachemoune A. Retronychia of the toenails: a review with emphasis on pathogenesis, new diagnostic and management trends. Arch Dermatol Res. 2019;311(7):505-512. doi:10.1007/S00403-019-01925-W

Wollina U. Systemic Drug-induced Chronic Paronychia and Periungual Pyogenic Granuloma. Indian Dermatol Online J. 2018;9(5):293. doi:10.4103/IDOJ.IDOJ_133_18

García-Silva J, Almagro M, Peña-Penabad C, Fonseca E. Indinavir-induced retinoid-like effects: incidence, clinical features and management. Drug Saf. 2002;25(14):993-1003. doi:10.2165/00002018-200225140-00002

Keating GM. Ledipasvir/Sofosbuvir: A review of its use in chronic hepatitis c. Drugs. 2015;75(6):675-685. doi:10.1007/s40265-015-0381-2

Iorizzo M. Tips to treat the 5 most common nail disorders: brittle nails, onycholysis, paronychia, psoriasis, onychomycosis. Dermatol Clin. 2015;33(2):175-183. doi:10.1016/J.DET.2014.12.001

Haneke E. Nail psoriasis: clinical features, pathogenesis, differential diagnoses, and management. Psoriasis (Auckl). 2017;7:51-63. doi:10.2147/PTT.S126281

Does A Vander, Gamret AC, Yosipovitch G. Nail Loss in Mild to Moderate Pemphigus Vulgaris. Skin Appendage Disord. 2022;8(6):504-507. doi:10.1159/000525462

Relhan V, Goel K, Bansal S, Garg VK. Management of Chronic Paronychia. Indian J Dermatol. 2014;59(1):15. doi:10.4103/0019-5154.123482

Roy B, Lipner SR. A Review of Nail Changes in Acrokeratosis Paraneoplastica (Bazex Syndrome). Skin Appendage Disord. 2021;7(3):163. doi:10.1159/000513828

Widya Monica P, Ishitsuka Y, Kawakita H, et al. Nail apparatus squamous cell carcinoma mimicking paronychia. J Dermatol. 2019;46(12):e460-e461. doi:10.1111/1346-8138.15084

Curtis KL, Lipner SR. Metastases to the nail unit and distal phalanx: a systematic review. Arch Dermatol Res. 2023;315(3):347-358. doi:10.1007/S00403-022-02411-6

Wöckel W, Meerbach W, Willnow U. [Metastasising squamous-cell carcinoma of the skin in a ten-year-old girl]. Dtsch Med Wochenschr. 1979;104(31):1104-1107. doi:10.1055/S-0028-1129048

Gupta AK, Baran R. Ciclopirox nail lacquer solution 8% in the 21st century. J Am Acad Dermatol. 2000;43(4 Suppl):S96-102. doi:10.1067/mjd.2000.109068

Bednar MS, Lane LB. Eponychial marsupialization and nail removal for surgical treatment of chronic paronychia. J Hand Surg Am. 1991;16(2):314-317. doi:10.1016/S0363-5023(10)80118-2

Sechi A, Zengarini C, Piraccini BM, et al. Treatment of retronychia: A systematic review and suggested treatment algorithm. Dermatol Ther. 2022;35(2). doi:10.1111/DTH.15251

Pabari A, Iyer S, Khoo CT. Swiss roll technique for treatment of paronychia. Tech Hand Up Extrem Surg. 2011;15(2):75-77. doi:10.1097/BTH.0B013E3181EC089E

Dulski A, Edwards CW. Paronychia. The American Journal of Surgery. 2023;36(1):362-365. doi:10.1016/S0002-9610(37)90847-X

Koshy JC, Bell B. Hand Infections. J Hand Surg Am. 2019;44(1):46-54. doi:10.1016/J.JHSA.2018.05.027

Watson PA, Jebson PJ. The natural history of the neglected felon. Iowa Orthop J. 1996;16:164. Accessed May 17, 2024. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2378126/

Dikhtyar A, Stack LB. Felon caused by foreign body. Vis J Emerg Med. 2021;24:101059. doi:10.1016/J.VISJ.2021.101059

Nardi NM, McDonald EJ, Syed HA, Schaefer TJ. Felon. StatPearls. Published online April 30, 2024. Accessed May 17, 2024. https://www.ncbi.nlm.nih.gov/books/NBK430933/

Rabarin F, Jeudy J, Cesari B, et al. Acute finger-tip infection: Management and treatment. A 103-case series. Orthop Traumatol Surg Res. 2017;103(6):933-936. doi:10.1016/J.OTSR.2017.03.024

Blumberg G, Long B, Koyfman A. Clinical Mimics: An Emergency Medicine-Focused Review of Cellulitis Mimics. J Emerg Med. 2017;53(4):475-484. doi:10.1016/J.JEMERMED.2017.06.002

Subramaniam S, Bober J, Chao J, Zehtabchi S. Point-of-care Ultrasound for Diagnosis of Abscess in Skin and Soft Tissue Infections. Acad Emerg Med. 2016;23(11):1298-1306. doi:10.1111/ACEM.13049

Adhikari S, Blaivas M. Sonography first for subcutaneous abscess and cellulitis evaluation. J Ultrasound Med. 2012;31(10):1509-1512. doi:10.7863/JUM.2012.31.10.1509

Tosti R, Ilyas AM. Empiric Antibiotics for Acute Infections of the Hand. J Hand Surg Am. 2010;35(1):125-128. doi:10.1016/J.JHSA.2009.10.024

Koshy JC, Bell B. Hand Infections. J Hand Surg Am. 2019;44(1):46-54. doi:10.1016/J.JHSA.2018.05.027

Langer MF, Grünert JG. [Diagnostic and therapeutic Problems in Paronychia and Felons]. Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V. 2021;53(3):259-266. doi:10.1055/A-1472-2030

Franko OI, Abrams RA. Hand infections. Orthop Clin North Am. 2013;44(4):625-634. doi:10.1016/J.OCL.2013.06.014

Kilgore ES, Brown LG, Newmeyer WL, Graham WP, Davis TS. Treatment of felons. The American Journal of Surgery. 1975;130(2):194-198. doi:10.1016/0002-9610(75)90370-0

INFECTIONS OF THE HAND - TeachMe Orthopedics. Accessed May 17, 2024. https://teachmeorthopedics.info/infections-of-the-hand/

Mohler A. Herpetic whitlow of the toe. J Am Board Fam Pract. 2000;13(3):213-215. doi:10.3122/15572625-13-3-213

Saleh D, Yarrarapu SNS, Sharma S. Herpes Simplex Type 1. StatPearls. Published online August 28, 2023. Accessed May 19, 2024. https://www.ncbi.nlm.nih.gov/books/NBK482197/

Lewis MAO. Herpes simplex virus: an occupational hazard in dentistry. Int Dent J. 2004;54(2):103-111. doi:10.1111/J.1875-595X.2004.TB00263.X

Get the lowdown on ankle and foot ulcers. Nursing (Brux). 2010;40(1):42-43. doi:10.1097/01.NURSE.0000365917.01384.E7

Lewis MAO. Herpes simplex virus: an occupational hazard in dentistry. Int Dent J. 2004;54(2):103-111. doi:10.1111/J.1875-595X.2004.TB00263.X

Browning WD, McCarthy JP. A Case Series: Herpes Simplex Virus as an Occupational Hazard. Journal of Esthetic and Restorative Dentistry. 2012;24(1):61-66. doi:10.1111/J.1708-8240.2011.00469.X

Lieberman L, Castro D, Bhatt A, Guyer F. Case report: Palmar herpetic whitlow and forearm lymphangitis in a 10-year-old female. BMC Pediatr. 2019;19(1). doi:10.1186/s12887-019-1828-5

Feder HM, Long SS. Herpetic Whitlow: Epidemiology, Clinical Characteristics, Diagnosis, and Treatment. American Journal of Diseases of Children. 1983;137(9):861-863. doi:10.1001/archpedi.1983.02140350035009

Lieberman L, Castro D, Bhatt A, Guyer F. Case report: Palmar herpetic whitlow and forearm lymphangitis in a 10-year-old female. BMC Pediatr. 2019;19(1):1-4. doi:10.1186/S12887-019-1828-5/FIGURES/2

Belongia EA, Goodman JL, Holland EJ, et al. An Outbreak of Herpes Gladiatorum at a High-School Wrestling Camp. New England Journal of Medicine. 1991;325(13):906-910. doi:10.1056/nejm199109263251302

Rerucha CM, Ewing JT, Oppenlander KE, Cowan WC. Acute Hand Infections. Am Fam Physician. 2019;99(4):228-236. Accessed May 19, 2024. https://www.aafp.org/pubs/afp/issues/2019/0215/p228.html

Gill MJ, Bryant HE. Oral acyclovir therapy of recurrent herpes simplex virus type 2 infection of the hand. Antimicrob Agents Chemother. 1991;35(2):382. doi:10.1128/AAC.35.2.382

Nikkels AF, Pièrard GE. Treatment of mucocutaneous presentations of herpes simplex virus infections. Am J Clin Dermatol. 2002;3(7):475-487. doi:10.2165/00128071-200203070-00004

Downloads

  • PDF

Published

2024-10-10

How to Cite

1.
DOMAŃSKI, Mikołaj, WIERZEJSKA, Natalia, KOPCZYŃSKA, Barbara, CZYŻNIEWSKA, Oliwia, CZUPRYŃSKA, Karolina, OTRĘBA, Karina, SZAŁAJSKA, Julia and WOJCIESZEK, Maria. Whitlow, felon and paronychia - a clinical review of superficial hand infections. Quality in Sport. Online. 10 October 2024. Vol. 24, p. 55531. [Accessed 13 June 2025]. DOI 10.12775/QS.2024.24.55531.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 24 (2024)

Section

Health Sciences

License

Copyright (c) 2024 Mikołaj Domański, Natalia Wierzejska, Barbara Kopczyńska, Oliwia Czyżniewska, Karolina Czupryńska, Karina Otręba, Julia Szałajska, Maria Wojcieszek

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Stats

Number of views and downloads: 232
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

paronychia, nail diseases, skin diseases, infections
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop