Paronychia

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Painful red swellings of the nailfolds which may be due to bacteria or yeast infection.

I & D if abscess form

Medicine	Adult dose	Frequency
fluconazole po	200mg	Single Dose
clotrimazole cream	apply	twice daily

Acute Paronychia

Tenderness and presence of pus indicates systemic treatment with antibiotics is required:

Medicine	Adult dose	Frequency	Duration
erythromycin po	250-500mg [Paed = 125-250mg]	4 times a day	5 days
If Ineffective:
cloxacillin po	250-500mg [Paed = 125-250mg]	4 times a day	5-7 days

Chronic Paronychia

Often fungal - due to candida. Avoid excessive contact with water, protect from trauma and apply:

Treat secondary infection with antibiotics as above.

For both acute and chronic, incision and drainage may be needed