Hand Case 15 History/Physical Exam

The patient will have rapid-onset swelling, erythema, and tenderness of the proximal and/or lateral nail fold.

Occasionally, there will be a history minor trauma to the area or exposure which increases the risk of paronychia development, including manicuring, nail biting, thumb sucking, or frequent water immersion (i.e. occupational dish washing). An ingrown nail can lead to paronychia, particularly in the toes. Paronychia frequently occurs, however, without predisposing factors.

Paronychia almost always involves a single digit. If multiple fingers are involved, this increases the concern for a medication-induced adverse event or drug-induced paronychia.