Types of felon
The forms of panaritium are distinguished by the depth of the lesion. Superficial affects the skin and ridge around the nail, deep – subcutaneous tissue, tendons, bones and joints. The deeper the process, the higher the risk of irreversible consequences: tendon necrosis, osteomyelitis, finger stiffness. It is important to distinguish acute paronychia from chronic paronychia, which develops in people who constantly work in a damp environment and is often associated with fungi and dermatitis.
- Cutaneous - a purulent blister under the skin
- Periungual (paronychia)
- Subungual - pus under the nail plate
- Subcutaneous - on the palmar surface of the finger
- Tendon, bone and joint
- Pandactylitis - damage to all tissues of the finger
Reasons
The entry point for infection is the smallest lesions in the skin of the fingers. Most often these are cut or torn off hangnails, cuticles damaged during manicure, injections with thorns, fish bones, needles, splinters and small cuts. The risk increases for people who work with their hands in a damp environment, in the kitchen, in the garden, and in production. In children, inflammation often occurs due to the habit of biting nails and thumb sucking. Diabetes mellitus and circulatory disorders aggravate the course.
- Biting nails and hangnails
- Injuries during manicure
- Pricks, splinters, cuts
- Working with water, meat, fish, soil
- Diabetes mellitus
- Ingrown toenail
Symptoms
The beginning is redness and slight swelling near the nail or on the fingertip, a feeling of heat and fullness. Then the pain intensifies and becomes throbbing, especially at night and when the arm is lowered. With paronychia, the cushion becomes tense and pus appears under the skin. Subcutaneous panaritium is manifested by severe pain in the pad with mild redness. Tendon panaritium causes swelling of the entire finger, its semi-bent position and sharp pain when trying to straighten it.
- Redness and swelling
- Throbbing pain that gets worse at night
- Pus under the skin or nail
- Restriction of finger movements
- Increase in temperature with deep forms
- Detachment of the nail plate
Diagnostics
The surgeon examines the finger, finds the point of greatest pain and assesses how deep the inflammation has spread. If damage to a bone or joint is suspected, or if the process has been going on for more than a week, an x-ray is performed, although changes in the image do not appear immediately. Ultrasound helps to find accumulations of pus and foreign bodies. Culture of pus is needed if the flow is persistent. In patients with frequent purulent infections, blood sugar levels are checked.
- Examination and palpation by a surgeon
- X-ray of fingers
- Ultrasound of the soft tissues of the finger
- Culture of pus for sensitivity to antibiotics
- Complete blood count and glucose
Treatment and prevention
At the very beginning, while there is no pus, the doctor may prescribe warm baths, antiseptic dressings and, if necessary, antibiotics. If throbbing pain appears and purulent contents are visible, conservative treatment will no longer help: the surgeon, under local anesthesia, opens the lesion, removes the pus and drains the wound. During the subungual process, part of the nail is sometimes removed. Deep forms are operated on in a hospital. You cannot pierce an abscess or apply ointment compresses on your own.
- Do not pick or bite burrs
- Treat injections and cuts with an antiseptic
- Wear gloves when working with water and soil
- Choose a manicure with sterile instruments
- Don't push back the cuticle too aggressively
- Control sugar in diabetes
