Onychia, paronychia, panaritium, nail bed inflammation
The nail bed is an anatomical structure that is located just below the fingernail and toenail. Within this tissue, especially bacterial pathogens and fungi can lead to the development of inflammatory processes (inflammation of the nail bed). In most cases, inflammation in this area is not just limited to the nail bed, but spreads to the surrounding nail region (especially in the nail fold, the nail wall and the cuticle). For this reason, the areas affected by inflammation of the nail bed are often not clearly delineated in everyday clinical practice and show smooth transitions.
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As a rule, the pathogens relevant for the development of inflammation of the nail bed reach the nail bed via the smallest wounds in the cuticle, nail fold or nail wall. Such Injuries can already be caused by daily nail care.
Immediately below the fingernail or toenail, these bacterial pathogens find an ideal habitat, can multiply undisturbed and cause inflammatory processes. The main pathogens that are relevant for the development of inflammation of the nail bed are found Staphylococci.
In addition, herpes viruses and Mushrooms lead to inflammation in the area of the nail bed. In addition to the acute forms of nail bed inflammation, inflammatory processes can also occur chronically in some of the affected patients.
In everyday clinical practice it can be observed that women in particular tend to develop inflammation in the nail bed. The reason is frequent use of nail scissors, arrows and corrosive nail polish remover.
In addition, people apply the very much dry skin show or close atopic Eczema (synonym: neurodermatitis) tend to develop inflammation at the nail bed as particularly at risk. This increased risk for the development of inflammatory processes in the area of the nail bed also applies to patients who suffer from diabetes mellitus and therefore have dry and / or cracked skin areas. Furthermore, especially people are with chronic circulatory disorders or one weakened immune system often affected by nail bed inflammation.
Inflammation at the nail bed usually starts with one minor injury to a phalanx of a finger or toe. Bacterial pathogens, viruses or fungi can penetrate the tissue through this small injury. Below the fingernail, the relevant pathogens find an ideal habitat in which they can settle and multiply undisturbed. Over time, the organism initiates various cascades of reactions - one pronounced inflammation of the nail bed. In most cases, the nail bed inflammation is caused by bacteria of the species "Staphylococcus aureus" caused. This pathogen is a Bacterium that can also be found on the healthy surface of the skin. Only a corresponding injury to the nail region and the entry of these germs into the tissue make disease possible.
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Symptoms of inflammation around the nail bed can be depending on the extent of the disease be differently pronounced. In most cases this shows up skin clearly in the area of the affected nail reddened.
In addition, patients with nail bed inflammation usually take one severe overheating of the nail which can spread to the beginning of the phalanx, true. Another typical symptom that indicates the presence of inflammation of the nail bed is the appearance of severe, throbbing pain.
Classically, the pounding perceived by the patient is synchronous with the heartbeat. Especially on the side edges of the nail wall and directly under the nail can small collections of pus form. However, the appearance of such accumulations of pus is in the case of an ordinary inflammation at the nail bed (synonym: Panaritium paraunguale) rather seldom.
If purulent secretion emerges from the infected nail bed, then it is an advanced inflammation which in medical terminology as "Panaritium subunguale" referred to as.
In addition, if there is a pronounced inflammation of the nail bed, there may be a significant restriction of movement come which is mainly due to the shooting pain with any movement. If an inflammation at the nail bed is not treated in time, the inflammatory processes can spread to neighboring structures and affect other parts of the finger or toe.
The tendons and bony structures are particularly at risk. In the case of particularly severe disease, it can happen that the Deformed nail plate or even completely detached from the infected nail bed. Compared to acute inflammation of the nail bed, chronic nail bed inflammation is usually much less painful. This type of inflammation of the nail bed usually occurs on several fingers or toes at the same time. In addition, the Nail fold usually in affected patients bluish or reddish discoloration. In the further course, both types of inflammation of the nail bed can lead to serious complications.
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Since the smallest injuries to the fingers or toes promote the development of inflammation at the nail bed, some risk factors could be determined. The smallest injuries through which, for example, bacterial pathogens can penetrate the tissue, occur primarily if the Fingernails or toenails are cut very short. In addition, it can Round off the toenails lead to the fact that the nail edges grow into the cuticle and enable bacterial transfer.
For this reason, toenails should always be cut straight and never rounded. In addition, the shelf-like carrying of too tight or small shoes as a risk factor for the development of inflammation at the nail bed. Even patients suffering from general illnesses like Diabetes mellitus sufferers have a significantly increased risk of inflammatory processes developing in the area of the nail bed. The reason for this is, for example, the limited sensitivity on the feet of those affected.
In addition, people with diabetes mellitus often suffer from impaired wound healing, which makes it easier for bacterial pathogens to penetrate. Another risk factor for the development of inflammation at the nail bed should not be underestimated frequent contact with water and / or chemical agents. There is an increased risk especially for people who are exposed to these substances due to their work and who do not protect their hands and feet adequately during their work.
Overview of risk factors:
The treatment of inflammation at the nail bed is based on the extent of the disease as well as on the time of diagnosis. If the inflammation at the nail bed is recognized as such at the beginning, applying an antiseptic ointment to the affected nail is sufficient in most cases. The affected finger or toe can then be bandaged with a sterile compress or bandage and the healing process can be awaited. If the disease has progressed so far that bacterial pathogens can be detected in the area of the wound, an additional antibiotic must be administered. The antibiotic usually has to be taken as a tablet. It fights the bacterial pathogens and in this way prevents the inflammatory processes from spreading to neighboring structures. In cases in which the inflammation at the nail bed was caused by fungi, an anti-fungal agent (antifungal) must be prescribed instead of an antibiotic. If there is no improvement within a week using these treatment methods, surgical therapy should be considered. In most cases, the affected patient is given a local anesthetic before the surgical procedure is conditional. The pus can then be drained from the wound under surgical conditions. Immediately after the surgical treatment of the inflammation at the nail bed, the affected hand or foot must be immobilized with a splint. Following treatment of the inflammation at the nail bed, the wound must be cleaned and re-bandaged by the doctor every day for a period of about a week. The affected patient is also asked to take care of the arm or foot, to cool it regularly and to position it as high as possible.
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Acute forms of inflammation at the nail bed can usually be treated much better than chronic nail bed inflammation. The latter should be examined at regular intervals by a doctor. In order to get the inflammatory processes under control, one usually has to trained foot care be included in the treatment.
The development of inflammation at the nail bed can often be prevented by simple measures. In this context it is important that Never push cuticles back completely or cut away. Otherwise, bacterial pathogens or fungi can penetrate the tissue much more easily, settle and trigger inflammatory processes. In addition, should when in contact with chemical cleaning agents protective measures are always taken. In most cases, that's enough Wear protective gloves to prevent inflammation at the nail bed.
