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Acute Paronychia — SCE Dermatology MCQ

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EasyNail DisordersAcute ParonychiaSCE Dermatology

A 25-year-old woman presents with pain and swelling of her nail fold with purulent discharge around the nail of her index finger. Symptoms developed 3 days ago after a manicure. What is the most likely diagnosis and causative organism?

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Correct answer: B — Acute paronychia — Staphylococcus aureus

Acute paronychia presenting with rapid-onset pain, swelling, erythema, and purulent discharge of the nail fold is most commonly caused by Staphylococcus aureus. The manicure has likely introduced bacteria through a breach in the nail fold. Management includes warm soaks and oral Flucloxacillin; incision and drainage if an abscess has formed. Chronic paronychia (Candida) develops gradually over weeks with bolstering of the proximal nail fold and loss of cuticle, typically in those with frequent wet work. Herpetic whitlow shows grouped vesicles with pain disproportionate to appearance.

Reference: BAD 2016; NICE CKS Paronychia