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Chronic Paronychia — SCE Dermatology MCQ

Instant feedback + full explanation. One question, done properly.

HardNail DisordersChronic ParonychiaSCE Dermatology

A bartender has six months of boggy proximal nail-fold swelling and absent cuticles affecting several fingers. Candida grows from a swab, but there is no abscess. What is the best initial disease-directed plan?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Reduce wet work, restore barrier protection and use topical anti-inflammatory treatment

Explanation lettering: B = shown as A · E = shown as B · A = shown as E

D is correct. Chronic paronychia is usually an irritant inflammatory disorder caused by repeated wet work and loss of the cuticle seal; Candida commonly colonizes the damaged fold rather than acting as the sole driver. Management therefore centres on reducing water and irritant exposure, gloves and emollient barrier care, plus a topical corticosteroid or calcineurin inhibitor. Antifungal treatment is added when clinically indicated but does not replace barrier restoration. Incision is for a fluctuant acute abscess, and routine nail avulsion or prolonged antibiotics add morbidity without correcting the cause.

Reference: Primary Care Dermatology Society: paronychia: https://www.pcds.org.uk/clinical-guidance/paronychia