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Forum Name: Other infections

Question: Swelling of skin on toe after ripping off a deep hangnail.


 Outdoorsman - Fri Jul 16, 2010 6:44 pm

I have a severely sore toe that is infected after ripping a hangnail off. It is swollen, and there is a lot of pain and what seems almost like skin or tissue that is sitting against my toe, that I can barely stand to touch. I have tried antibiotic ointments in band-aids overnight with regular hydrogen peroxide treatments during the day. It seemed to be getting better but is now worse after we tried draining it with a very small needle. My father is an EMT and flebotomist, and my stepmother was an LPN for 23 years, they think it could possibly be an ingrown toenail, but I am not so sure.
 Dr.M.Aroon kamath - Tue Jul 20, 2010 5:17 am

User avatar Hi,
Your history strongly suggests an acute paronychia.

Paronychia is a soft tissue infection which arises close to the finger/toe nail.It is caused by damage to the nail's cuticle which normally acts as a barrier between the skin of the nail fold and the nail.

There are two types,
- acute and
- chronic.

Predisposing factors:
Diabetes mellitus, immunocompromise, constant wetting of fingers(certain professions, homemakers, nail biting/sucking fingernails, ingrown nails, improper technique of nail manicuring, drug therapy(steroids) etc.

Infection usually starts at one of the collateral nail folds or proximal nail fold. If untreated, it can spread around the nail or even under the nail.

Most common causative organism is staph aureus but, other organisms may also be involved.

Early cases are managed non-operatively (Warm water soaks, elevating the limb, oral antibiotics and analgesics).

More advanced cases may go on to form an abscess that may need incision and drainage.

In your case, you need to see a surgeon and get it sorted out.
Best wishes!

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