Sometimes, our parents and friends will find that one of the baby's fingers or toes is suddenly red and swollen, the baby who cannot speak becomes crying all the time, and the baby who can speak will point to the red and swollen place and say that it hurts. The disease progresses very quickly, some come to the hospital with suppuration, and some severe nails have pus under the nails. This situation we can often see when we visit the emergency department, which is a relatively common disease, paronychia.
Paronychia of the fingers is suppurated
This is suppuration of paronychia of the toes
What is paronychia? How can it be avoided? How can it be treated?
The so-called paronychia, as the name suggests, is an infection of the small furrow next to our nails and the small flesh around it, which tends to have an acute onset and quickly suppurates if left unintervened. If the infection expands and the entire nail sulcus is involved, then periungualitis is present.
As we all know, skin and mucous membranes are the first line of defense of our human body, if our skin can remain intact, no breakage, no wounds, then the probability of infection will be extremely low, and the occurrence of paronychia, in fact, is also the infection caused by the invasion of bacteria through these defects. Therefore, in order to avoid the occurrence of paronychia, to put it bluntly, it is to protect the integrity of our periungual skin, or, when the skin is broken, intervene in time.
So what can happen to us during the first week?
1. Skin thorns
The production of skin thorns may be related to excessive dry skin or lack of vitamins. Therefore, in autumn and winter, you can properly apply oil to the hands, if it is a lack of vitamins, you need to supplement in moderation.
When there is a thorn, that is, the barb skin is cocked, the thorn should be cut in time to avoid peeling longer and deeper.
2. Nail root skin fissure
The two corners of the root of our nails are prone to nail root cracks or keratinized thorns, at this time, we should wash our hands with soap in time, seal and protect with adhesive tape after local cleaning and disinfection, and replace it in time if the tape is soiled by dirt.
3. Stabbing wounds
When our baby plays, especially when playing, it often ignores safety issues, and may be stabbed by sharp objects, which need to be disinfected in time, such as wiping with iodophor, but if the wound is larger and deeper, it is necessary to seek medical attention in time, and sometimes tetanus injections are required.
4. Trim your nails
Some parents like to cut the two sides of the front of the nail very short, which may cause damage during the nail trimming process, so it should not be too short when trimming the nail.
5. Suck your fingers
There is no good way to do this, or parents pay attention to correcting their children and developing good habits.
How to deal with:
In the early stages of paronychia, only some skin folds appear red, swollen, and painful, some may heal on their own, and some will quickly suppurate. We cannot hope for the disease itself, we should intervene early. For the early stage of paronychia, when there is only redness, swelling and pain, you can use hot water soaking, or iodophor soaking, 5-6 times a day, 20-30 minutes each time, and then apply antibiotic ointment, such as fusidic acid cream, Baiduobang or erythromycin ointment, etc.
If not treated promptly, or despite treatment, the infection worsens, causing subepidermal abscess or concomitant subungual abscess, incision and drainage of pus is required, and nail extraction is required in severe cases.
We have also seen some chronic paronychia clinically, mostly caused by improper treatment of repeated infections, these children have a relatively mild degree of redness, swelling and pain, but there is often inflammatory granulation tissue protruding from the skin surface at the nail sulcus, from time to time will secrete some pus, and it is easy to bleed by friction, which seems to be a small problem, but often affects the child's daily life.
In chronic paronychia, inflammatory granulation tissue is visible in the nail sulcus
For chronic paronychia, we need to come to the hospital and ask the doctor to remove the granulation tissue.
Paronychia rarely presents symptoms of systemic infection and generally does not require oral antibiotics. However, if the pain in the finger is severe and there is a sharp throbbing pain at the finger tip, it is necessary to be alert to purulent dactylitis, because severe purulent dactylitis may cause osteomyelitis of the terminal phalangeal, which is completely different from paronychia, and requires early use of antibiotics, and if suppuration, incision and drainage are required.
In convalescent paronychia, the wound is relatively dry and clean, can be exposed, and does not have to be bandaged!
In short, although paronychia is a "small problem", it is very common and can also cause inconvenience and pain to babies and parents. Therefore, prevention is greater than cure. We need to educate and cultivate good hygiene habits in children, and do a good job in hand hygiene and hand care.
Let's raise children scientifically together and make a little progress every day!
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【About author】Author: Xu Sheng, @青岛妇女儿童医院 Attending physician of pediatric oncology surgery,
【Douyin number】Pediatric surgeon Xu Sheng
【Good at treatment】I am good at common diseases in pediatric general surgery, urology and oncology surgery, skin and subcutaneous masses (dermoid cysts, calcified epitheliomas, pigmented nevi, hemangiomas, lymphangiomas, etc.) and abdominal tumors.
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