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I have an itchy bump around the second toe nail. What is it?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hello doctor,

I have an itchy bump around the nail of one of my toes, the second one. It has happened in the past years, usually when the season gets warmer. It started about a month ago and grew into a quite itchy, sensitive and swollen area. It is now turning to purple. I tried antifungals before, but it was hard to know whether they made a difference. Please help.

Thanks.

Answered by Dr. Suvash Sahu

Hi,

Welcome to icliniq.com.

I have read your concern.

I have examined your pictures (attachment removed to protect patient identity). It seems that you are having paronychia. Acute paronychia is a soft tissue infection around a fingernail that begins as cellulitis, but that may progress to a definite abscess. It is a painful and pus containing condition; most frequently caused by Staphylococci.

I hope this information will help you.

Thanks.

The Probable causes

Ingrowing nail.

Investigations to be done

1. Gram staining and culture. 2. Potassium hydroxide (KOH) 5 % smears.

Treatment plan

1. Acute paronychia without obvious abscess can be treated nonsurgically like in your case. 2. I suggest tablet Augmentin 625 mg thrice daily (combination of Amoxicillin and Clavulanic acid) for five days and 1 % Clotrimazole plus Fusidic acid cream twice daily for one week. Consult your specialist doctor, discuss with him or her and take the medicine with consent.

Preventive measures

Cut the nail from the side as it grows from the side and cause recurrent problem. Also, do not use tight foot wear.

Regarding follow up

Revert back after a week to a dermatologist online.
Answered byDr. Suvash Sahu
Medically reviewed byiCliniq medical review team
Published At August 3, 2016
Reviewed AtOctober 15, 2024

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Dr. Suvash Sahu
Dr. Suvash Sahu

Dermatology

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