hi chronic paronychia is very resistant disease you have used almost all treatments which are actually recommended in this case. treatment also depend upon the incriminating factors of the disease, most of the time it is due to irritants which come in contact of your hand,, repeated washing also lead to increased fungal growth, sometimes on drugs also lead to this condition and some diseases also likes psoriasis, pemphigus, cancers at other sites of the body. so you can tell me if you are having any of these conditions but if not I will advise you following treatment plan according to the history that you are not able to take antifungals and antibiotics and topical has not worked on you. kindly follow this treatment for 4 weeks and then tell me with photo how much improvement you have. I must tell you at this moment that some cases medical treatment is not successful in such cases some surgical treatments has also been used like complete removal of the the nail folds. Rx tacrolimus 0.1%at night. hidrocortisone cream in morning both for 4 weeks. tab cefuroxime clavulinate 500mg twice daily for five days. avoid cold to body and hands. cover your hands with gloves to avoid contact with some allergens you may be exposed. review after 4 weeks.
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