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Controversy: the role of yeasts in chronic paronychia: contra

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Controversy: the role of yeasts in chronic paronychia: contra
C. Ralph Daniel III, Melissa P. Daniel, F. Emily Bell
Abstracts of the Fifth Meeting of the European Nail Society:DOJ 9(1): 17F

USA.

Chronic paronychia is a very common condition. There are many disorders associated with chronic paronychia.1 For the purposes of this discussion; simple chronic paronychia will be discussed. (not associated with psoriasis, systemic disease, etc.)

We looked at 44 patients with simple chronic paronychia.2 Average age was 47, age range 1-85, 91% female. 81% grew yeast, on Mycosel and on plain Sabouraud’s agar with chloramphenicol. 55% grew Candida albicans on Mycosel agar alone. 93% gave a strong history of contact irritants.

It is the contention of this author that contact irritants are the primary problem in chronic paronychia and Candida plays a secondary role.

References

Daniel CR, Daniel MP, Gupta AK: Non-fungal Infections and Paronychia in Nails: Therapy Diagnosis Surgery, second edition. WB Saunders, Philadelphia, 163-171, 1997.

Daniel CR, Daniel MP, Daniel CM, Sullivan S, Ellis G: Chronic Paronychia and Onycholysis: A Thirteen Year Experience. Cutis 58: 397-401, 1996.

Daniel CR, Elewski BE: Candida as a Nail Pathogen in Healthy Patients. J Miss State Med Assoc 36: 3-39, 1995.

Tosti A, Guerra L, Morelli R, et al: Role of Foods in Pathogenesis of Chronic Paronychia. J Amer Acad Dermatol 27: 706-709, 1992.

Daniel CR, Gupta AK, Daniel MP, Sullivan S: Candida Infection of the Nail: Role of Candida as a Primary or Secondary Pathogen. Intern J Dermatol 37:904-907, 1998.

Daniel CR, Daniel MP, Sullivan S: Chronic Paronychia and Onycholysis: Management Considerations for Optimal Therapeutic Results. Nashville, Summer AAD, August 2000. (Poster)

Tosti A, Piraccini BM, Ghetti E, et al: Topical Steroids versus Systemic Antifunga’s in the Treatment of Chronic Paronychia: An Open Randomized Double blind and Double Dummy Study. J Amer AC Dermatol 47: 73076, 2002.

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