Nail bed inflammation (panaritium) is an inflammation of the nail fold, which can spread to the entire nail bed and surrounding structures. The inflammation is caused by the immigration of pathogens, which can migrate mainly through small tears in the skin (rhagades). The pathogen spectrum is usually bacterial staphylococci or streptococci, but nail bed inflammation can also occur at the base of a fungal infection or an infection with the herpes virus.
The symptoms
In most cases one notices a nail bed inflammation on the toe by an increased pain sensitivity of the affected toe. The affected toe is usually very red, swollen and overheated. The pain is often perceived as pulsating.
The entire inflammation usually begins with inflammation of the nail wall (paronychia) and then progresses as inflammation of the nail bed (panaritium subungunale). At this stage, one can usually see a pus bubble under the nail or in the nail wall. If the nail bed inflammation is not treated, it can spread to the adjacent tissue (Panaritium subcutanem).
In very severe cases, this superficial form of the infection can continue and lead to a detachment of the upper skin layer (Panaritium cutaneum). In this case, blistered distensions of the skin can be detected. The forms of nail bed inflammation listed so far are the superficial forms, which are to be distinguished from the deep forms.
The deep forms occur when the inflammation can progress unhindered into the surrounding tissue. This form can spread to the bone (Panaritium ossale) or to the tendons (Panaritium tendinosum). Sometimes the inflammation can also spread to the toe joints (Panaritium articulare).
Only in the case of advanced nail bed inflammation do the general signs of inflammation such as fever and chills appear. The pain can also be the reason for problems with walking in the lighter superficial forms. Pus is caused by an inflammation caused by bacteria.
The body reacts to the pathogens with cells of the immune system that kill the bacteria. Pus consists of decomposed bacteria and decayed defence cells. Therefore, the symptom pus in a nail bed inflammation at the toe is an indication of a bacterial cause.
It is important that the pus can drain off well in case of an inflammation so that it can heal. If pus forms under the nail plate, the outflow can be hindered by this. In such a case, a small surgical procedure must be performed to create a way for the pus to drain away.
This is done either by drilling a hole or by removing part of the nail plate under local anesthesia. Wild flesh (medically called granulation tissue) is formed during the healing of open wounds. In the case of nail bed inflammation on the toe, for example, an ingrown toenail can cause constant injury to the surrounding tissue.
As a result, germs such as bacteria or fungi repeatedly invade, so that a chronic inflammation with open sores can develop. In the area of these open places the body forms wild flesh. This is actually an intermediate stage of wound healing, but the chronic inflammation does not overcome it.
