Nail bed inflammation

Synonyms in a broader sense

  • Onychie
  • Oncychitis
  • Onychia subungualis
  • Onychia maligna
  • Panaritium paraunguale
  • Paronychia
  • “circulation”

Definition

The nail bed is the part of the finger or toe that is covered by the nail and from which the nail grows. Nail bed inflammation is a mostly bacterial infection of the skin at this site and can affect both finger and toe nails. It manifests itself through the typical signs of inflammation, which include swelling, redness and pain. An accumulation of pus is also often found in the affected areas.

General information

Acute nail bed inflammation usually lasts about a week and regresses by itself, but in some cases it can spread and become chronic if left untreated or due to the additional occurrence of risk factors. There are two forms of nail bed inflammation, depending on whether it affects only the nail bed itself or also the surrounding area. If the inflammation only affects the nail bed itself and pus accumulates under the nail, it is called Panaritium subunguale (Panaritium is the general term for an infection of a finger or toe). If the inflammation quickly spreads to the skin around the nail bed, the area around the nail bed is particularly affected and is therefore also called “circulation” or in the Medical Panaritium paranguale.

Frequency

Nail bed inflammation is the most common infection of the fingers. Women are more frequently affected, as they are more prone to nail injuries as a result of manicures or pedicures. In addition, people with immune deficiencies, circulatory disorders, neurodermatitis and above all diabetes have an increased risk of getting a nail bed inflammation.

The triggers of the inflammation of the nail bed (nail bed inflammation) are usually bacteria, mostly from the strain of staphylococci, more rarely streptococci, but viruses or fungi can also be responsible for nail bed infections. These penetrate through wounds in the cuticle, which are often so small that they themselves go unnoticed, into the deeper lying tissue. The causes of the injuries are very diverse.

The skin below and at the edges of the nail can be wounded, for example, by nails cut too short, ingrown nails, nail biting, a torn cuticle, nails torn at the corners, long-lasting pressure on the nail, corns under the nail or even a splinter. In the case of toenails, shoes that are too tight can also cause injury. Bacterial infestation leads to a fast, fungal infestation to a rather slow inflammation development.

Diabetes is one of the risk factors. Diabetics are prone to infections, which softens the skin and makes it easier for bacteria to penetrate. For the same reason, frequent contact with cleaning agents and/or water also favors the development of nail bed inflammation.

The first sign of an acute nail bed inflammation is the reddening of the skin adjacent to the nail. This is followed by the development of the other typical signs of inflammation: The infected skin becomes hot and swells. The swelling causes sometimes severe pain, which usually has a throbbing character, caused by the pulse of the small blood vessels in the affected region.

Over time, a more or less pronounced accumulation of pus usually develops under the nail plate, which sometimes empties from the corners of the nails spontaneously or after applying pressure (nail bed inflammation). It is not uncommon for the skin around the nail to itch, especially in the initial phase of the inflammation. Pain and/or swelling may cause a severe limitation of the ability of the inflamed area to act.

In rare cases, an inflammation of the nail bed also leads to the development of fever or swelling of the lymph nodes. If the infection is not treated sufficiently, the nail may become deformed or even fall off completely. The symptoms of chronic nail bed inflammation differ slightly from those of the acute form.

Here, one usually finds only a reddish to bluish discoloration of the affected nail, pain is only very slight or absent completely, which often means that the inflammation is not noticed at all or only very late.In contrast to acute inflammation, the chronic form usually affects several nails. This type is particularly common on the toenails of diabetics. Pus is caused by the death of the body’s own inflammatory cells, which migrate into infected areas.

Pus-forming infections are usually caused by an inflammation with bacteria, which are therefore also called “pyogenic” (pus-producing) bacteria. In the case of nail bed inflammation, these are usually so-called “staphylococci“. These are also found on healthy human skin and only cause problems when they break through the barrier “skin”.

Pus is particularly frequent in the case of a so-called “Panaritium subunguale”. This is an inflammation of the cuticle under the nail, which is why pus usually emerges at the edges of the nail. Often, especially if the pus is located very close to the skin, the pus is transported to the surface by itself and pushed off there.

However, if the pus lies in deeper skin layers or under the nail, this is often not possible. In this case a surgical opening may be necessary. In most cases, pus can and must be opened and drained, as otherwise the germs can be “carried away”, for example into the bones.

Moreover, pus is often the cause of painful swelling. Since the nail bed and the nail receptacle are very sensitive, it can be pain-relieving to drain or express pus. However, it is advisable to leave this procedure to the professionals, namely surgeons or the family doctor!

Wild meat is a so-called “excessive granulation”. Due to the fact that tissue damage usually lasts longer, this leads to an increased healing reaction. The injured or non-existent tissue is not only replaced, but a kind of overgrowth develops.

This is usually very well supplied with blood and therefore appears pinkish red. The surface of the granulation tissue is roughly “granular”, as the name already suggests (granular=grainy). In the case of nail bed inflammation and especially ingrown nails, wild flesh is often formed because the body reacts in this way to the irritation caused by the nail or the inflammation.

If, as described above, an inflammation of the nail bed leads to a spread of the infection into deeper tissues, the bacteria may under certain circumstances enter the bloodstream. This can trigger a systemic inflammation, which is known as blood poisoning or “sepsis”. Symptoms of blood poisoning are fever, fatigue, decreased blood pressure, increased pulse, paleness and increased sweating.

Contrary to popular belief, there is no red line on the skin. Blood poisoning due to nail bed inflammation is extremely rare and occurs mainly in people with a weakened immune system. and symptoms of blood poisoning.