FUNGAL INFECTIONS OF SKIN AND SUBCUTANEOUS TISSUE (A BONIFAZ, SECTION EDITOR)
Fungal Paronychia. Clinical, Diagnosis and Treatment Aspects
Published online: 8 July 2017
Springer Science+Business Media, LLC 2017
Purpose of Review The purpose of this study is to recognize
and expand the knowledge of mycotic paronychia as a vari-
able clinical condition due to various predisposing factors and
multiple fungal organisms.
Recent Findings Candida-associated mycotic paronychia is
common but other non-dermatophyte molds, such as
Fusarium, are identified as potential agents of paronychia
Summary Mycotic paronychia is characterized by inflamma-
tion of the proximal or lateral nail folds caused by certain
fungi. Mycological analysis is necessary to identify the causal
agent and prescribe an appropriate treatment. Further studies
are needed to know the involved microorganisms in the dis-
ease and the pathogenicity factors involved in this localized
area of the nail apparatus.
Keywords Chronic paronychia
The word paronychia comes from the root para,(around)and
onukh (nail) and literally means next to the nail .
Inflammation of the tissues surrounding the nail plate of the
fingers or toes is commonly referred to as paronychia, and less
commonly as perionyxis. Paronychia may be acute or chronic
and may be related to multiple local or systemic conditions,
drugs, as well as bacterial, viral, parasitic, or fungal infections.
Classification and treatment is based on the main cause .
Chronic paronychia can be defined as inflammation of the
proximal and or lateral fold of the nail for more than 6 weeks
. It is a frequent dermatological condition, especially in the
nails of the hands of adult women, usually of the hand and
dominant fingers. The most common sites are the right hand
and thumb, index, and middle fingers (Fig. 1a). Some of the
major predisposing factors for paronychia are trauma and con-
stant moisture, local irritants, finger sucking, housework,
washing clothes or dishes, cooking, and manicure treatments.
The loss of the cuticle or the periungual folds may allow the
entry and infection of fungal microorganisms and perpetuate
inflammation of the soft tissues [4–6].
The first report of mycotic paronychia associated with
yeasts is that of Kingery and Thienes in 1925, in fruit canners
. Fungal paronychia has been associated more frequently
with yeast infection by Candida and less common with other
yeasts or filamentous fungi [8–11].
In Candida paronychia, the onset is chronic paronychia with
loss of the cutaneous barrier, absence of the cuticle, and sep-
aration of proximal and lateral periungual folds. Constant ex-
posure to liquids, sugars, or irritants produces a humid envi-
ronment that favors colonization and infection by Candida
spp. . At the beginning, there is erythema and edema of
the proximal or lateral nail folds, followed by its separation
from the eponychium (Fig. 1b); transverse grooves, Beau’s
lines, and subsequent infection of the nail matrix that finalizes
This article is part of the Topical Collection on Fungal Infections of Skin
and Subcutaneous Tissue
* Martin Arce
Calle Tercera 7442-4, Centro, Tijuana, Baja California, Mexico
Hospital Angeles Tijuana, Tijuana, Mexico
Curr Fungal Infect Rep (2017) 11:98–103