Candida paronychia

Candida paronychia is often difficult to treat. Topical treatment is insufficient the best therapeutic approach is intermittent (pulsed) itraconazole or fluconazole, following the schedules indicated in the treatment of dermatophyte onychomycosis. Prevention of candidosis is straightforward. It includes the avoidance of maceration at work. Chronic paronychia is best prevented by the use of appropriate gloves. The avoidance of contact with foods incriminated in the initiating protein contact dermatitis (assessed by positive prick tests) is mandatory. 

Cutaneous and mucocutaneous infections caused by Candida albicans, such as paronychia, oral thrush, and intertriginous candidiasis (Topical) Apply liberally to the affected area and rub in 2-4 times/day. 

Candida albicans can be isolated in the majority of cases of chronic paronychia. The yeast has traditionally been considered to play an etiological role in the condition, but bacteria and irritant or allergic contact dermatitis also play a role, although the contribution of each varies from patient to patient. A more recent proposal is the primary role of repeated contact with various kinds of foods. Proteins of foods could induce a protein contact dermatitis (Tosti et al. 1992) and, secondarily, an infection by Candida albicans. The primary role of the yeast is, therefore, minimised. Professions at risk, apart from those already quoted as prone to develop Candida intertrigo of the interdigital folds, include all categories... 

Fig. 13. Candida intertrigo of an interdigital fold with paronychia...

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