Başkent University Faculty of Medicine, Department of Dermatology, Adana Hospital, Adana, Turkey.
Department of Dermatology, Second University of Naples, Naples, Italy.
J Am Acad Dermatol. 2014 Jan;70(1):120-6.e1. doi: 10.1016/j.jaad.2013.09.042.
Acute paronychia usually is treated as a bacterial infection, but antibiotic-resistant acute paronychia may be caused by other infectious and noninfectious problems.
We sought to describe the clinical, etiologic, cytologic, and therapeutic features of antibiotic-resistant acute paronychia.
A retrospective review of medical records and cytology was performed in 58 patients (age, 1 month-91 years; 36 children and adolescents [62%] and 22 adults [38%]) who had antibiotic-resistant acute paronychias.
Causes of paronychia included bacteria (25 patients [43%]), viruses (21 patients [36%]), fungi (5 patients [9%]), drugs (3 patients [5%]), pemphigus vulgaris (3 patients [5%]), and trauma (1 patient [2%]). Diagnostic cytologic findings were noted in 54 patients (93%); no diagnostic cytologic findings were present with drug-induced (3 patients) or traumatic (1 patient) paronychia. The most common predisposing factors were the habits of finger- or thumb-sucking (14 patients [24%]) and nail-biting (11 patients [19%]). Complications included id reaction with erythema multiforme in 3 patients (5%).
Limitations include retrospective study design from 1 treatment center.
Antibiotic-resistant acute paronychia may be infectious or noninfectious. Cytologic examination with Tzanck smear may be useful diagnostically and may prevent unnecessary use of antibiotics and surgical drainage.
急性甲沟炎通常被视为细菌感染，但抗生素耐药性急性甲沟炎可能由其他传染性和非传染性问题引起。
我们旨在描述抗生素耐药性急性甲沟炎的临床、病因、细胞学和治疗特征。
对 58 例（年龄 1 个月至 91 岁；36 例儿童和青少年[62%]和 22 例成年人[38%]）抗生素耐药性急性甲沟炎患者的病历和细胞学进行回顾性研究。
甲沟炎的病因包括细菌（25 例[43%]）、病毒（21 例[36%]）、真菌（5 例[9%]）、药物（3 例[5%]）、寻常性天疱疮（3 例[5%]）和创伤（1 例[2%]）。54 例（93%）患者有诊断性细胞学发现；药物诱导（3 例）或创伤性（1 例）甲沟炎无诊断性细胞学发现。最常见的诱发因素是吮指（14 例[24%]）和咬甲（11 例[19%]）习惯。并发症包括 3 例（5%）患者出现红斑多形性反应。
局限性包括来自 1 个治疗中心的回顾性研究设计。
抗生素耐药性急性甲沟炎可能是传染性或非传染性的。Tzanck 涂片细胞学检查在诊断上可能有用，并可防止不必要地使用抗生素和外科引流。
