Candidial paronychia is common in females as prolongued water exposure is the main causative factor. This patient was male nevertheless same risk factors were present as he is a juice shop worker. Nail involvement of characteristic of this condition and a mixed bacterial infection is almost always present. I read an article about the role of immediate contact dermatitis to food allergens (?protein contact dermatitis) in the pathogenesis which I was not aware. What are the implications of this new finding in its treatment? If there is progression to total nail dystrophy Cushings and Raynauds need to be ruled out.
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The current thinking is Chronic paronychia is a type of cumulative insult or an irritant dermatitis sec to the effects of water,detergents etc.Yes there are some reports of protein contact dermatitis too,which can be established by open and closed patch testing!Chronic paronychia is one condition which is definitely an indication for prescribing 3 in 1 creams – steroid,antibacterial,antifungal combination.