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70-Year-Old Female with Swelling of Lateral Distal Nail Fold

Can you diagnose this case?

David L. Kaplan 2014 Series Editor @ University of Missouri – Kansas City School of Medicine

Signs and Symptoms

A 70-year-old female presented with two days of sudden pain and swelling involving the lateral distal nail fold of one finger. She is otherwise healthy with no history of trauma or exposure.

How would you diagnose this nail condition?

Choose one to reveal diagnosis and discussion

Paronychia
Felon
Whitlow
Infectious flexor tenosynovitis
Ingrown fingernail

Answer: Paronychia

See the full case at Consultant360

This was a lateral nail fold paronychia presumed to be due to Staphyloccal aureus. It responded to a 1-week course of cephalexin.

Differential Diagnosis: Felon affects the distal fingertip pulp and whitlow is a herpes simplex infection of the digit. Infectious flexor tenosynovitis affects the palmar aspect of the finger and an ingrown fingernail is a foreign body reaction that can sometimes become secondarily infected.

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