Panaritium - What Is It? Causes, Symptoms And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-15 09:49

Panaritium: causes, symptoms and treatment

According to statistics, panaritium is the reason for going to the doctor for 20-30% of patients (of the total mass of patients). This disease is accompanied by acute inflammation of the fingers or toes, from the side of the palms or from the sole. Also, the periungual spaces are involved in the pathological process.

Panaritium often leads to the development of a purulent process. If treatment is not started on time, phlegmon may develop. Although the superficial form of the disease is most often diagnosed.

Content:

• What is felon?
• Reasons for the appearance of felon
• Classification
• Stages of defeat
• Symptoms of felon
• Diagnostics
• Treatment of panaritium
• Complications
• Prevention of panaritium

What is felon?

Panaritium is a purulent inflammation of the fingers or toes. A variety of injuries, even minor skin damage, are capable of provoking its development. Through the damage, infection penetrates inside and causes acute inflammation.

A distinctive characteristic of felon is that it develops quickly. The pathological process extends not only to soft tissues, but also to bone structures. This is dangerous for the health of the skeletal system in general.

Reasons for the appearance of felon

The main cause of panaritium is an infection that penetrates the soft tissues of the patient. The entrance gate for it can be microscopic skin injuries, cuts, punctures, burns, abrasions, splinters. Sometimes even severe scratching or insect bites will cause inflammation.

Microbial flora leads to suppuration, namely:

• Staphylococci.
• Streptococci.
• Gonococci.
• Enterococci.

A mixed infection is sometimes observed. In addition, the herpetic and fungal nature of felon cannot be ruled out.

Panaritium is a contagious disease. The risk of infection increases if an abscess breaks out in a patient. In this case, it is strictly forbidden to use the same manicure accessories, towels and household items.

Risk factors for the development of panaritium:

• Poor treatment of the received wounds.
• Use of manicure supplies that have not been sterilized.
• Incorrect cutting of the nail plates.
• Wearing shoes that are inappropriate and poorly ventilated.
• Maceration of the skin.
• Diabetes.
• Vitamin deficiency.
• Immunodeficiency states.
• Microcirculation disorders in the fingers or toes. The reason can be constant vibrations, hypothermia of the limbs, the effect on the body of toxic substances, for example, quicklime, mineral oils or metals.
• Some chronic diseases: allergic dermatitis, psoriasis, systemic lupus erythematosus and other skin pathologies.

Classification

Panaritium may be purulent or serous. Depending on which tissues were involved in the pathological process and where the inflammation is concentrated, the following forms of the disease are distinguished:

Surface felon:

• Skin form. Compared to other types of the disease, it has the mildest course. The purulent process is concentrated in the epidermis.
• Paronychia or periungual felon. The inflammation is concentrated near the nail fold. The main cause of inflammation is manicure, which was performed in violation of technique.

Deep panaritium:

It is impossible to leave deep felon without treatment. If measures are not taken in time, the inflammation will spread to the fingers, hand and forearm. The patient will develop pandactylitis. A neglected form of the disease can cause limb amputation.

• Subcutaneous panaritium. Pus accumulates in the subcutaneous tissue on the palmar side of the fingers.
• Bone panaritium. Bone structures are involved in the pathological process.

• Subungual felon. Pus will build up under the nail.
• Articular panaritium. The inflammation spreads to the joints of the fingers.
• Tendon felon. Tendons of the extremities are affected.
• Pandactylitis. The disease develops when the purulent process spreads to all tissues of the limb. This is the most severe form of the disease and can lead to loss of fingers or even an arm.

Stages of defeat

There are 3 stages in the development of the disease:

1. First stage. The infection spreads to the soft tissue of the finger. During this period, symptoms of the disease may be absent.
2. The second stage is infiltration. A person's swelling increases, pains appear, the skin in the affected area turns red, becomes hot to the touch.
3. The third stage is an abscess. Pus melts the tissue of the infiltrate, leading to the formation of a specific cavity - an abscess.

It is possible to cope with panaritium without the help of a surgeon if the disease is at 1 or 2 stages of development. When an abscess is formed, surgery is indicated.

Symptoms of felon

Symptoms of felon are divided into general and local. Their intensity depends on the depth of tissue damage, on the type of pathogen and on the state of the human immune system.

Common symptoms of panaritium:

• Intoxication of the body: headache, heart palpitations, weakness, decreased performance.
• Increased body temperature.
• Fever.

Local symptoms of panaritium:

• Pain.
• Hyperemia of tissues.
• Swelling in the affected area.
• Local temperature rise.

Pus can show through tight skin. When the dermis breaks through, it comes out.

Not always panaritium is manifested by a slight increase in body temperature. Sometimes it immediately reaches 40 ° C. It is impossible to hesitate in contacting a specialist. Panaritium only at first glance seems to be a frivolous disease. In fact, inflammation can have dire health consequences.

Symptoms of panaritium may differ depending on the type of disease:

• Cutaneous panaritium leads to the formation of a purulent bladder on the finger. The skin turns red, pulsation is felt.
• Periungual felon is accompanied by tissue edema. They become hot to the touch. As the inflammation progresses, the periungual ridge forms a purulent focus. The person begins to be bothered by severe pain.
• The subcutaneous form of the disease is more common than others. The skin in the affected area turns red, becomes hot to the touch. The pain is pulsating, worse when touched.
• The subungual felon is accompanied by an accumulation of pus under the nail. It can be seen through the plate. The finger is swollen and difficult to move. There may be a significant deterioration in general well-being, an increase in body temperature to high levels.
• Bone panaritium. The patient's body temperature rises, severe pains appear. All symptoms of body intoxication are present.
• Articular panaritium. Pathology is accompanied by symptoms characteristic of the bone form of the disease, but is complemented by difficulties in flexing the joints.
• Tendon felon. The man complains of acute pain. They get worse when you try to move your fingers. The hand swells, the symptoms of intoxication of the body are pronounced.
• Pandactylitis. The patient has severe intoxication, purulent axillary lymphadenitis develops. This condition is dangerous for the development of sepsis.

Diagnostics

Doctors do not experience any difficulties in making a diagnosis. In order to determine panaritium, an external examination of the patient is sufficient. To determine the infectious flora that provoked inflammation, fluid is taken from the pustule.

To treat panaritium, the patient will need to contact both a therapist and a surgeon. The general practitioner examines the patient, makes a diagnosis and gives a referral to a narrow specialist. He, in turn, assesses the depth of tissue damage. Depending on this, the patient may be prescribed conservative treatment or surgery.

If the doctor cannot visualize pustules with pus, then he uses a bulbous probe. With its help, the place of maximum pain and the depth of inflammation are determined.

If there is a suspicion that the patient is developing felon of joints or tendons, then he is sent for an x-ray. To clarify the severity of the disease, a general blood test may be required to determine the leukocyte count and ESR.

Treatment of panaritium

Therapy depends on the stage of development of the disease, as well as on its type. It is possible to cope with pathology with conservative methods in the early stages.

Conservative treatment

Antibiotics: Amoxiclav, Ceftriaxone, Josamycin.

Antibacterial drugs are used, including when opening a purulent focus. They can also be prescribed to patients who do without surgical treatment.

• Anti-inflammatory drugs: Nimesulide.
• Antifungal agents: Fluconazole, Micoderil.
• Antipyretic: Efferalgan.
• Dressings with ointments that promote recovery: Vishnevsky ointment, Levomekol, Dioxidine ointment.

Ichthyol ointment is not used for the treatment of panaritium. It is considered ineffective unless the inflammation was caused by the herpes virus.

• Healing baths. Potassium permanganate and saline are diluted in them. You can use herbal decoctions.
• Lotions with Dimexidum.
• Physiotherapy: UHF, iontophoresis, ultraviolet irradiation. Such procedures help to reduce inflammation, improve the nutrition of the affected tissues, relieve swelling, and relieve pain.

It is strictly forbidden to open an abscess on your own. This can lead to the ingress of pus into the fiber, which will develop phlegmon. The risk of sepsis increases.

Sometimes even deep felon can be cured with conservative methods. To do this, you need to contact a doctor on time.

Surgery

Surgical intervention is the most effective method of treating panaritium. For the procedure, local anesthesia is most often done. If the inflammation has spread to the joints or bones, then general anesthesia is required.

Further stages of treatment:

• The doctor makes an incision and removes the pus, along with the dead tissue.
• The affected cavity is sanitized using antiseptics.
• A drain is inserted into the wound to drain the pus.
• A bandage is applied over the wound.

If necessary, the doctor can amputate the phalanx or the entire finger.

After the operation, the patient is prescribed pain relievers, antibiotics. The wound is regularly bandaged and treated with Furacilin or Betadine. For the fastest tissue restoration, physiotherapy is indicated.

Complications

Complications of panaritium include:

• Blood poisoning. At the same time, purulent foci are formed in other internal organs, and DIC syndrome develops. Sepsis often ends with the death of the patient.
• Purulent tendovaginitis with lesions of the synovial bags of the hands and forearm. This complication is most often caused by a panaritium focused on the I or V finger of the hand.
• Phlegmon brush.
• Osteomyelitis of the metacarpal and carpal bones.
• Vascular thrombosis with tissue necrosis, periphlebitis and thrombophlebitis of the extremities.
• Purulent lymphadenitis. Sometimes it is lymphadenitis and general intoxication of the body that become the first symptoms of panaritium.
• Finger contractures. This complication develops against the background of the articular or tendon form of the disease.

Prevention of panaritium

In order to prevent the development of panaritium, the following preventive measures must be observed:

• Keep your hands clean. However, it is not worth washing it too often, since overdried skin is easily injured, microcracks appear on it. They can act as gateways for infection.
• Use gloves when working with the ground, while cleaning. If not, then hands need to be treated with a protective cream. After completing their work, they are washed and lubricated with a fat cream.
• Observe safety rules when working with cutting tools. Especially when there is a high risk of infection entering the wound, for example, when peeling potatoes, or when cutting fish.
• Using your own nail supplies. During the processing of nails, you should try not to injure the skin and soft tissues. The cuticle should not be cut, it is enough to push it back.

Video: Elena Malysheva in the program Live Healthy "Finger suppuration"

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".