Woman's hands are her calling card. They are always in sight. Therefore, for most beauties, a weekly manicure in the salon is a mandatory procedure. Unfortunately, clients rarely think that the next trip to the master may end badly. The procedure can cause the development of such a pathology as subcutaneous panaritium. The disease often leads to the removal of the nail. It also provokes the development of even more serious complications.
Purulent inflammation of the finger
At the very base of the nail plate is a small area of living skin. This is an eponymy. But most call it cuticle. This epithelial thin film surrounds the nail plate in the area of the hole. Its main role is protective. Thin skin is a barrier to foreign bodies and bacteria. Thanks to the cuticle, they are not able to penetrate into the growth zone of the nail.
Cutting off eponychies is not recommended. If you do this, it begins to grow stronger and becomes coarser. A similar mechanism can be observed with the formation of scars.
In the event that for some reason the eponychium is damaged, the gates for infection open. Most often this happens during a manicure. In addition, it can be observed during games in children. Pyogenic microbes penetrate the tissue. For example: staphylococcus or streptococcus. Sometimes mixed microflora is also diagnosed.
In most cases, localization of subcutaneous panaritium occurs on the palmar surface. Nevertheless, swelling is more noticeable on the back of the finger.
Under the skin of the palms are very dense tendon cords. They intertwine with bundles of connective tissue and create cells. In their structure, they resemble a honeycomb. Each cell is filled with fat. This structure contributes to the fact that the inflammatory process does not spread on a plane, but goes deep. This poses a risk to tendons, joints and bones.
Inflammatory effusion, due to the conditions listed above, is under intense pressure. This provokes the appearance of acute, throbbing pain. The accumulation of exudate disrupts blood circulation. Vascular constriction occurs, which can lead to tissue necrosis.
Factors that increase the risk of developing panaritium
The subcutaneous panaritium of the finger is able to develop only if the infection penetrates into the soft tissues. Most often, staphylococcus is the culprit of the pathology. In addition, intestinal, gram-positive and gram-negative bacillus can become the cause of the development of the disease; anaerobic non-clostridial microflora; Proteus; putrefactive infection and streptococcus.
Doctors say that subcutaneous panaritium of the finger on the hand is most often observed in children. And also in people aged 20 to 50 years. According to statistics, 30% of patients fall ill due to minor injuries that they receive at work. In most cases, the infection is localized on the index, middle and ring fingers of the right hand.
The following factors contribute to the development of infection:
- Diabetes.
- The habit of biting your nails or biting your fingertips.
- Hand washing using chemicals or certain types of soap.
- Immunodeficiency conditions.
- Abuse of cosmetic procedures that can injure a finger nail or skin. For example: manicure or pedicure.
- Avitaminosis. Subcutaneous panaritium of the finger often develops in people who are forced to take medications with vitamin A or its derivatives. Such medications can negatively affect immunity.
- Chemotherapy.
- Lupus erythematosus, psoriasis. As well as other chronic skin diseases.
- Reception of immunosuppressants.
- Hypothermia.
- Frequent exposure to vibration.
- Vascular disease of the extremities.
- The introduction of a foreign body. For example, a small pebble or sliver.
- Mycosis of the foot or nail.
- Hyperhidrosis.
- Burn.
- Ingrown nail.
Classification
Subcutaneous felon (ICD code 10 L03.0), doctors attributed to the private form of cellulite. Depending on the location of the inflammation and the nature of the lesion, several types of pathology are distinguished:
- Cutaneous. This is the lightest, superficial form. An abscess is localized in the thickness of the skin. In appearance it resembles a blister. Sometimes you can consider a cavity with yellow pus and impurities of blood. Around the focus there is hyperemia.
- Subcutaneous felon. It is this form that occurs most often. As a rule, inflammation focuses on the nail phalanx. Over time, it can extend to others. The finger is swollen. Necrosis and purulent fusion of fiber may be noted. Finger mobility is limited. The pain is sharp and throbbing. Possible increase in body temperature. In the event that conservative treatment does not produce results, an autopsy of the subcutaneous panaritium is required. It must be urgently performed after the patient’s first sleepless night. Palpation helps to correctly determine the point of the greatest pathological changes in tissue.
- Paronychial. Inflammation of the nail roller. This disease can provoke agnails. The roller becomes painful, turns red and swells.
- Subungual felon. The cause of development may be a splinter, a puncture wound or a hematoma. Often it is the result of the development of paronychia. The roller swells. Pressing it may produce pus.
- Bone. There are primary, which develops as a result of puncture wounds. Provided that the periosteum is damaged. Secondary arises as a complication of subcutaneous. With this pathology, the patient's body temperature can rise to 40 degrees. Chills and severe headache are noted. Destructive changes in the phalanges can be detected on a radiograph on the 10th day of illness. In the event that conservative treatment fails within 48 hours, surgical intervention is required.
- Articular Spindle-shaped edema, hyperemia and finger pain develop. First, the infection affects the soft tissues. Gradually, it affects the cartilage and surfaces of the interphalangeal joints. The destruction of ligaments can provoke the appearance of crunching and pathological mobility.
- Tendinous. It is considered the most dangerous form. The cause of the development of this pathology can be subcutaneous panaritium. As well as infection through a puncture. Purulent inflammation affects the tendons and their connective membranes. Immediate intervention by an experienced surgeon is required.
All of the listed species are diagnosed both individually and in combination. Most often, patients are affected by the subcutaneous form. If the patient ignores the problem, the pathology begins to progress. In this case, it poses a real threat to health and even life.
Stages
The subcutaneous felon of the finger on the arm has three stages of development. Only a doctor can accurately determine it. The treatment tactics that he chooses depend on this. The first stage is often asymptomatic. The infection penetrates the soft tissues and begins to multiply. The only thing that the patient can feel is itching at the site of penetration of the bacterial flora.
In the second stage, cellular elements with an admixture of lymph and blood begin to accumulate in the affected tissue. The inflammatory infiltrate contains lymphocytes, histiocytes, erythrocytes. As well as lymphoid and plasma cells. Tissues swell. The patient feels severe pain.
In the third stage, abscess formation occurs. There is a melting of inflamed tissues. A cavity is formed in which pus accumulates.
Conservative therapy is effective in the first and second stages. Under the supervision of a doctor, treatment can be carried out at home. But in the event that an abscess forms, surgical intervention is required. In the third stage, conservative treatment is already ineffective.
Symptoms
The first stage of panaritium is usually asymptomatic. In the future, signs of pathology begin to gradually manifest and intensify. The main symptoms of this disease include:
- Hyperemia and edema.
- Malaise.
- Low-grade fever.
- Feeling of fullness in the finger.
- Pain on palpation at the site of inflammation. Most often, discomfort intensifies at night. Throbbing pain almost always accompanies subcutaneous panaritium. Treatment in this case is required immediately.
- Local temperature increase.
- Decreased motor function of the phalanx.
- Enlarged lymph nodes.
- Headache.
- In severe cases, severe intoxication is observed. The patient may suffer from dizziness and nausea.
Possible complications
Treatment of subcutaneous panaritium of the finger should not be delayed. It should be carried out immediately under the supervision of a physician. If the patient ignores the first symptoms of the pathology and delays with treatment, the disease progresses rapidly. Conservative therapy is no longer able to help in the third stage.
Panaritium is not a harmless disease, as many people think. It can provoke the development of the following complications:
- Inflammation of the lymphatic vessels and nodes.
- Sepsis.
- Inflammation of the muscles.
- Vascular thrombosis. As well as inflammation of the walls of the veins.
- Osteomyelitis.
- Gangrene of the finger.
Pus can spread to the hand and even the forearm. This condition is already a real threat to the life of the patient. In this case, finger amputation may be required.
Surgery
Purulent surgeons often encounter in their practice such a problem as subcutaneous panaritium. The operation is prescribed if the disease has passed into the third stage. Most often, the surgeon prescribes an operation immediately after the patient’s first sleepless night due to severe pain.
The procedure is performed under general anesthesia or under conduction anesthesia. Only an experienced doctor should perform it. Otherwise, it will not be possible to completely stop the pain syndrome. This may adversely affect the success of the operation. Patients who have previously gone through a similar procedure, remember well the feeling of pain. They await the repetition of these sensations with horror. Often they even refuse surgery. Therefore, the primary task of the doctor is to completely anesthetize the affected area.
After the anesthesia began to act, the doctor proceeds to the surgical treatment of subcutaneous panaritium. Cuts should be performed directly above the center of the purulent-necrotic focus. The cavity is washed. For this, "Dimexide", "Chlorhexidine" or "Furosimide" is used. To drain the pus, a drainage is installed. It is made from a small piece of medical gum.
Many modern surgeons refuse to use drainage. During surgery, they cut out a spindle-shaped strip of subcutaneous fat within healthy tissue. Such an open, crater-like wound heals much faster and does not provoke the development of complications. What can not be said about lateral incisions that require drainage. At the end of the operation, a bandage is applied with Levomekol or another drug chosen by the surgeon.
During rehabilitation, the attending physician prescribes antibiotics. The dressing should be changed daily. In the early days, ointments are used to help draw pus out. In the future, antibacterial agents are used.
During the rehabilitation period, physiotherapy may be prescribed:
- Electrophoresis
- UHF
- Ural Federal District.
Pharmacy preparations
Conservative therapy will be effective in the first stages of the development of pathology if the patient consulted a doctor on time. Most likely, surgery will not be needed. The doctor will confirm the diagnosis and give detailed instructions on how to treat subcutaneous panaritium with medications.
The best drugs have proven themselves best in the fight against pathology:
- "Azithromycin". The duration of treatment is three days. Once a day, the patient should take a tablet containing 500 mg of the active substance. If necessary, the dose can be increased by the doctor.
- "Sumalek." The patient should take 0.5 g of the active substance once a day. The duration of treatment is determined by the doctor.
- Ziromin The drug allows you to cure panaritium in three to five days. The recommended dose is 500 mg once daily.
- Ichthyol ointment. This is a traditional tool in the fight against panaritium. The drug contributes to the release of pus. Ointment is used for dressings, which should be changed at least three times a day.
- "Dimexide". Before use, the drug is diluted with water in a ratio of 1: 4. Gauze is soaked in liquid and used for a compress. The duration of the procedure is 40 minutes.
- Levomekol. Ointment is used for compress. The drug helps to cleanse tissues from pus. In addition, it destroys pathogenic flora. "Levomekol" is used for a compress that is applied twice a day.
- Vishnevsky ointment. This is one of the most effective means that can cure subcutaneous panaritium. Photos taken by patients confirm that swelling and hyperemia are reduced within a few hours after the start of treatment. This is due to the rapid blocking of inflammation. Ointment helps to open the abscess and cleanse the wound. It is used twice a day for compresses.
- Tetracycline ointment. This antibacterial agent relieves pain, hyperemia and inflammation well. Ointment is applied twice a day, for ten days. Its thin layer is applied to the site of inflammation. In order to enhance the effectiveness, tetracycline ointment can be alternated with zinc.
- "Dermasept" (gel). A sterile gauze cloth is impregnated with a drug and applied to the site of inflammation. Dermasept gel can be applied four times a day.
- Syntomycin ointment. The drug is used for dressing, which is applied at night. The amount of ointment, for one procedure, should not exceed the size of a pea. Treatment using this drug should not last longer than two weeks.
Folk ways
Many recipes of traditional medicine allow you to painlessly eliminate subcutaneous panaritium. Treatment at home should be carried out with the consent and under the supervision of a physician. This will avoid the development of unwanted effects.
The most effective recipes include the following:
- Eight - ten cloves of garlic to pass through a press. Pour the resulting slurry with a glass of hot water, the temperature of which is 80 degrees. The fluid should be infused for seven minutes. The affected finger is lowered into the solution for several seconds. The manipulation is repeated until the liquid has cooled. You can also use baths with a crumb of laundry soap, soda, copper sulphate, salt and celandine. The procedure should be repeated three times a day.
- Aloe juice or pulp is used for compresses.
- Castor oil is heated in a water bath to a temperature of 40 degrees. A gauze cloth is impregnated with a warm agent and applied to the site of inflammation. Cover with cellophane and warm. The compress is left for two hours.
- A quarter of the onion head and four cloves of garlic are passed through a meat grinder. The resulting slurry is used for compresses.
- One hundred grams of raw beets are ground on a fine grater. Add 50 g of fat sour cream. The resulting mixture is applied to the affected area and closed with a bandage.
Prevention
Most people begin to value their health only after they become ill. It is difficult for women to imagine that such a routine procedure as a manicure can cause the development of gangrene and loss of a finger. Fortunately, such cases are quite rare. Nevertheless, you need to be serious about maintaining your health.
Prevention is always preferable to treatment. The subcutaneous felon of the finger on the hand refers to those pathologies that are quite easy to prevent. To do this, it is enough to adhere to the following rules:
- Always wash your hands thoroughly with soap and water.
- Treat with peroxide or chlorhexidine any, even the most minor, skin lesions. Cover the wounds with a bactericidal patch.
- Use personalized tools for manicure or visit only a trusted master.
- When working with the ground, always wear rubber gloves with a textile lining.
- Monitor the condition of the cuticle and prevent burrs.