Panaritium subcutaneous: photo, causes and symptoms, treatment methods

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

A 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 can 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 eponychium. But most call it cuticle. This epithelial thin film surrounds the nail plate in the region 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.

Trimming the eponychium is not recommended. If this is done, it begins to grow stronger and becomes more rough. A similar mechanism can be observed withscar formation.

In the event that for some reason the eponychium is damaged, the gate for infection opens. Most often this happens during a manicure. In addition, it can be observed during games in children. Pyogenic microbes penetrate the tissues. For example: staphylococcus or streptococcus. Sometimes a mixed microflora is also diagnosed.

In most cases, the localization of subcutaneous panaritium occurs on the palmar surface. However, the swelling is more visible on the back of the finger.

Under the skin of the palms are very dense tendon bands. They intertwine with bundles of connective tissue and create cells. In their structure, they resemble honeycombs. Each cell is filled with fat. Such a structure contributes to the fact that the inflammatory process does not spread along the plane, but goes deeper. This poses a risk to tendons, joints and bones.

Inflammatory effusion, due to the above conditions, is under strong pressure. This provokes the appearance of a sharp, throbbing pain. The accumulation of exudate disrupts blood circulation. Vascular compression occurs, which can lead to tissue necrosis.

Factors that increase the risk of panaritium

Subcutaneous panaritium of the finger can develop only if the infection penetrates into the soft tissues. Most often, the culprit of the pathology is staphylococcus aureus. In addition, intestinal, gram-positive and gram-negative coli can cause the development of the disease; anaerobic non-clostridial microflora; Proteus; putrefactive infection and streptococcus.

Doctorsthey say that subcutaneous panaritium of the finger on the hand is observed most often in children. And also in people aged 20 to 50 years. According to statistics, 30% of patients fall ill due to minor injuries 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:

1. Diabetes mellitus.



2. Nail biting or fingertip biting.
3. Washing hands with chemicals or some soaps.
4. Immunodeficiency states.
5. Abuse of cosmetic procedures that can injure the nail or skin of the finger. For example: manicure or pedicure.
6. 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 adversely affect the immune system.
7. Chemotherapy.
8. Lupus erythematosus, psoriasis. As well as other chronic skin diseases.
9. Taking immunosuppressants.
10. Hypercooling.
11. Frequent exposure to vibration.
12. Vascular diseases of the extremities.
13. The introduction of a foreign body. For example, a small stone or wood chips.
14. Mycosis of the foot or nail.
15. Hyperhidrosis.
16. Burn.
17. Ingrown toenail.

Classification

Subcutaneous felon (ICD code 10 L03.0) doctors attributed to a private form of cellulite. Depending on locationinflammation and the nature of the lesion, there are several types of pathology:

1. Dermal. This is the lightest, most superficial form. The abscess is localized in the thickness of the skin. In appearance it resembles a blister. Sometimes you can see a cavity with yellow pus and blood impurities. There is hyperemia around the focus.
2. Subcutaneous felon. It is this form that occurs most often. As a rule, inflammation focuses on the nail phalanx. Over time, it can spread 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 fails, an opening of the subcutaneous panaritium is required. It must be urgently carried out after the first sleepless night of the patient. Palpation helps to correctly determine the point of the greatest pathological changes in the tissue.



3. Paronychius. Inflammation of the nail fold. This disease can provoke burrs. Roll becomes painful, red and swollen.
4. Subungual panaritium. The cause of development may be a splinter, stab wound or hematoma. Often it is the result of the development of paronychia. The roller swells up. Pressing it may exude pus.
5. Bone. There are primary, which develops as a result of stab wounds. Provided that the periosteum is damaged. Secondary occurs as a complication of the subcutaneous. With this pathology, the patient's body temperature can rise to 40 degrees. notedchills and severe headache. Destructive changes in the phalanges can be detected on the x-ray on the 10th day of illness. In the event that conservative treatment fails within 48 hours, surgical intervention is required.
6. Articular. Fusiform edema, hyperemia and pain in the finger develop. First, the infection affects the soft tissues. Gradually, it affects the cartilage and surfaces of the interphalangeal joints. The destruction of the ligaments can provoke the appearance of a crunch and pathological mobility.
7. Tendinous. It is considered the most dangerous form. The cause of the development of this pathology may be subcutaneous panaritium. As well as infection through a puncture. Purulent inflammation affects the tendons and their connective sheaths. Immediate intervention by an experienced surgeon is required.

All of the listed types 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 he alth and even life.

Stages

Subcutaneous panaritium of the finger on the hand has three stages of development. Only a doctor can accurately determine it. It depends on the treatment tactics that he chooses. 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. As part ofinflammatory infiltrate are lymphocytes, histiocytes, erythrocytes. As well as lymphoid and plasma cells. The tissues swell. The patient feels severe pain.

In the third stage, abscess formation occurs. Melting of inflamed tissues is observed. 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 has formed, surgical intervention will be required. In the third stage, conservative treatment is no longer effective.

Symptoms

The first stage of panaritium is usually asymptomatic. In the future, the signs of pathology begin to gradually manifest and intensify. The main symptoms of this disease include:

1. Hyperemia and edema.
2. Unwell.
3. Subfebrile temperature.
4. Feeling fullness in the finger.
5. 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.
6. Local temperature increase.
7. Decreased motor function of the phalanx.
8. Swollen lymph nodes.
9. Headache.
10. In severe cases, there is severe intoxication. The patient may suffer from dizziness and nausea.

Possible Complications

Treatment of subcutaneous panaritium of the finger cannot be delayed. It must be carried out immediately under the supervisiondoctor. If the patient ignores the first symptoms of the pathology and delays 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:

1. Inflammation of the lymphatic vessels and nodes.
2. Sepsis.
3. Inflammatory muscle damage.
4. Thrombosis of vessels. As well as inflammation of the walls of the veins.
5. Osteomyelitis.
6. 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, amputation of the finger may be required.

Surgical treatment

Purulent surgeons often face 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 the operation immediately after the first sleepless night of the patient due to severe pain.

The procedure is performed under general anesthesia or 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 the feeling of pain well. They are anxiously waiting for the repetition of these sensations. Often they even refuse the operation. Therefore, the primary task of the doctor is the complete anesthesia of the affectedplot.

After the anesthesia has begun to act, the doctor proceeds to the surgical treatment of subcutaneous panaritium. The incisions should be made directly over the center of the purulent-necrotic focus. The cavity is washed. For this, "Dimexide", "Chlorhexidine" or "Furosimide" is used. For the outflow of pus, a drain is installed. It is made from a small piece of medical gum.

Many modern surgeons refuse to use drainage. During the operation, they cut out a spindle-shaped strip of subcutaneous fat within he althy tissue. Such an open, crater-like wound heals much faster and does not provoke the development of complications. The same cannot be said about lateral incisions that require drainage. Upon completion of the operation, a bandage is applied with Levomekol or another drug chosen by the surgeon.

During rehabilitation, the attending physician prescribes antibiotics. The bandage should be changed daily. In the early days, ointments are used to help draw out the pus. In the future, antibacterial agents are used.

Physiotherapy may be prescribed during the rehabilitation period:

1. Electrophoresis.
2. UHF.
3. UFO.

Pharmacy preparations

Conservative therapy will be effective in the first stages of the development of pathology, if the patient consulted a doctor in time. Most likely, surgery is not required. The doctor will confirm the diagnosis and give detailed instructions on how to treat subcutaneous panaritium with medicinalfunds.

The following drugs have proven themselves best in the fight against pathology:

1. "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 may be increased by a doctor.



2. "Sumalek". The patient should take 0.5 g of the active substance once a day. The duration of treatment is determined by the doctor.
3. "Ziromin". The drug allows you to cure panaritium in three to five days. The recommended dose is 500 mg once daily.
4. Ichthyol ointment. This is a traditional remedy in the fight against panaritium. The drug promotes the release of pus. The ointment is used for dressings, which should be changed at least three times a day.
5. "Dimexide". Before use, the drug is diluted with water in a ratio of 1:4. Gauze is soaked with liquid and used for a compress. The duration of the procedure is 40 minutes.
6. "Levomekol". The ointment is used for compress. The drug helps to cleanse the tissues of pus. In addition, it destroys pathogenic flora. "Levomekol" is used for a compress, which is applied twice a day.
7. Vishnevsky's ointment. This is one of the most effective remedies that can cure subcutaneous panaritium. Photos taken by patients confirm that swelling and hyperemia decrease within a few hours after the start of treatment. This is due to the rapid blocking of inflammation. Ointmentcontributes to the opening of the abscess and the cleansing of the wound. It is used twice a day for compresses.



8. Tetracycline ointment. This antibacterial agent relieves pain, hyperemia and inflammation well. The ointment is applied twice a day for ten days. It is applied in a thin layer to the site of inflammation. In order to enhance the effectiveness, tetracycline ointment can be alternated with zinc.
9. "Dermasept" (gel). A sterile gauze pad is impregnated with the drug and applied to the site of inflammation. Dermacept gel can be applied four times a day.
10. Synthomycin ointment. The drug is used for a bandage that is applied at night. The amount of ointment for one procedure should not exceed the size of a pea. Treatment with this drug should not last longer than two weeks.

Folk ways

Many recipes of traditional medicine can 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:

1. Eight - ten cloves of garlic pass through the press. Pour the resulting slurry with a glass of hot water, the temperature of which is 80 degrees. The liquid should be infused for seven minutes. The affected finger is dipped into the solution for a few seconds. The manipulation is repeated until the liquid cools down. You can also use baths with a crumb of laundry soap,soda, copper sulfate, s alt and celandine. The procedure should be repeated three times a day.
2. Juice or pulp of aloe leaves is used for compresses.
3. Castor oil is heated in a water bath to a temperature of 40 degrees. A gauze napkin is soaked with a warm agent and applied to the site of inflammation. Close with cellophane and insulate. The compress is left for two hours.
4. A quarter of an onion head and four cloves of garlic are passed through a meat grinder. The resulting slurry is used for compresses.
5. One hundred grams of raw beets are crushed on a fine grater. Add 50 g of fatty sour cream. The resulting mixture is applied to the affected area and covered with a bandage.

Prevention

Most people begin to appreciate their he alth only after they get sick. It is difficult for women to imagine that such an everyday procedure as a manicure can cause the development of gangrene and loss of a finger. Fortunately, such cases are quite rare. However, you need to take your he alth seriously.

Prevention is always better than cure. Subcutaneous panaritium 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:

1. Always wash your hands thoroughly with soap and water.
2. Treat with peroxide or chlorhexidine any, even the most minor damage to the skin. Cover the wounds with a bactericidal plaster.
3. Use individual manicure tools or visit only a trusted nail technician.



4. Always wear textile-lined rubber gloves when working in the ground.
5. Monitor the condition of the cuticle and prevent the appearance of burrs.