Candidal Paronychia

After 6 months of suffering with an infection on her finger and several failed courses of antibiotic therapy, a 53-year-old woman sought a second opinion.

Chronic candidal paronychia was diagnosed following a culture of material from the site, which grew Candida albicans. The photograph, which contrasts the infected finger with an unaffected finger, demonstrates the typical inflammation of the periungual tissues seen in this yeast infection. The transverse ridging of the nail plate, separation of the cuticle from the nail plate, chronic edema, and slight erythema and tenderness involving the proximal paronychial tissue are characteristic of candidal paronychia.

Itraconazole, 200 mg/d for 2 weeks, followed by a topical econazole for 6 weeks resolved this infection.