Overview
Pathophysiology
Fingertip pulp is divided into numerous small compartments by vertical septa that stabilize the pad. Infection occurring within these compartments can lead to abscess formation, edema, and rapid development of increased pressure in a closed space. This increased pressure may compromise blood flow and lead to necrosis of the skin and pulp.
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Epidemiology
Frequency
United States
Felons and paronychias account for approximately one third of all hand infections. Thumb and index finger are the most commonly affected digits.
Mortality/Morbidity
With skin necrosis, spontaneous decompression may occur. When skin does not yield, osteomyelitis, tenosynovitis, and septic arthritis may result.
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Media Gallery
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Differential diagnosis for a felon includes herpetic whitlow.
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A paronychia can progress to a felon if left untreated.
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Drainage of pus from under perionychium in a paronychia.
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