
What Causes A Hard Painful Swollen Area At The End Of The Fingernail?

Acute on chronic paronychia i.e infection of nail fold
Detailed Answer:
Hello. Thank you for writing to us
i am dr.kakkar(dermatologist). I have gone through your query and i have reviewed the images.
I can see swelling of nail lateral fold and broken skin with discharge.
It is acute on chronic paronychia i.e secondary bacterial infection superimposed over underlying candidal paronychia.
The infection is more common in those involved in household work and food handlers, requiring frequent and long contact with water.
I suggest an oral antibiotic e.g amoxicilin 500mg or cephalexin 500mg, thrice daily for a week. Topically you may use an antibacterial ointment e.g neosporin ointment. You may also take an oral anti-inflammatory e.g ibuprofen for symptomatic relief from pain and swelling.
This would resolve acute pain and secondary bacterial infection.
Thereafter you must take an oral antifungal e.g fluconazole 150mg once a week for a few months (3-6 months).
Regards

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