[Medical Q&A] How to distinguish between paronychia and onychomycosis?

Planner: Chinese Medical Association

Reviewer: Professor Yang Ying, Military Medical Research Institute

Many people suffer from paronychia or onychomycosis (commonly known as "onychomycosis"), but most of them cannot tell which one they have after becoming ill. So, what is the difference between the two?

1. Symptoms of paronychia

When paronychia first occurs, one side of the nail will be slightly painful and red and swollen. When it becomes serious, it will become purulent and the pus will spread to the other side or under the nail, thus forming a subungual abscess. Yellow-white pus can be seen under the nail, which separates the deep nail from the nail bed. Therefore, if necessary treatment measures are not taken in time in the early stage of paronychia, the condition will worsen. There are many drugs for the treatment of paronychia, such as antibiotics, which can inhibit bacterial growth and have a certain anti-inflammatory effect. They are available in intramuscular injection, intravenous medication, topical medication and other dosage forms; in addition, anti-inflammatory analgesics can also be used, which are available in oral, ointment, injection and other dosage forms to relieve the symptoms of pain and swelling.

2. Symptoms of onychomycosis

The nail plate loses its smoothness and luster. Over time, the nail plate thickens and deforms, and becomes grayish white or turbid yellow. The nail plate becomes brittle and breaks and falls off, and sometimes the nail plate separates from the nail bed. The lesions begin at the distal end, lateral edge, or nail fold. Onychomycosis is easily transmitted to family and friends. Friends and relatives often get fungal infections due to changing shoes, contact between hands and feet, and sharing daily necessities, causing skin diseases such as tinea manuum, tinea corporis, tinea cruris, and erysipelas. Female patients may also infect other parts of their bodies and develop gynecological diseases such as fungal and candidal vaginitis.