Panaris, also called white disease, is an acute dermatological infection. It appears around the nail or on the fingertips in the majority of cases. If diagnosed quickly, whitlow can be treated quite easily and complications are rare.
1. The causes of a whitlow
Panaris is an infection of the skin around the nail caused by bacteria such as Staphylococcus aureus or Streptococcus. These bacteria enter under the skin via a small wound that may go unnoticed. In general, whitlow appears 2 to 5 days after the germ penetrates the skin. The small injuries causing the appearance of a whitlow can be caused by the tearing of the small skin around the nails, a slightly aggressive manicure, a blister, a splinter, a bite or even a scratch. People with chronic illnesses such as diabetes, or weak immune systems, and people with skin conditions such as psoriasis or eczema are more likely to develop whitlow. Whitney is not contagious, but it is advisable to avoid cooking for the duration of the infection or to wear protective gloves. The bacteria causing whitlow can indeed contaminate certain foods.
2. The main symptoms of a whitlow
Symptoms of whitlow can vary from patient to patient, and they progress depending on the stage of the infection. The area affected by a whitlow is most frequently located on the fingers of the hand. More rarely, whitlow can affect the toes. In the majority of cases, we find this infection more precisely around the edge of the nail, at the level of the last phalanx or even on the pulp of the finger. The main symptoms associated with this infection are:
- redness that appears around the fingernail or toenail;
- swelling accompanied by a feeling of heat in the affected area;
- intense, throbbing pain, which seems to beat with the rhythm of the heart;
- the formation of an abscess, which is a whitish ball filled with pus, at the base of the nail, if the whitlow has not been taken care of beforehand.
3. The diagnosis of a whitlow
It is recommended to consult a doctor as soon as the first symptoms of a whitlow appear. If the whitlow develops into an abscess or if pus flows, a consultation within 48 hours is recommended. During the medical consultation, the doctor will carry out a clinical diagnosis to identify the symptoms and study the physical signs that may indicate the presence of a whitlow. He will therefore examine the infected area and assess the redness, swelling, sensitivity to the touch or even the presence of pus. He will also question the patient about the nature of his pain, which is generally intense and throbbing in cases of whitlow. Finally, the healthcare professional will check the validity of the tetanus vaccination.
4. How to care for a whitlow?
Panaris can be treated in several ways depending on the stage of the infection, as specified by the French Society of Dermatology. Before the abscess appears, the healthcare professional may recommend antiseptic baths of the affected finger at least five times a day for ten minutes, as well as taking paracetamol to relieve the pain. If an abscess is present, a surgical incision procedure is generally recommended. In the majority of cases, this incision is made under local anesthesia. Thereafter, antiseptic care and daily dressings are necessary until healing, which can take one to two weeks. If the patient is diabetic or immunocompromised, antibiotics may also be prescribed at the onset of the infection to avoid any complications.
5. Complications linked to a whitlow
Complications following whitlow are rare, as this infection heals easily when managed. If the whitlow is not treated, however, the patient can suffer from complications, such as the spread of the infection to the nail which will then become permanently deformed. In more severe cases, bacteria can spread to tendons, joints or bones.
6. How to prevent the appearance of a whitlow?
It is possible to prevent the appearance of this skin infection by adopting the right actions on a daily basis. To prevent the appearance of whitlow, the Public Health Information Service recommends of :
- wash your hands regularly;
- wear gloves for manual work;
- immediately clean and disinfect a wound on a finger or toe;
- cut your nails regularly;
- do not bite your nails or the small skin around the nails;
- do not press back the cuticles.
Sources
- Bacterial infections, French Society of Dermatology, December 3, 2019
- Panaris, Public health information service, January 12, 2024