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 JCDSA  Vol.3 No.4 , December 2013
Treatment of Chronic Paronychia: A Double Blind Comparative Clinical Trial Using Singly Vaseline, Nystatin and Fucidic Acid Ointment
Abstract: Background: Chronic paronychia is a chronic inflammatory reaction of the proximal and lateral nail folds of multifactorial in etiology like irritant, bacterial and monilial causes. But housewife work is a major cause of chronic paronychia. Objective: To assess the efficacy and prophylactic effects of Vaseline by occlusion of nail folds in comparison with nystatin ointment and fucidic acid in treatment of housewife chronic paronychia. Patients and Methods: This double, blinded, comparative therapeutic, clinical trial is conducted at the Department of Dermatology-Baghdad Teaching Hospital from May 2010 to May 2011. Eighty female housewife patients with chronic paronychia were included in this trial. They were divided into three groups according to the following therapeutic model: Group A treated by Vaseline consisted of 40 patients; Group B and Group C treated by nystatin ointment, fucidic acid ointment respectively and each group consisted of 20 patients. All demographic points related to the disease were recorded from all patients. Invented score system was applied to assess the severity of disease and the response to therapy. Patients had used therapy twice daily on the proximal and lateral nail folds. Treatment duration was 12 weeks. Results: Group A (Vaseline): The recovery rate after 12 weeks of treatment was 26 (65%) patients, while there was no recovery in 14 (35%) patients. Group B (Nystatin ointment): The recovery rate after 12 weeks was 13 (65%) cases and there was no recovery in 7 (35%) patients. Group C (Fucidic acid ointment): The recovery rate 12 weeks of treatment was 12 (60%) patients and there was no recovery in 8 (40%) patients. The earliest signs of recovery in all groups were decreased in nail fold tenderness, redness, swelling followed by improvement in the nail shape, then decreased in the separation of proximal nail fold from nail bed followed by re-growth of cuticle. There was significant difference in clinical response before and after therapy in all groups (P ≤ 0.0001) while there was no statistical significant difference when the three groups were compared with each other (P = 0.784). Conclusions: Vaseline occlusion therapy of the nail folds in patient with chronic paronychia was enough to induce recovery from the disease and there was no statistical significant difference when compared with nystatin or fucidic acid treatment of chronic paronychia.
Cite this paper: K. Sharquie, A. Noaimi and S. Galib, "Treatment of Chronic Paronychia: A Double Blind Comparative Clinical Trial Using Singly Vaseline, Nystatin and Fucidic Acid Ointment," Journal of Cosmetics, Dermatological Sciences and Applications, Vol. 3 No. 4, 2013, pp. 250-255. doi: 10.4236/jcdsa.2013.34038.
References

[1]   K. E. Sharquie and S. I. Al-Omran, “Occupational Housewife Dermatosis,” Diploma Dissertation, University of Baghdad, Baghdad, 1988.

[2]   K. E. Sharquie, S. M. Al-Salloum and R. N. Al-Saadi, “Microbiology of Chronic Paronychia in Iraqi Housewives,” Journal of Pan Arab League of Dermatologists, Vol. 1, No. 2, 1990, pp. 17-23.

[3]   I. Brook, “Paronychia: A Mixed Infection: Microbiology and Management,” The Journal of Hand Surgery: Journal of the British Society for Surgery of the Hand, Vol. 18, No. 3, 1993, pp. 385-359.

[4]   C. R. Daniel, M. P. Daniel, C. M. Daniel, S. Sullivans and G. Ellis, “Chronic Paronychia and Onycholysis: A Thirteen Year Experience,” Cutis, Vol. 85, No. 6, 1996, pp. 397-401.

[5]   D. A. R. De Berker and E. R. Baran, “Disorders of Nails,” In: T. Burns, S. Breathnach, N. Cox and C. Griffiths, Eds., Rooks Textbook of Dermatology, 6th Edition, Blackwell Scientific Publications, Melblorne, 1998, p. 65.

[6]   C. Grover, B. S. N. Reddy and K. U. Chaturvedi, “Nail Biopsy: An Assessment of Indications and Outcome,” Dermatologic Surgery, Vol. 31, No. 2, 2005, pp. 190-194. http://dx.doi.org/10.1111/j. 1524-4725.2005.31042

[7]   E. S. M. Wong, R. J. Hay, Y. M. Clayton and W. C. Noble, “Comparison of the Therapeutic Effect of Ketoconazole Tablets and Econazole Lotion in the Treatment of Chronic Paronychia,” Clinical and Experimental Dermatology, Vol. 9, No. 5, 1984, pp. 489-496. http://dx.doi.org/10.1111/j.1365-2230.1984.tb00843.x

[8]   M. A. A. Al-Nuaimi, “Chronic Paronychia: The Fungal and Bacteriological Etiology in Iraqi Patients,” MS Thesis, University of Baghdad, Baghdad, 2001.

 
 
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