Caleb Foster
Swelling of the fingers and fingernails can be caused by a variety of factors, including infections, allergies, and medical conditions. One common cause is paronychia, an infection of the fingernail or toenail folds that can result from bacteria entering broken skin near the cuticle. This can lead to swelling, redness, and pain in the affected area. Other potential causes of swollen fingers include arthritis, contact dermatitis, and compromised circulation due to conditions such as lymphadema. Identifying the underlying cause is crucial to determine the appropriate treatment, which may include antibiotics, antifungal agents, or medical intervention in more severe cases.
| Characteristics | Values |
|---|---|
| Type of swelling | Acute |
| Chronic | |
| Cause | Infection |
| Trauma | |
| Irritation | |
| Symptoms | Redness |
| Warmth | |
| Pain | |
| Pus | |
| Tenderness | |
| Treatment | Antibiotics |
| Drainage | |
| Topical corticosteroid ointment | |
| Antifungal agents | |
| Prevention | Wear gloves |
| Avoid nail-biting | |
| Keep nails trimmed |
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What You'll Learn
Paronychia (nail infection)
Paronychia is a bacterial or fungal skin infection that develops around the nail. It can affect both the fingernails and toenails. The area next to the nail appears red and swollen, with a collection of pus visible under the skin and nail. The area is tender and painful to the touch.
Acute paronychia appears suddenly, with swelling, warmth, and redness around a fingernail or toenail, usually after an injury to the area. It is typically caused by an infection with bacteria that invade the skin where it was injured. The injury can be caused by aggressive manicuring, biting the edges of the nails or skin around them, or sucking on the fingers. Acute paronychia can be treated by soaking the infected nail in warm water 3 to 4 times a day to help reduce pain and swelling. It usually clears up in a few days.
Chronic paronychia, on the other hand, develops more slowly, causing gradual swelling, tenderness, and redness of the skin around the nails. It often affects several nails on the same hand. It is caused by inflammation with or without an allergic reaction. Treatment for chronic paronychia includes the use of topical corticosteroid ointments or creams, and keeping the skin clean, dry, and protected with gloves when exposed to potential irritants.
In severe cases of chronic paronychia, especially in people with diabetes or vascular disease, the infection can spread deeper into the finger or toe, leading to a serious infection that may require amputation to prevent further spread. Therefore, it is important to seek medical attention if you experience any symptoms of paronychia, as early treatment can help prevent complications and ensure a faster recovery.
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Arthritis
There are different types of arthritis that can affect the fingers. One type is osteoarthritis, which often causes lumps or nodules around the knuckles of the fingers. These lumps are called Heberden's nodes when they form around the knuckle closest to the fingertip, and Bouchard's nodes when they form around the middle knuckle. These lumps are bone spurs that can make the knuckles enlarged, swollen, and stiff. Rheumatoid arthritis can cause similar symptoms, but it can also lead to deformities in the hands. The inflammation associated with rheumatoid arthritis can cause finger joints to become crooked and bend away from the thumb.
Another type of arthritis that can affect the fingers is psoriatic arthritis (PsA). PsA is a common cause of dactylitis, which is severe inflammation that affects the entire finger, not just an individual joint. PsA can also cause a rash on the hands that may look flaky and scale-like. The nails may also be affected, becoming thickened and pitted, or even separating from the nail bed.
Treatment for arthritis in the fingers aims to reduce pain, swelling, and inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to help manage these symptoms and can be taken orally or applied topically. If NSAIDs are not suitable or effective, steroid injections may be administered. Hand therapy performed by an occupational therapist can also help to maintain motion and prevent the stiffening of the joints.
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Contact dermatitis
The finger-webs are the first place to be affected, but inflammation can extend to fingers, the backs of the hands, and the wrists. Acute irritant contact dermatitis is caused by potent irritants such as acids and alkalis, often in an occupational setting. Repeated exposure to low-grade irritants such as water, soaps, and detergents leads to chronic cumulative irritant dermatitis.
The most common causes of allergic contact dermatitis include plants or parts of plants (botanicals), skin care products with fragrances, metals such as nickel, medications including antibiotics, and preservatives or chemicals. The most common causes of irritant contact dermatitis include wet work and repeated exposure to low-grade irritants.
Treatment for contact dermatitis includes avoidance of the allergen or irritant, anti-itch creams, topical or oral antihistamines, and corticosteroid creams.
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Compromised circulation
Poor circulation can be caused by various conditions, including obesity, diabetes, heart conditions, and arterial issues. For example, peripheral artery disease, a circulatory condition, causes a narrowing of the arteries, reducing blood flow to the extremities, typically the legs. Atherosclerosis, an associated condition, causes arteries to stiffen due to plaque buildup, decreasing blood flow to the extremities and potentially leading to nerve and tissue damage.
Another condition that can cause poor circulation is Raynaud's disease, which causes the small arteries in the hands and toes to narrow temporarily, often in response to cold temperatures or stress. This narrowing of the arteries reduces blood flow, leading to symptoms such as cold and numb fingers. Smoking can also increase the risk of peripheral arterial disease and blood clots, contributing to poor circulation.
In addition to these factors, high blood pressure can weaken blood vessel walls, making it harder for blood to move through them. Diabetes can also impact circulation by causing high blood glucose levels, which can damage nerves and blood vessels, affecting circulation in the arms, legs, hands, and feet. Diabetic neuropathy, a complication of diabetes, can result in reduced sensation in the extremities, making it more challenging to detect signs of poor circulation or wounds.
Poor circulation in the hands and fingers can lead to symptoms such as coldness, numbness, tingling, and pain. The hands may feel swollen and painful, and the fingernails may appear pale or have a blue tint. These symptoms indicate that the cells in these areas are not receiving sufficient oxygen and nutrients due to compromised circulation.
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Flexor tenosynovitis
Pyogenic flexor tenosynovitis (FTS) is a rare but serious condition that requires immediate medical attention. It is a deep space infection of an upper extremity digit that carries a high morbidity rate. FTS is characterised by an infection of the flexor tendon sheath synovial fluid, which can result in serious structural damage to the hand.
FTS typically occurs after direct penetrating trauma to the volar aspect of an upper extremity digit. This can be caused by bacterial seeding from trauma overlying the sheath, followed by swift proximal propagation. The infection can quickly spread through the flexor tendon sheath of a digit, causing significant morbidity such as finger amputation or even death. Signs of FTS include symmetrical swelling of the affected finger, the affected finger being held in a flexed position, pain on any attempt of passive finger extension, and tenderness along the course of the flexor tendon sheath (known as Kanavel's signs).
The acute infectious etiology of FTS represents a surgical emergency. Untreated FTS may rapidly destroy the gliding mechanism, cause adhesion formation, and potentially lead to necrosis of the tendon and its fibro-osseous sheath. The loss of a functional flexor tendon can result in severe disruption of hand function. Therefore, rapid identification and treatment of FTS are critical to preventing poor outcomes.
Chronic infectious flexor tenosynovitis can be caused by atypical microorganisms such as gonococci and mycobacteria (e.g., Mycobacterium tuberculosis or Mycobacterium avium complex). It is important to note that most patients with FTS will present with complaints of pain, redness, and swelling of the affected digit over a period ranging from hours to days. A thorough medical history and physical examination are crucial for diagnosis and determining the appropriate treatment plan.
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Frequently asked questions
Paronychia is an infection of the proximal and lateral fingernail and toenail folds, including the tissue that borders the root and sides of the nail. It is caused by bacteria entering broken skin near the cuticle and nail fold. The area around the nail becomes red, swollen, and tender.
The symptoms of paronychia include redness, swelling, and tenderness around the nail. There may also be a visible collection of pus under the skin and nail. In some cases, the nail may become detached, abnormally shaped, or discoloured.
Paronychia is usually treated with antibiotics or antifungal medications, depending on the type of infection. Soaking the infected nail in warm water and applying a topical antibacterial ointment can also help heal the infection. In some cases, drainage of pus or surgical intervention may be necessary.
