Fingers soaking with saliva as a cause of chronic paronychia among infants

Abstract

Background Paronychia is a common dermatological complaint characterized by inflammation of the lateral and/or proximal nail folds. Most childhood paronychia acquired through the habit of finger sucking which represent the dominant etiologic factor in predisposing this age group to watery and irritant component of saliva with oral microbial flora which ultimately results in infection of the nail fold with resultant paronychia. Objective To record infants and children with chronic paronychia in whom the finger sucking with saliva contamination was the main predisposing factor.   Patients and methods In this case descriptive study, all children with chronic paronychia were enrolled during the period from 2013-2022. A thorough history, complete skin and hair examination were done for every child aiming to exclude the possible etiological factor other than finger sucking incriminated in its development. Results Fourteen patients, 8 males ( 57.1%) and 6 (42.9%) females, with age ranging from 6 -18 months with mean 13.78 months suffering from chronic paronychia during nine  years’ time period were involved in the present study. Finger sucking history was elucidated in 9 (64.3%) patients while the remaining 5 (35.7%) patients were just fingers soaking with mouth saliva as a part of playing as described by their parents. With regards to fingers affected by paronychia in all presenting patients, a  total of 25 fingers were affected, 13 (52%) left hands fingers, and 12(48%) right hands fingers were involved  .The frequency of the involved fingers in decreasing orders was  thumb 12 (48%)  , index 8 (32%) , middle 2 (8%), little 2(8%) and lastly the ring 1(4%). The nail fold swelling was the standard observation in all the presenting children affecting 25 fingers (100%). Other nail changes include ridging, nail plate dystrophy, pitting, and onycholysis were observed .   Conclusion Infantile chronic paronychia is not uncommon dermatological problem that results from fingers soaking with saliva as a part of mouth sucking and fingers contamination with saliva. There is swelling of nail folds with nail dystrophy. It is a benign condition but annoying for the parents.