Bacterial infections of the nail unit may involve not only the proximal and lateral nail folds (paronychia) but also the nail plate and the underlying nail bed. Staphylococcus aureus or pyogenes and Pseudomonas species are the typical etiologic agents, but Streptococci and gram-negative bacteria are possible culprits.
A viral infection of the nail unit may present as a chronic dermatosis such as a wart or as an acute paronychia. In antibiotic-resistant acute paronychia, in fact, a viral infection should always be ruled out.
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