Occurring most often in women and on the fingers, chronic paronychia can affect the proximal nail folds for month or years, fluctuating in severity over time.
A 45-year-old woman had an eight-month history of occasionally painful or pruritic swelling of the proximal nail folds of several of her fingernails. When she presented, the condition was affecting the third and fifth fingernail folds on her right hand, but some other fingers had been previously affected. She also did not like the unsightly transverse depressions on her nail plates. Fungal cultures ordered by her GP grew Candida albicans on one occasion, but there was no growth on another occasion. The swelling of her nail folds did not respond to a six-week course of the antifungal griseofulvin.