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thumb nail infection
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thumb nail infection

I have had a reoccuring infection in my right thumb since I was aprox 13 yrs old.  At 13 I had a hole drilled in my nail to release the puss. I have since slammed my thumb in the car door on numerous occasions.  Now in my mid 20's I find I have an intermitent infection that comes every few months.  It has eaten away at the skin under my nail and damaged the bed.  I have been put on a 3 month treatment of oral lamisil, used lamisil cream and I am still having the problem.  It has been 9-12 months since the last time it happened.  My nail bed was almost back to normal when it just happened again.  There is green puss, it is extremely painful, the nail is pulling away from the bed again and the skin is rough and peeling.  My thumb is also very hot, and the skin almost erupts from under the nail and is raw and red, which is the same problem I was having each time it happened in the past.  I have tried the fungus treatments to no avail, I have been to a dermatoligist who just scratched his head and advised it could be psoriasis and advised I put liquid cortizone on the area.  I have a true nail fungus under my big toe (according to the dermatoligist), but this is totally different, and painful.  I dont know if this is related, but I have noticed it usually comes around the time of my period, and sometimes I get sore gums around the same time as the infection.  The dermatoligist said that if the fungal treatments were not working then it is not a fungal infection.  I thought I was rid of it due to the timeframe since I last had this occur.  I am stumped, embarassed, and tired of having this painful doctor stumping, oozing outbreak a few times a year. There has to be something I can do to treat and rid myself of this annoying infection.  All I am doing now is soaking my thumb in hot epsom salt water to relieve the pain.  What could this be.
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242489_tn?1210500813
Not fungus, for starters.

1)  Redness around the nail is called paronychia.  It is usually caused by yeasts.  I suggest getting 1% clotrimazole cream (non-prescription) and applying it daily to the whole thumb, and keeping this up indefinitely.

2)  Green color under the nail is pigment produced by pseudomonas bacteria.  This bug proliferates where air gets between the nail and the bed.  It is not an infection.  The treatment consists of keeping the nail trimmed short and not cleaning uner it with any kind of stick.  In time the nail invariably reattaches.  Meantime, keep it covered with polish if you want.

I recommend that you consult another dermatologist, one with an interest in nail diseases if you can find one, to corroborate these opinions and recommendations.

Best.

Dr. Rockoff
2 Comments
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Just another question for the doctor, what is causing the skin at the tip of the nail to become hard, dry and thick, and why does it peel away from under the nail to the tip of my thumb.  Also is there anything you could suggest for the pain, a soak or something?
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A related discussion, Yeast Related Nail Fungus *Ony in THUMBS!! was started.
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