Emerging treatments
Tacrolimus (topical)
One small randomised controlled trial (n=45) randomised patients with chronic paronychia to treatment with betamethasone ointment, tacrolimus ointment, or an emollient. After 3 weeks’ treatment and 6 weeks’ follow-up, tacrolimus and betamethasone were both associated with significantly better responses than emollient. Eight patients in the betamethasone group were considered cured, compared with 13 patients in the tacrolimus group.[18]
Swiss roll surgical technique
The Swiss roll technique is a potential surgical treatment option for severe acute and chronic paronychia. The nail fold is elevated then reflected proximally over a non-adherent dressing, rolled, and secured in place with sutures. The wound is allowed to drain and, once clean, the nail fold is returned to its original position and heals by secondary intention.[19]
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