TITLE:
Treatment of Chronic Paronychia: A Double Blind Comparative Clinical Trial Using Singly Vaseline, Nystatin and Fucidic Acid Ointment
AUTHORS:
Khalifa E. Sharquie, Adil A. Noaimi, Sunbul A. Galib
KEYWORDS:
Housewife; Paronychia; Vaseline; Occlusive Therapy
JOURNAL NAME:
Journal of Cosmetics, Dermatological Sciences and Applications,
Vol.3 No.4,
December
3,
2013
ABSTRACT:
Background: Chronic paronychia is a chronic
inflammatory reaction of the proximal and lateral nail folds of multifactorial
in etiology like irritant, bacterial and monilial causes. But housewife work is
a major cause of chronic paronychia. Objective: To assess the efficacy
and prophylactic effects of Vaseline by occlusion of nail folds in comparison
with nystatin ointment and fucidic acid in treatment of housewife chronic
paronychia. Patients and Methods: This double, blinded, comparative
therapeutic, clinical trial is conducted at the Department of Dermatology-Baghdad Teaching Hospital from
May 2010 to May 2011. Eighty female housewife patients with chronic paronychia
were included in this trial. They were divided into three groups according to
the following therapeutic model: Group A treated by Vaseline consisted
of 40 patients; Group
B and Group C treated by nystatin ointment, fucidic acid ointment
respectively and each group consisted of 20 patients. All demographic points
related to the disease were recorded from all patients. Invented score system
was applied to assess the severity of disease and the response to therapy. Patients
had used therapy twice daily on the proximal and lateral nail folds. Treatment
duration was 12 weeks. Results: Group A (Vaseline): The recovery
rate after 12 weeks of treatment was 26 (65%) patients, while there was no
recovery in 14 (35%)
patients. Group B (Nystatin ointment): The recovery rate after 12
weeks was 13 (65%) cases and there was no recovery in 7 (35%) patients. Group C (Fucidic
acid ointment): The recovery rate 12 weeks of treatment was 12 (60%)
patients and there was no recovery in 8 (40%) patients. The earliest signs of
recovery in all groups were decreased in nail fold tenderness, redness,
swelling followed by improvement in the nail shape, then decreased in the separation of proximal nail fold from nail bed followed by re-growth of cuticle. There
was significant difference in clinical response before and after therapy in all
groups (P ≤ 0.0001) while there was no statistical significant difference when
the three groups were compared with each other (P = 0.784). Conclusions: Vaseline
occlusion therapy of the nail folds in patient with chronic paronychia was
enough to induce recovery from the disease and there was no statistical
significant difference when compared with nystatin or fucidic acid treatment of
chronic paronychia.