Finger Discoloration Following Paronychia Incision and Drainage

Case at a Glance

A 28-year-old male presents with concerns about yellow-orange discoloration of the finger following incision and drainage of acute paronychia.

Patient's Story

The patient developed acute paronychia of the finger approximately one week prior to presentation. He was initially treated with oral flucloxacillin 500mg four times daily for five days. Despite antibiotic therapy, the pain became unbearable over the weekend, prompting him to seek urgent medical care for surgical intervention.

Initial Assessment

Physical examination revealed acute paronychia with significant pain and swelling. The decision was made to proceed with incision and drainage due to inadequate response to conservative antibiotic treatment and worsening symptoms.

The Diagnostic Journey

Following the minor surgical procedure, the patient was discharged on an increased dose of flucloxacillin (1000mg four times daily). The next morning, after removing the surgical dressing, the patient noticed yellow-orange discoloration of the skin adjacent to the nail bed and became concerned about potential complications.

Final Diagnosis

Post-procedural changes following incision and drainage of acute paronychia, with expected tissue discoloration secondary to residual hemorrhage and inflammatory debris.

Treatment Plan

Continued high-dose oral flucloxacillin therapy (1000mg four times daily) as prescribed. Standard wound care with regular dressing changes. Patient counseled on signs and symptoms requiring immediate medical attention.

Outcome and Follow-up

Clinical consultation confirmed that the observed discoloration was within normal post-procedural expectations, likely representing residual blood products and purulent material. The patient was reassured that this finding was not concerning in an immunocompetent individual. Routine follow-up was arranged to monitor healing progress and ensure complete resolution of the infection.