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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Infection On Toenail, Tender To Touch, Blood Clot On Nail Fold That Bleeds, Taking Azithromycin, Using Fucidic Acid. Is Treatment Correct?

i have an infection on my toenail, most probably paronychia . It is very tender to the touch. I can see a small blood clot about 2mm x 1mm, just on the nail fold but it bleeds if i try to remove it. Already on azithromycin 500 mg / day for 5 days and fusidic acid locally applied 3-4 times a day, and hot compress and betadine wash thrice daily. Is this correct treatment?
Wed, 22 Aug 2012
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Dermatologist,  's  Response
Hi there. The blood clot you describe could very well be what we in medical terminology call a pyogenic granuloma. The treatment you mention is fine but is it working is the question. Personally i prefer an antibiotic like metronidazole given the nail's unique position on the foot & the chance of gram negative organisms growing. You may choose to add this to the regime in addition to ibuprofen in a dose suited to your body weight. The lesion if pyogenic granuloma will need to be addressed separately & cauterised & all this will require the services of a dermatologist nearest you. Good luck & Godspeed!
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Infection On Toenail, Tender To Touch, Blood Clot On Nail Fold That Bleeds, Taking Azithromycin, Using Fucidic Acid. Is Treatment Correct?

Hi there. The blood clot you describe could very well be what we in medical terminology call a pyogenic granuloma. The treatment you mention is fine but is it working is the question. Personally i prefer an antibiotic like metronidazole given the nail s unique position on the foot & the chance of gram negative organisms growing. You may choose to add this to the regime in addition to ibuprofen in a dose suited to your body weight. The lesion if pyogenic granuloma will need to be addressed separately & cauterised & all this will require the services of a dermatologist nearest you. Good luck & Godspeed!