Paronychia caused by Pseudomonas aeruginosa may cause a greenish coloration of finger or toe nails. The color is due to diffusion of pyocyanin, which is a water-soluble pigment produced by Pseudomonas aeruginosa.
Risk factors:
(1) nail fold trauma
(2) frequent and protracted immersion of the hands in water that contains soaps and detergents (housewives, dishwashers, medical personnel)
Clinical findings:
(1) paronychia that is typically nontender
(2) greenish tinge to the nail plate, which may last for weeks or months
Treatment:
(1) topical polymyxin B
(2) finger soaks in vinegar or 1% acetic acid
Prevention:
(1) avoiding risk factors
(2) wearing gloves
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