Whitlow, or PARONYCHIA, is a painful inflammatory affection of the fingers, almost always proceeding to suppuration. There are several varieties of this affection, according to the texture primarily attacked; thus, it may be situated in the skin, the cellular (or connective) tissue beneath the skin or under the nail, the tendons or tendinous sheaths running along the fingers, or the periosteum. If the skin be the seat of inflammation vesicles appear, which soon discharge pus, after which relief is rapidly afforded. Such cases require little care or attention, and give rise to hardly any constitutional disturbance. If the cellular tissue be the primary seat of inflammation there is a painful sensation of tenseness and throbbing of the part, and often considerable febrile disturbance, until the pus can be evacuated. Although this form is painful no serious mischief is to be apprehended. When, however, the tendons and their sheaths, or the periosteum, are affected, a much more serious form of whitlow is developed, which has been already discussed in the article TENDON. In this form the suppuration may extend up the arm and occasion destruction of the joints, and even death.
Whitlow may originate either spontaneously or after an external injury, such as a prick from a needle, thorn, &c. In the treatment of the milder forms the finger or thumb should be held for half an hour or longer in water as hot as can be borne, or enveloped in an antiseptic poultice. When matter shows itself, an incision should be made to admit of its escape. Even if suppuration has not taken place, a free incision into the inflamed part often gives great relief, and much limits the extension of the inflammation.