Chronic recalcitrant paronychia in a farmer

Chronic paronychia is a common condition mainly afflicting middle-aged women. It is usually due to long-standing and repeated irritation and contact with moisture. We observed a male farmer with chronic paronychia. Cow hair was found under the proximal nail fold of the right middle finger. Bacterial culture revealed Mycobacterium elephantis in addition to mixed aerobic and anaerobic bacteria. Avulsion of the radial nail strip and phenolisation of the matrix horn led to a rapid and sustained resolution.