Cross-Sectional Analysis of Paronychias in the National Electronic Injury Surveillance System 1999-2018

Introduction: Paronychia is the most common hand infection. Prior paronychia studies were limited by small patient numbers. We conducted a national-level analysis over two decades, analyzing demographics, etiologies, and trends in paronychia cases. Methods: We conducted a retrospective analysis of paronychia cases in the 1999-2018 National Electronic Injury Surveillance System database. Sex, race, age, and cause were recorded and compared using chi(2), ANOVA, and t tests. Multivariable linear regression analysis assessed changes in age, weight, and sex over time. Results: We analyzed a total of 2,512 cases, with an average age of 27.6 +/- 20.6 years, 45.5% females, and 25.6% white and 28.6% black patients. In multivariable linear regression, both age and weight significantly increased over time. Manicuring was the most common etiology (30.9%), increasing in incidence over time and with a higher frequency in adults (p < 0.0001) and females (p < 0.0001). There was a significant decrease in pediatric paronychia cases over time, particularly in 0- to 4-year-olds. Possible limitations include missed paronychia cases or additional non-paronychia cases due to improper coding, infrequent race reporting, and inability to analyze treatments or distinguish between paronychia subtypes. Conclusions: Paronychia cases were associated with increased age and weight over time with different presentations by age. Manicuring represents the largest growing paronychia etiology.