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Skin Care and Diseases

Infections

10/24/2006

Question:

I have an infection in the corner of my big toe nail for about 3 months. I tried preoxcide and antisceptic creams that has not helped. Sometimes there is a white puss and other times it is clear with a tint of yellow and it is sticky. I am on Enbrel and Prednisone for my rheumatoid arthritis so I know that it might take along time for me to heal. What kind of infection could this be and how can I red of it?

Answer:

Your description of the corner of your toenail draining is of significant concern, given the fact that you are being treated with two immune-suppressing agents, Enbrel and Prednisone.  You need to see your dermatologist or internist, or possibly your podiatrist if you have a very well trained one.

There are several issues that may be at work here.  You may have an ingrown toenail or a spicule nail that was missed in the normal trimming process that needs to be removed at the present time.  The purulent material should be cultured and specific antibiotic therapy instituted.  Topical management, without medical supervision could be a problem, so I urge you to seek medical care to be certain that infection is controlled and foreign bodies removed at present.

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Response by:

Charles L Heaton, MD
Professor
College of Medicine
University of Cincinnati