More likely to be bacterial
Warm compresses, soaks, elevation
Incision and drainage, if fluctuance or purulence is present
Consider soaking hand for preparation
Consider digital block
Incise area of greatest fluctuance
Incise parallel to nail (do NOT incise perpendicular to fluctulance)
Use iris scissors, flat tweezers, or #11 blade
Antibiotics
Triple antibiotic ointment TID x 5-10 days (mild cases) ± topical steroid
PO Antibiotics (more severe or persistent cases)
Augmentin BID x 7 days OR
Clindamycin 150-450mg TID or QID x 7 days OR
TMP-SMX DS 1-2 tab PO BID x 7 days
Warm compresses, soaks, elevation
Consider soaking hand for preparation
Consider digital block
Incise area of greatest fluctuance
Incise parallel to nail (do NOT incise perpendicular to fluctulance)
Use iris scissors, flat tweezers, or #11 blade
Incise parallel to nail (do NOT incise perpendicular to fluctulance)
Use iris scissors, flat tweezers, or #11 blade
Triple antibiotic ointment TID x 5-10 days (mild cases) ± topical steroid
PO Antibiotics (more severe or persistent cases)
Augmentin BID x 7 days OR
Clindamycin 150-450mg TID or QID x 7 days OR
TMP-SMX DS 1-2 tab PO BID x 7 days
Augmentin BID x 7 days OR
Clindamycin 150-450mg TID or QID x 7 days OR
TMP-SMX DS 1-2 tab PO BID x 7 days
Multifactorial inflammation due to persistent irritation; may also have fungal component
Mainstay of therapy is avoidance of irritant
Consider topical antifungals vs Diflucan 150mg po qweek x 4-6 weeks
Traditional treatments have been antifungals, but accumulating evidence suggests chronic<unk>  is eczematous
Topical steroids to start in ED, with follow up for possible systemic steroids with PCP should be considered
Methylprednisolone aceponate cream 0.1%, over 3 weeks
OR betamethasone 17-valerate 0.1% for 3 weeks
Topical steroids to start in ED, with follow up for possible systemic steroids with PCP should be considered
Methylprednisolone aceponate cream 0.1%, over 3 weeks
OR betamethasone 17-valerate 0.1% for 3 weeks
Paronychia
Bed bugs
Black hairy tongue
Closed fist infection 
Pellagra
Digital Mixoid Cyst 
Ataxia
Hand cellulitis