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 Indian J Med Microbiol  
 

Figure 3: Pathogenesis of CP-CP is form of hand dermatitis with secondary (bacterial/fungal) colonization. Repeated exposure to moisture and irritants leads to damage to the cuticle, causing unchecked entry of allergens as well as pathogens leading to repeated episodes of acute inflammation resulting in edema, fibrosis and consequent retraction of the nail folds. The nail sulcus is thus, further exposed compromising the effective seal again resulting in the unchecked entry of organisms/allergens. This vicious cycle impedes the cuticle regeneration. In addition, the fibrosis as well as progressive loss of vascular supply prevents topical and systemic drugs from reaching the nail folds. Thus, a failed treatment response perpetuates this cycle

Figure 3: Pathogenesis of CP-CP is form of hand dermatitis with secondary (bacterial/fungal) colonization. Repeated exposure to moisture and irritants leads to damage to the cuticle, causing unchecked entry of allergens as well as pathogens leading to repeated episodes of acute inflammation resulting in edema, fibrosis and consequent retraction of the nail folds. The nail sulcus is thus, further exposed compromising the effective seal again resulting in the unchecked entry of organisms/allergens. This vicious cycle impedes the cuticle regeneration. In addition, the fibrosis as well as progressive loss of vascular supply prevents topical and systemic drugs from reaching the nail folds. Thus, a failed treatment response perpetuates this cycle