Acute paronychia management typically includes which initial step?

• A. Immediate incision and drainage without other measures
• B. Soak the affected finger in warm water and apply mupirocin; if an abscess forms, perform incision and drainage
• C. Use antifungal cream only
• D. Initiate systemic steroids

Answer: (B)

Acute paronychia is usually a bacterial infection around the nail, so the first step focuses on local care to reduce infection and pressure. Warm water soaks help soften tissue and promote drainage, and applying a topical antibiotic like mupirocin adds targeted local action against surface bacteria. If a collection of pus has formed (an abscess), then incision and drainage is the next necessary step to evacuate the pus and relieve pressure. Antifungal cream won’t address the bacterial infection, and systemic steroids aren’t indicated for this infection. Immediate incision and drainage isn’t required as the initial step unless there’s a definite abscess; starting with soaks and a topical antibiotic is typically appropriate.