DEAR DR. DONOHUE: I would appreciate your input on an infection and/or allergy that my wife has on her fingers. The thumb and first two fingers of both her hands exhibit a red and swollen cuticle around the nail. She has had the problem since her 30s, and she is presently in her 70s.

She was once treated by a dermatologist, who injected antibiotics under the cuticle with a needle and syringe. This was extremely painful, and she is apprehensive about seeing another dermatologist. She has tried antifungal creams without success. Wearing latex gloves worsens the problem. — A.S.

ANSWER: You describe chronic paronychia, an inflammation of the fold of skin that frames each nail. The redness and tenderness come about from repeated skin trauma, from frequent submersion of the fingers in water, from a variety of irritants and possibly from allergens. Usually, the longstanding irritation provides shelter for the yeast Candida.

Your wife has to go on an all-out program of protecting her fingers from water and irritants. If she has to work with water, she should try to wear waterproof gloves. If latex gloves bother her, then get a different product or have her wear cotton gloves under the latex gloves. An antifungal medicine will rid her of Candida. Spectazole (econazole) cream (prescription needed), or Lotrimin AF (clotrimazole) lotion and cream (no prescription) are two examples. She must use one of these products for two or more months. Then she can start using a cortisone cream or ointment. Cortizone-10 is an example. She has to apply this for months.

Dermatologists can prescribe stronger medicines. Antibiotic injections into the cuticle aren’t all that common a practice. If she sees the doctor coming at her with a syringe, all she needs to do is say, “Back off.”

DEAR DR. DONOHUE: My wife is 76. At age 72, due to atrial fibrillation, she was shocked back into a normal heartbeat. A daily dose of Coumadin was prescribed. At age 73, her aortic valve was replaced, and she had one bypass. During the operation, a maze procedure was done. Will this maze procedure eventually prevent atrial fibrillation and the need for Coumadin? — C.G.

ANSWER: Atrial fibrillation is a common heartbeat disturbance where the heart beats fast and erratically. Coumadin is prescribed to prevent clots from forming in the fibrillating heart. It’s a blood thinner — an anticoagulant. Clots in the heart can be transported to the brain, where they cause a stroke.

In the maze procedure, small cuts are made in the upper heart chambers (the atria) to form scars that stop the propagation of the abnormal electrical signals causing atrial fibrillation. Success of the procedure is seen shortly after it is done. Your wife is unlikely to benefit from it three years later.

She might benefit from catheter ablation techniques, a procedure where a thin, flexible tube is inched into the heart from a surface blood vessel. Radio waves from the catheter can create scars that block the propagation of the abnormal signals causing fibrillation. Or, if she’s weary of taking Coumadin and having the necessary blood tests that go with it, she might be able to take the new blood thinner Pradaxa.

Heartbeat disturbances are many. The booklet on irregular heartbeats describes them and their treatment. To obtain a copy, write: Dr. Donohue — No. 107, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Allow four weeks for delivery.

DEAR DR. DONOHUE: What are “hypercarbic respiratory failure” and “acute respiratory acidosis”? My sister recently died from having both. — D.S.

ANSWER: Respiratory failure means the lungs are not bringing oxygen in and getting rid of carbon dioxide. “Hypercarbic” indicates that the level of carbon dioxide in the blood is way too high. “Respiratory acidosis” points out that the blood has become too acidic because it retains so much carbon dioxide. Pneumonia, blood infections and ARDS (acute respiratory distress syndrome) are some of the causes of both.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.