I have finger paronychia. It is painful and swollen. I soaked it and it drained a little pus but is still swollen and painful. When should I see a dr?

Be seen. Chances are, by continuing the hot saline soaks for a few more days, your condition will resolve without the need for a procedure. But if it appears to be getting worse, you should be seen by a hand surgeon. The procedure is simple. Hot saline soaks should continue. Antibiotics are rarely necessary. Only chronic infections may be due to yeast, in which case mycolog ointment will be prescribed.
Now. You may need to have it drained which will give you quick relief. Oral antibiotics and possibly topical anti candida medications may be necessary. You can schedule with local dermatologist in nyc.