For example, a young man recently hit his thumb and had a subungual hematoma
. He visited an orthopedic physician's office, where the physician ordered an unnecessary x-ray and sent him home without draining the hematoma.
Melanotic lesions can be pared off but can also resolve spontaneously in 2-3 weeks.21 Toenails of the athletes also get injured in games like badminton, tennis and squash and subungual hematoma
develops usually under big toenails.
Differential Diagnosis of Onychomycosis in Children (7) * Nail psoriasis * Congenital malalignment of large toenail * Subungual exostosis * Subungual warts * Subungual hematoma
* Paronychia secondary to finger sucking * Parakeratosis pustolosa
Fenestrating a subungual hematoma
with a known or unknown underlying fracture has been controversial, in that doing so effectively converts a closed fracture into an open one.
The differential diagnosis for melanonychia is broad, however, and includes benign nevi, lentigo in the nail matrix, genetic and ethnic-type pigmentation, subungual hematoma
, drug-induced pigmentation, vitamin-deficiency fungal infections, and squamous cell carcinoma in situ, she said.
This can prove to be a diagnostic nightmare, given that even the confirmed presence of a subungual hematoma
does not exclude the possibility of a coexisting cancerous lesion.
This patient has a closed fracture of the : distal phalanx, called a tuft fracture, and a subungual hematoma
, evident from the x-ray and the physical presentation.
It doesn't influence my decision to biopsy, with the possible exception of subungual hematoma
. Dermoscopy can help distinguish it from melanoma," Dr.
One study found 52% of subungual melanomas were mistaken for benign or traumatic lesions of the nail bed such as pyogenic granuloma, paronychia, onychomycosis, chronic infection, subungual hematoma
, or pigmented nevus.
Common misdiagnoses include fungal nail changes, ischemic ulcer, and subungual hematoma
. In addition, "a lesion on the foot, especially if it is not painful, may not be readily noticed by the patient, particularly if the location is plantar," she said.
Longitudinal melanonychias can have a nonmelanocytic etiology, which can range from subungual hematomas
to Pseudomonas and fungal infections to exogenous pigment.
I believe you're experiencing recurrent subungual hematomas
beneath the toenail.