Brief Answer:
Chronic Nail bed infection?of Right Great toe

Detailed Answer:
Hi,Dear thanks for the query to HCM virtual clinic.

I studied your photograph and need more information,before I suggest anything on its treatment-
How it started, by trauma or after toenail cutting?and How long back this started?
How many times you had recurrence of infection?
Any blood test done? please update its reports?
Any tobacco chewing / smoking habits?

Awaiting your reply.
Have a good day.
Dr.Savaskar M.N.
M.S.Genl-CVTS XXXXXXX Surgical Specialist

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Brief Answer:
Onychocryptosis (Ingrown Nail)with Non-Healing Wound and Pyogenic Granuloma

Detailed Answer:
Hi,Dear,Thanks for your updates.
I would reply your health concerns as follows-
I reviewed your photo and your query and your first reply.

Disease you have is-Onychocryptosis(Ingrown Nail) with Pyogenic Granuloma
My impression that You suffer from -Ingrown Nail of Right toe with Pyogenic Granuloma with genetic inheritance ( as it happened in other toe also-as submitted by YOu)

Reason of its Non-Healing for 3 mths this time-
It's not healing for last 3 months because the Paronychia with pus discharge is persisting for long time due to the chronic ingrowing nail, which appears to be burrowing in the nail fold of your right toe.
No tons of antibiotic would heal it,as the chronic trauma and re-infection of the nail folds into which the nail is burrowing as it grows continuously from the nail bed.
Reason of the
Wound on rt toe started on its own./ Similar event happened with other toe and Now this toe(Right-from the photo)-This suggests the "genetic inheritance which predisposes you" for the Ingrown nails in your case.In some it starts with wrong nail removal with inflammation and resultant infection of the nail(Paronychia)

Treatment-
Surgical treatment by ER Surgeon is advisable in your case after Scraping of the Granuloma with proper antibiotic cover and wound care as follows-
Surgical Care Would be -of 2 types-
1-Temporary by Avulsion of the nail,where recurrence needs to be avoided by proper nail care of the toes.
and Permanent Remedy would be
2-a-Nail Avulsion with killing of the Root Nail with astringent medicines to destroy the nail regrowth.
2-b-Matrixectomy-Surgical excision of the nail bed which gives permanent remedy as the nail growth is stopped and hence Recurring Onychocryptosis does not occur.
Besides this antibiotics/anti-inflammatory drugs after ruling out the diabetic possibility in your case , with nail bed -wound care in both types of treatment is same and would resolve this issue.

Hope this reply has resolve your health query to the fullest satisfaction of yours.
Welcome for any further query in this regard to ME by a direct question at HCM.
Write excellent review and hit thanks after reading this reply,as it would improve my rating for many visitors to HCM.
Wishing you fast recovery,
Have a good day.
Dr.Savaskar M.N.
M.S.Genl-CVTS, XXXXXXX Surgical Specialist.

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Brief Answer:
Onychocryptosis(In Growing Nail) with Pyogenic Granuloma of Right Toe

Detailed Answer:
HI,Dear,Thanks once again and Welcome for any other query in this regard.
Do write a good review with your strong recommendations and experience of this service.
Have a Good day
Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS

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Brief Answer:
ER Podiatrist/ Foot Surgeon if not ER Surgeon would do

Detailed Answer:
Specialist advisable for your disease-ER Podiatrist/ Foot Surgeon if not ER Surgeon would do

Hi,Dear,Thanks for the query.

If you review my last reply,I already advised you to consult ER Surgeon,who would be a specialist treating your Onychocryptosis (In Growing Toe Nail)with Pygenic granuloma.

Its my pleasure to repeat the same for your convenience with more details.
So consult a Surgeon or a Podiatrist(special orthopedic doctor who treats only forefoot and ankle problems).

In Nigeria you could easily get the ER Surgeon.But still if you have Podiatric Surgeon (foot Surgeon) you could avail his services.

Thanks again for your repeat and specific good query.
Hope you don't have any hurdeles in treating your very complex problem for you.

Welcome any further query by a direct question to me any time in time to come in this regard or for that matter for any health problem to ME at HCM.

Wishing you fast recovery and a very Good health.
Have a good day.

Dr.Savaskar M.N. XXXXXXX Surgical Specialist
M.S.Genl-CVTS
Expert in Non-Curable Diseases and rejuvenative treatments for Cancer/asthma/autoimmune diseases.

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